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Maldonado IL, Descoteaux M, Rheault F, Zemmoura I, Benn A, Margulies D, Boré A, Duffau H, Mandonnet E. Multimodal study of multilevel pulvino-temporal connections: a new piece in the puzzle of lexical retrieval networks. Brain 2024; 147:2245-2257. [PMID: 38243610 PMCID: PMC11146422 DOI: 10.1093/brain/awae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/18/2023] [Accepted: 12/30/2023] [Indexed: 01/21/2024] Open
Abstract
Advanced methods of imaging and mapping the healthy and lesioned brain have allowed for the identification of the cortical nodes and white matter tracts supporting the dual neurofunctional organization of language networks in a dorsal phonological and a ventral semantic stream. Much less understood are the anatomical correlates of the interaction between the two streams; one hypothesis being that of a subcortically mediated interaction, through crossed cortico-striato-thalamo-cortical and cortico-thalamo-cortical loops. In this regard, the pulvinar is the thalamic subdivision that has most regularly appeared as implicated in the processing of lexical retrieval. However, descriptions of its connections with temporal (language) areas remain scarce. Here we assess this pulvino-temporal connectivity using a combination of state-of-the-art techniques: white matter stimulation in awake surgery and postoperative diffusion MRI (n = 4), virtual dissection from the Human Connectome Project 3 and 7 T datasets (n = 172) and operative microscope-assisted post-mortem fibre dissection (n = 12). We demonstrate the presence of four fundamental fibre contingents: (i) the anterior component (Arnold's bundle proper) initially described by Arnold in the 19th century and destined to the anterior temporal lobe; (ii) the optic radiations-like component, which leaves the pulvinar accompanying the optical radiations and reaches the posterior basal temporal cortices; (iii) the lateral component, which crosses the temporal stem orthogonally and reaches the middle temporal gyrus; and (iv) the auditory radiations-like component, which leaves the pulvinar accompanying the auditory radiations to the superomedial aspect of the temporal operculum, just posteriorly to Heschl's gyrus. Each of those components might correspond to a different level of information processing involved in the lexical retrieval process of picture naming.
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Affiliation(s)
- Igor Lima Maldonado
- UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France
- Department of Neurosurgery, CHRU de Tours, 37000 Tours, France
| | - Maxime Descoteaux
- Sherbrooke Connectivity Imaging Laboratory, Department of Computer Science, Faculty of Sciences, Université de Sherbrooke, J1K 2X9 Sherbrooke, Quebec, Canada
- Imeka Solutions, J1H 4A7 Sherbrooke, Quebec, Canada
| | | | - Ilyess Zemmoura
- UMR 1253, iBrain, Université de Tours, Inserm, 37000 Tours, France
- Department of Neurosurgery, CHRU de Tours, 37000 Tours, France
| | - Austin Benn
- CNRS, Integrative Neuroscience and Cognition Center (UMR 8002), Université de Paris Cité, 75006 Paris, France
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, OX1 3QD Oxford, UK
| | - Daniel Margulies
- CNRS, Integrative Neuroscience and Cognition Center (UMR 8002), Université de Paris Cité, 75006 Paris, France
| | - Arnaud Boré
- Sherbrooke Connectivity Imaging Laboratory, Department of Computer Science, Faculty of Sciences, Université de Sherbrooke, J1K 2X9 Sherbrooke, Quebec, Canada
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, 34090 Montpellier, France
- Team ‘Plasticity of Central Nervous System, Stem Cells and Glial Tumors’, U1191 Laboratory, Institute of Functional Genomics, National Institute for Health and Medical Research (INSERM), University of Montpellier, 34000, Montpellier, France
| | - Emmanuel Mandonnet
- Department of Neurosurgery, Lariboisière Hospital, AP-HP, 75010 Paris, France
- Frontlab, CNRS UMR 7225, INSERM U1127, Paris Brain Institute (ICM), 75013 Paris, France
- UFR Médecine, Université de Paris Cité, 75006 Paris, France
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Froesel M, Gacoin M, Clavagnier S, Hauser M, Goudard Q, Ben Hamed S. Macaque claustrum, pulvinar and putative dorsolateral amygdala support the cross-modal association of social audio-visual stimuli based on meaning. Eur J Neurosci 2024; 59:3203-3223. [PMID: 38637993 DOI: 10.1111/ejn.16328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/14/2024] [Accepted: 03/07/2024] [Indexed: 04/20/2024]
Abstract
Social communication draws on several cognitive functions such as perception, emotion recognition and attention. The association of audio-visual information is essential to the processing of species-specific communication signals. In this study, we use functional magnetic resonance imaging in order to identify the subcortical areas involved in the cross-modal association of visual and auditory information based on their common social meaning. We identified three subcortical regions involved in audio-visual processing of species-specific communicative signals: the dorsolateral amygdala, the claustrum and the pulvinar. These regions responded to visual, auditory congruent and audio-visual stimulations. However, none of them was significantly activated when the auditory stimuli were semantically incongruent with the visual context, thus showing an influence of visual context on auditory processing. For example, positive vocalization (coos) activated the three subcortical regions when presented in the context of positive facial expression (lipsmacks) but not when presented in the context of negative facial expression (aggressive faces). In addition, the medial pulvinar and the amygdala presented multisensory integration such that audiovisual stimuli resulted in activations that were significantly higher than those observed for the highest unimodal response. Last, the pulvinar responded in a task-dependent manner, along a specific spatial sensory gradient. We propose that the dorsolateral amygdala, the claustrum and the pulvinar belong to a multisensory network that modulates the perception of visual socioemotional information and vocalizations as a function of the relevance of the stimuli in the social context. SIGNIFICANCE STATEMENT: Understanding and correctly associating socioemotional information across sensory modalities, such that happy faces predict laughter and escape scenes predict screams, is essential when living in complex social groups. With the use of functional magnetic imaging in the awake macaque, we identify three subcortical structures-dorsolateral amygdala, claustrum and pulvinar-that only respond to auditory information that matches the ongoing visual socioemotional context, such as hearing positively valenced coo calls and seeing positively valenced mutual grooming monkeys. We additionally describe task-dependent activations in the pulvinar, organizing along a specific spatial sensory gradient, supporting its role as a network regulator.
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Affiliation(s)
- Mathilda Froesel
- Institut des Sciences Cognitives Marc Jeannerod, UMR5229 CNRS Université de Lyon, Bron Cedex, France
| | - Maëva Gacoin
- Institut des Sciences Cognitives Marc Jeannerod, UMR5229 CNRS Université de Lyon, Bron Cedex, France
| | - Simon Clavagnier
- Institut des Sciences Cognitives Marc Jeannerod, UMR5229 CNRS Université de Lyon, Bron Cedex, France
| | - Marc Hauser
- Risk-Eraser, West Falmouth, Massachusetts, USA
| | - Quentin Goudard
- Institut des Sciences Cognitives Marc Jeannerod, UMR5229 CNRS Université de Lyon, Bron Cedex, France
| | - Suliann Ben Hamed
- Institut des Sciences Cognitives Marc Jeannerod, UMR5229 CNRS Université de Lyon, Bron Cedex, France
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3
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Cieslik EC, Ullsperger M, Gell M, Eickhoff SB, Langner R. Success versus failure in cognitive control: Meta-analytic evidence from neuroimaging studies on error processing. Neurosci Biobehav Rev 2024; 156:105468. [PMID: 37979735 DOI: 10.1016/j.neubiorev.2023.105468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/23/2023] [Accepted: 11/13/2023] [Indexed: 11/20/2023]
Abstract
Brain mechanisms of error processing have often been investigated using response interference tasks and focusing on the posterior medial frontal cortex, which is also implicated in resolving response conflict in general. Thereby, the role other brain regions may play has remained undervalued. Here, activation likelihood estimation meta-analyses were used to synthesize the neuroimaging literature on brain activity related to committing errors versus responding successfully in interference tasks and to test for commonalities and differences. The salience network and the temporoparietal junction were commonly recruited irrespective of whether responses were correct or incorrect, pointing towards a general involvement in coping with situations that call for increased cognitive control. The dorsal posterior cingulate cortex, posterior thalamus, and left superior frontal gyrus showed error-specific convergence, which underscores their consistent involvement when performance goals are not met. In contrast, successful responding revealed stronger convergence in the dorsal attention network and lateral prefrontal regions. Underrecruiting these regions in error trials may reflect failures in activating the task-appropriate stimulus-response contingencies necessary for successful response execution.
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Affiliation(s)
- Edna C Cieslik
- Institute of Systems Neuroscience, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany.
| | - Markus Ullsperger
- Institute of Psychology, Otto-von-Guericke University, D-39106 Magdeburg, Germany; Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Martin Gell
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH, Aachen, Germany
| | - Simon B Eickhoff
- Institute of Systems Neuroscience, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
| | - Robert Langner
- Institute of Systems Neuroscience, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
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Wong GM, Hofmann K, Shlobin NA, Tsuchida TN, Gaillard WD, Oluigbo CO. Stimulation of the pulvinar nucleus of the thalamus in epilepsy: A systematic review and individual patient data (IPD) analysis. Clin Neurol Neurosurg 2023; 235:108041. [PMID: 37979562 DOI: 10.1016/j.clineuro.2023.108041] [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: 08/21/2023] [Revised: 10/05/2023] [Accepted: 10/31/2023] [Indexed: 11/20/2023]
Abstract
Emerging neuromodulatory treatments, such as deep brain stimulation (DBS) and responsive neurostimulation (RNS), have shown promise in reducing drug-resistant seizures. While centromedian thalamic nucleus and anterior thalamic nucleus stimulation have been effective in certain types of seizures, limited research has explored pulvinar nucleus stimulation for epilepsy. To address this gap, we conducted a systematic review and individual patient data analysis. Of 78 resultant articles, 5 studies with transient stimulation and chronic stimulation of the pulvinar nucleus were included. Of the 20 patients reviewed, 65% of patients had temporal lobe seizures, while 20% had temporooccipital/occipital lobe seizures. Transient stimulation studies via stereoelectroencephalography (SEEG) showed pulvinar evoked potential response rates of 80% in the mesial temporal region, 76% in the temporal neocortex, and 67% in the TP junction. Another study reported clinically less severe seizures in 62.5% of patients with pulvinar stimulation. In chronic stimulation studies, 80% of patients responded to RNS or DBS, and 2 of 4 patients experienced > 90% seizure reduction. The pulvinar nucleus of the thalamus emerges as a potential target for chronic stimulation in drug-resistant epilepsy. However, knowledge regarding pulvinar connectivity and chronic stimulation remains limited. Further research should investigate specific subregions of the pulvinar for epilepsy treatment. Understanding the role of pulvinar stimulation and its cortical connectivity will advance therapeutic interventions for epilepsy patients.
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Affiliation(s)
- Georgia M Wong
- Department of Neurological Surgery, Georgetown University School of Medicine, Washington, DC, USA.
| | - Katherine Hofmann
- Department of Neurosurgery, Children's National Hospital, Washington, DC, USA
| | - Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Tammy N Tsuchida
- Department of Neurology, Children's National Hospital, Washington, DC, USA
| | - William D Gaillard
- Department of Neurology, Children's National Hospital, Washington, DC, USA
| | - Chima O Oluigbo
- Department of Neurosurgery, Children's National Hospital, Washington, DC, USA
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Novitskaya Y, Dümpelmann M, Schulze-Bonhage A. Physiological and pathological neuronal connectivity in the living human brain based on intracranial EEG signals: the current state of research. FRONTIERS IN NETWORK PHYSIOLOGY 2023; 3:1297345. [PMID: 38107334 PMCID: PMC10723837 DOI: 10.3389/fnetp.2023.1297345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/17/2023] [Indexed: 12/19/2023]
Abstract
Over the past decades, studies of human brain networks have received growing attention as the assessment and modelling of connectivity in the brain is a topic of high impact with potential application in the understanding of human brain organization under both physiological as well as various pathological conditions. Under specific diagnostic settings, human neuronal signal can be obtained from intracranial EEG (iEEG) recording in epilepsy patients that allows gaining insight into the functional organisation of living human brain. There are two approaches to assess brain connectivity in the iEEG-based signal: evaluation of spontaneous neuronal oscillations during ongoing physiological and pathological brain activity, and analysis of the electrophysiological cortico-cortical neuronal responses, evoked by single pulse electrical stimulation (SPES). Both methods have their own advantages and limitations. The paper outlines available methodological approaches and provides an overview of current findings in studies of physiological and pathological human brain networks, based on intracranial EEG recordings.
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Affiliation(s)
- Yulia Novitskaya
- Epilepsy Center, Department of Neurosurgery, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Matthias Dümpelmann
- Epilepsy Center, Department of Neurosurgery, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Microsystems Engineering (IMTEK), University of Freiburg, Freiburg, Germany
| | - Andreas Schulze-Bonhage
- Epilepsy Center, Department of Neurosurgery, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Manjunatha RT, Vakilna YS, Chaitanya G, Alamoudi O, Ilyas A, Pati S. Advancing the frontiers of thalamic neuromodulation: A review of emerging targets and paradigms. Epilepsy Res 2023; 196:107219. [PMID: 37660585 DOI: 10.1016/j.eplepsyres.2023.107219] [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: 05/14/2023] [Revised: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 09/05/2023]
Abstract
The thalamus is a key structure that plays a crucial role in initiating and propagating seizures. Recent advancements in neuroimaging and neurophysiology have identified the thalamus as a promising target for neuromodulation in drug-resistant epilepsies. This review article presents the latest innovations in thalamic targets and neuromodulation paradigms being explored in pilot or pivotal clinical trials. Multifocal temporal plus or posterior quadrant epilepsies are evaluated with pulvinar thalamus neuromodulation, while centromedian thalamus is explored in generalized epilepsies and Lennox Gastaut syndrome. Multinodal thalamocortical neuromodulation with novel stimulation paradigms such as long bursting or low-frequency stimulation is being investigated to quench the epileptic network excitability. Beyond seizure control, thalamic neuromodulation to restore consciousness is being studied. This review highlights the promising potential of thalamic neuromodulation in epilepsy treatment, offering hope to patients who have not responded to conventional medical therapies. However, it also emphasizes the need for larger randomized controlled trials and personalized stimulation paradigms to improve patient outcomes further.
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Affiliation(s)
- Ramya Talanki Manjunatha
- Texas Institute of Restorative Neurotechnologies [TIRN], University of Texas Health Science Center, Houston, TX, USA; Texas Comprehensive Epilepsy Program, Texas Institute of Restorative Neurotechnologies, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Yash Shashank Vakilna
- Texas Institute of Restorative Neurotechnologies [TIRN], University of Texas Health Science Center, Houston, TX, USA; Texas Comprehensive Epilepsy Program, Texas Institute of Restorative Neurotechnologies, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Ganne Chaitanya
- Texas Institute of Restorative Neurotechnologies [TIRN], University of Texas Health Science Center, Houston, TX, USA; Texas Comprehensive Epilepsy Program, Texas Institute of Restorative Neurotechnologies, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Omar Alamoudi
- Texas Institute of Restorative Neurotechnologies [TIRN], University of Texas Health Science Center, Houston, TX, USA; Texas Comprehensive Epilepsy Program, Texas Institute of Restorative Neurotechnologies, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Adeel Ilyas
- Department of Neurosurgery, UAB Heersink School of Medicine, Birmingham, AL, USA
| | - Sandipan Pati
- Texas Institute of Restorative Neurotechnologies [TIRN], University of Texas Health Science Center, Houston, TX, USA; Texas Comprehensive Epilepsy Program, Texas Institute of Restorative Neurotechnologies, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA.
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Venkatesh P, Wolfe C, Lega B. Neuromodulation of the anterior thalamus: Current approaches and opportunities for the future. CURRENT RESEARCH IN NEUROBIOLOGY 2023; 5:100109. [PMID: 38020810 PMCID: PMC10663132 DOI: 10.1016/j.crneur.2023.100109] [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: 05/14/2023] [Revised: 08/28/2023] [Accepted: 08/31/2023] [Indexed: 12/01/2023] Open
Abstract
The role of thalamocortical circuits in memory has driven a recent burst of scholarship, especially in animal models. Investigating this circuitry in humans is more challenging. And yet, the development of new recording and stimulation technologies deployed for clinical indications has created novel opportunities for data collection to elucidate the cognitive roles of thalamic structures. These technologies include stereoelectroencephalography (SEEG), deep brain stimulation (DBS), and responsive neurostimulation (RNS), all of which have been applied to memory-related thalamic regions, specifically for seizure localization and treatment. This review seeks to summarize the existing applications of neuromodulation of the anterior thalamic nuclei (ANT) and highlight several devices and their capabilities that can allow cognitive researchers to design experiments to assay its functionality. Our goal is to introduce to investigators, who may not be familiar with these clinical devices, the capabilities, and limitations of these tools for understanding the neurophysiology of the ANT as it pertains to memory and other behaviors. We also briefly cover the targeting of other thalamic regions including the centromedian (CM) nucleus, dorsomedial (DM) nucleus, and pulvinar, with associated potential avenues of experimentation.
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Affiliation(s)
- Pooja Venkatesh
- Department of Neurosurgery, University of Texas Southwestern, Dallas, TX, 75390, USA
| | - Cody Wolfe
- Department of Neurosurgery, University of Texas Southwestern, Dallas, TX, 75390, USA
| | - Bradley Lega
- Department of Neurosurgery, University of Texas Southwestern, Dallas, TX, 75390, USA
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Rezazadeh A, Bui E, Wennberg RA. Ipsilateral preictal alpha rhythm attenuation (IPARA): An EEG sign of side of seizure onset in temporal lobe epilepsy. Seizure 2023; 110:194-202. [PMID: 37423165 DOI: 10.1016/j.seizure.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/30/2023] [Accepted: 07/02/2023] [Indexed: 07/11/2023] Open
Abstract
PURPOSE Identification of the seizure onset zone is critically important for outlining the surgical plan in the treatment of pharmacoresistant focal epilepsy. In patients with temporal lobe epilepsy (TLE), bilateral ictal scalp EEG changes frequently occur and can make lateralization of the seizure onset zone difficult. We investigated the incidence and clinical utility of unilateral preictal alpha rhythm attenuation as a lateralizing sign of seizure onset in TLE. METHODS Scalp EEG recordings of the seizures acquired during presurgical video-EEG monitoring of 57 consecutive patients with TLE were reviewed retrospectively. Included patients had interictal baseline recordings demonstrating symmetrical posterior alpha rhythm and seizures occurring during wakefulness. RESULTS We identified a total of 649 seizures in the 57 patients, of which 448 seizures in 53 patients fulfilled the inclusion criteria. Among the 53 included patients, 7 patients (13.2%) exhibited a distinct attenuation of the posterior alpha rhythm prior to the first ictal EEG changes, in 26 of 112 (23.2%) included seizures. Preictal alpha rhythm attenuation in these seizures was ipsilateral to the ultimately determined side of seizure onset (based on video-EEG or intracranial EEG findings) in 22 (84.6%) of these seizures and bilateral in 4 (15.4%), and occurred on average 5.9 ± 2.6 s prior to ictal EEG onsets. CONCLUSION Our findings suggest that in some patients with TLE lateralized preictal attenuation of the posterior alpha rhythm may be a useful indicator of side of seizure onset, presumably due to early disruption of thalamo-temporo-occipital network function, likely mediated through the thalamus.
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Affiliation(s)
- Arezoo Rezazadeh
- Department of Medicine, University of Ottawa, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Esther Bui
- Department of Medicine, University of Toronto, Toronto, ON, Canada
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Cieslik EC, Ullsperger M, Gell M, Eickhoff SB, Langner R. Success versus failure in cognitive control: meta-analytic evidence from neuroimaging studies on error processing. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.10.540136. [PMID: 37214978 PMCID: PMC10197606 DOI: 10.1101/2023.05.10.540136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Brain mechanisms of error processing have often been investigated using response interference tasks and focusing on the posterior medial frontal cortex, which is also implicated in resolving response conflict in general. Thereby, the role other brain regions may play has remained undervalued. Here, activation likelihood estimation meta-analyses were used to synthesize the neuroimaging literature on brain activity related to committing errors versus responding successfully in interference tasks and to test for commonalities and differences. The salience network and the temporoparietal junction were commonly recruited irrespective of whether responses were correct or incorrect, pointing towards a general involvement in coping with situations that call for increased cognitive control. The dorsal posterior cingulate cortex, posterior thalamus, and left superior frontal gyrus showed error-specific convergence, which underscores their consistent involvement when performance goals are not met. In contrast, successful responding revealed stronger convergence in the dorsal attention network and lateral prefrontal regions. Underrecruiting these regions in error trials may reflect failures in activating the task-appropriate stimulus-response contingencies necessary for successful response execution.
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Affiliation(s)
- Edna C. Cieslik
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
| | - Markus Ullsperger
- Institute of Psychology, Otto-von-Guericke University, D-39106 Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Martin Gell
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Simon B. Eickhoff
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
| | - Robert Langner
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
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Fisher RS. Deep brain stimulation of thalamus for epilepsy. Neurobiol Dis 2023; 179:106045. [PMID: 36809846 DOI: 10.1016/j.nbd.2023.106045] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023] Open
Abstract
Neuromodulation (neurostimulation) is a relatively new and rapidly growing treatment for refractory epilepsy. Three varieties are approved in the US: vagus nerve stimulation (VNS), deep brain stimulation (DBS) and responsive neurostimulation (RNS). This article reviews thalamic DBS for epilepsy. Among many thalamic sub-nuclei, DBS for epilepsy has been targeted to the anterior nucleus (ANT), centromedian nucleus (CM), dorsomedial nucleus (DM) and pulvinar (PULV). Only ANT is FDA-approved, based upon a controlled clinical trial. Bilateral stimulation of ANT reduced seizures by 40.5% at three months in the controlled phase (p = .038) and 75% by 5 years in the uncontrolled phase. Side effects related to paresthesias, acute hemorrhage, infection, occasional increased seizures, and usually transient effects on mood and memory. Efficacy was best documented for focal onset seizures in temporal or frontal lobe. CM stimulation may be useful for generalized or multifocal seizures and PULV for posterior limbic seizures. Mechanisms of DBS for epilepsy are largely unknown, but animal work points to changes in receptors, channels, neurotransmitters, synapses, network connectivity and neurogenesis. Personalization of therapies, in terms of connectivity of the seizure onset zone to the thalamic sub- nucleus and individual characteristics of the seizures, might lead to improved efficacy. Many questions remain about DBS, including the best candidates for different types of neuromodulation, the best targets, the best stimulation parameters, how to minimize side effects and how to deliver current noninvasively. Despite the questions, neuromodulation provides useful new opportunities to treat people with refractory seizures not responding to medicines and not amenable to resective surgery.
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Affiliation(s)
- Robert S Fisher
- Department of Neurology and Neurological Sciences and Neurosurgery by Courtesy, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, 213 Quarry Road, Room 4865, Palo Alto, CA 94304, USA.
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Kalamatianos T, Mavrovounis G, Skouras P, Pandis D, Fountas K, Stranjalis G. Medial Pulvinar Stimulation in Temporal Lobe Epilepsy: A Literature Review and a Hypothesis Based on Neuroanatomical Findings. Cureus 2023; 15:e35772. [PMID: 37025746 PMCID: PMC10071339 DOI: 10.7759/cureus.35772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2023] [Indexed: 03/07/2023] Open
Abstract
While bilateral stimulation of the anterior thalamic nuclei remains the only approved deep brain stimulation (DBS) option for focal epilepsy, two additional thalamic targets have been proposed. Earlier work indicated the potential of centromedian thalamic nucleus stimulation with recent findings highlighting the medial pulvinar nucleus. The latter has been shown to exhibit electrophysiological and imaging alterations in patients with partial status epilepticus and temporal lobe epilepsy. On this basis, recent studies have begun assessing the feasibility and efficacy of pulvinar stimulation, with encouraging results on the reduction of seizure frequency and severity. Building on existing neuroanatomical knowledge, indicating that the medial pulvinar is connected to the temporal lobe via the temporopulvinar bundle of Arnold, we hypothesize that this is one of the routes through which medial pulvinar stimulation affects temporal lobe structures. We suggest that further anatomic, imaging, and electrophysiologic studies are warranted to deepen our understanding of the subject and guide future clinical applications.
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Zheng B, Liu DD, Theyel BB, Abdulrazeq H, Kimata AR, Lauro PM, Asaad WF. Thalamic neuromodulation in epilepsy: A primer for emerging circuit-based therapies. Expert Rev Neurother 2023; 23:123-140. [PMID: 36731858 DOI: 10.1080/14737175.2023.2176752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Epilepsy is a common, often debilitating disease of hyperexcitable neural networks. While medically intractable cases may benefit from surgery, there may be no single, well-localized focus for resection or ablation. In such cases, approaching the disease from a network-based perspective may be beneficial. AREAS COVERED Herein, the authors provide a narrative review of normal thalamic anatomy and physiology and propose general strategies for preventing and/or aborting seizures by modulating this structure. Additionally, they make specific recommendations for targeting the thalamus within different contexts, motivated by a more detailed discussion of its distinct nuclei and their respective connectivity. By describing important principles governing thalamic function and its involvement in seizure networks, the authors aim to provide a primer for those now entering this fast-growing field of thalamic neuromodulation for epilepsy. EXPERT OPINION The thalamus is critically involved with the function of many cortical and subcortical areas, suggesting it may serve as a compelling node for preventing or aborting seizures, and so it has increasingly been targeted for the surgical treatment of epilepsy. As various thalamic neuromodulation strategies for seizure control are developed, there is a need to ground such interventions in a mechanistic, circuit-based framework.
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Affiliation(s)
- Bryan Zheng
- The Warren Alpert Medical School of Brown University, Providence, RI, USA.,Department of Neurosurgery, Rhode Island Hospital, Providence, RI, USA
| | - David D Liu
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Brian B Theyel
- Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA.,Department of Neuroscience, Brown University, Providence, RI, USA
| | - Hael Abdulrazeq
- Department of Neurosurgery, Rhode Island Hospital, Providence, RI, USA
| | - Anna R Kimata
- The Warren Alpert Medical School of Brown University, Providence, RI, USA.,Department of Neurosurgery, Rhode Island Hospital, Providence, RI, USA
| | - Peter M Lauro
- The Warren Alpert Medical School of Brown University, Providence, RI, USA.,Department of Neuroscience, Brown University, Providence, RI, USA
| | - Wael F Asaad
- Department of Neurosurgery, Rhode Island Hospital, Providence, RI, USA.,Department of Neuroscience, Brown University, Providence, RI, USA.,The Carney Institute for Brain Science, Brown University, Providence, RI, USA.,The Norman Prince Neurosciences Institute, Rhode Island Hospital, Providence, RI, USA
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13
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Marins TF, Russo M, Rodrigues EC, Monteiro M, Moll J, Felix D, Bouzas J, Arcanjo H, Vargas CD, Tovar‐Moll F. Reorganization of thalamocortical connections in congenitally blind humans. Hum Brain Mapp 2023; 44:2039-2049. [PMID: 36661404 PMCID: PMC9980890 DOI: 10.1002/hbm.26192] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 11/14/2022] [Accepted: 11/24/2022] [Indexed: 01/21/2023] Open
Abstract
Cross-modal plasticity in blind individuals has been reported over the past decades showing that nonvisual information is carried and processed by "visual" brain structures. However, despite multiple efforts, the structural underpinnings of cross-modal plasticity in congenitally blind individuals remain unclear. We mapped thalamocortical connectivity and assessed the integrity of white matter of 10 congenitally blind individuals and 10 sighted controls. We hypothesized an aberrant thalamocortical pattern of connectivity taking place in the absence of visual stimuli from birth as a potential mechanism of cross-modal plasticity. In addition to the impaired microstructure of visual white matter bundles, we observed structural connectivity changes between the thalamus and occipital and temporal cortices. Specifically, the thalamic territory dedicated to connections with the occipital cortex was smaller and displayed weaker connectivity in congenitally blind individuals, whereas those connecting with the temporal cortex showed greater volume and increased connectivity. The abnormal pattern of thalamocortical connectivity included the lateral and medial geniculate nuclei and the pulvinar nucleus. For the first time in humans, a remapping of structural thalamocortical connections involving both unimodal and multimodal thalamic nuclei has been demonstrated, shedding light on the possible mechanisms of cross-modal plasticity in humans. The present findings may help understand the functional adaptations commonly observed in congenitally blind individuals.
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Affiliation(s)
- Theo F. Marins
- D'Or Institute for Research and Education (IDOR)Rio de JaneiroBrazil,Post‐Graduation Program in Morphological Sciences (PCM) of the Institute of Biomedical Sciences (ICB)Federal University of Rio de Janeiro (UFRJ)Rio de JaneiroBrazil
| | - Maite Russo
- Institute of Biophysics Carlos Chagas Filho (IBCCF)Federal University of Rio de Janeiro (UFRJ)Rio de JaneiroBrazil
| | | | - Marina Monteiro
- D'Or Institute for Research and Education (IDOR)Rio de JaneiroBrazil
| | - Jorge Moll
- D'Or Institute for Research and Education (IDOR)Rio de JaneiroBrazil
| | - Daniel Felix
- D'Or Institute for Research and Education (IDOR)Rio de JaneiroBrazil
| | - Julia Bouzas
- D'Or Institute for Research and Education (IDOR)Rio de JaneiroBrazil
| | - Helena Arcanjo
- Centro de Oftalmologia EspecializadaRio de JaneiroBrazil
| | - Claudia D. Vargas
- Institute of Biophysics Carlos Chagas Filho (IBCCF)Federal University of Rio de Janeiro (UFRJ)Rio de JaneiroBrazil
| | - Fernanda Tovar‐Moll
- D'Or Institute for Research and Education (IDOR)Rio de JaneiroBrazil,Post‐Graduation Program in Morphological Sciences (PCM) of the Institute of Biomedical Sciences (ICB)Federal University of Rio de Janeiro (UFRJ)Rio de JaneiroBrazil
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14
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Gadot R, Korst G, Shofty B, Gavvala JR, Sheth SA. Thalamic stereoelectroencephalography in epilepsy surgery: a scoping literature review. J Neurosurg 2022; 137:1210-1225. [PMID: 35276641 DOI: 10.3171/2022.1.jns212613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/10/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Stereoelectroencephalography (sEEG) is a well-established surgical method for defining the epileptogenic network. Traditionally reserved for identifying discrete cortical regions for resection or ablation, sEEG in current practice is also used for identifying more broadly involved subcortical epileptic network components, driven by the availability of brain-based neuromodulation strategies. In particular, sEEG investigations including thalamic nuclei are becoming more frequent in parallel with the increase in therapeutic strategies involving thalamic targets such as deep brain stimulation (DBS) and responsive neurostimulation (RNS). The objective to this study was to evaluate existing evidence and trends regarding the purpose, techniques, and relevant electrographic findings of thalamic sEEG. METHODS MEDLINE and Embase databases were systematically queried for eligible peer-reviewed studies involving sEEG electrode implantation into thalamic nuclei of patients with epilepsy. Available data were abstracted concerning preoperative workup and purpose for implanting the thalamus, thalamic targets and trajectories, and electrophysiological methodology and findings. RESULTS sEEG investigations have included thalamic targets for both basic and clinical research purposes. Medial pulvinar, dorsomedial, anterior, and centromedian nuclei have been the most frequently studied. Few studies have reported any complications with thalamic sEEG implantation, and no studies have reported long-term complications. Various methods have been utilized to characterize thalamic activity in epileptic disorders including evoked potentials, power spectrograms, synchronization indices, and the epileptogenicity index. Thalamic intracranial recordings are beginning to be used to guide neuromodulation strategies including RNS and DBS, as well as to understand complex, network-dependent seizure disorders. CONCLUSIONS Inclusion of thalamic coverage during sEEG evaluation in drug-resistant epilepsy is a growing practice and is amenable to various methods of electrographic data analysis. Further study is required to establish well-defined criteria for thalamic implantation during invasive investigations as well as safety and ethical considerations.
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Affiliation(s)
| | | | | | - Jay R Gavvala
- 2Neurology, Baylor College of Medicine, Houston, Texas
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15
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Ballerini A, Tondelli M, Talami F, Molinari MA, Micalizzi E, Giovannini G, Turchi G, Malagoli M, Genovese M, Meletti S, Vaudano AE. Amygdala subnuclear volumes in temporal lobe epilepsy with hippocampal sclerosis and in non-lesional patients. Brain Commun 2022; 4:fcac225. [PMID: 36213310 PMCID: PMC9536297 DOI: 10.1093/braincomms/fcac225] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 05/12/2022] [Accepted: 09/05/2022] [Indexed: 11/28/2022] Open
Abstract
Together with hippocampus, the amygdala is important in the epileptogenic network of patients with temporal lobe epilepsy. Recently, an increase in amygdala volumes (i.e. amygdala enlargement) has been proposed as morphological biomarker of a subtype of temporal lobe epilepsy patients without MRI abnormalities, although other data suggest that this finding might be unspecific and not exclusive to temporal lobe epilepsy. In these studies, the amygdala is treated as a single entity, while instead it is composed of different nuclei, each with peculiar function and connection. By adopting a recently developed methodology of amygdala’s subnuclei parcellation based of high-resolution T1-weighted image, this study aims to map specific amygdalar subnuclei participation in temporal lobe epilepsy due to hippocampal sclerosis (n = 24) and non-lesional temporal lobe epilepsy (n = 24) with respect to patients with focal extratemporal lobe epilepsies (n = 20) and healthy controls (n = 30). The volumes of amygdala subnuclei were compared between groups adopting multivariate analyses of covariance and correlated with clinical variables. Additionally, a logistic regression analysis on the nuclei resulting statistically different across groups was performed. Compared with other populations, temporal lobe epilepsy with hippocampal sclerosis showed a significant atrophy of the whole amygdala (pBonferroni = 0.040), particularly the basolateral complex (pBonferroni = 0.033), while the non-lesional temporal lobe epilepsy group demonstrated an isolated hypertrophy of the medial nucleus (pBonferroni = 0.012). In both scenarios, the involved amygdala was ipsilateral to the epileptic focus. The medial nucleus demonstrated a volume increase even in extratemporal lobe epilepsies although contralateral to the seizure onset hemisphere (pBonferroni = 0.037). Non-lesional patients with psychiatric comorbidities showed a larger ipsilateral lateral nucleus compared with those without psychiatric disorders. This exploratory study corroborates the involvement of the amygdala in temporal lobe epilepsy, particularly in mesial temporal lobe epilepsy and suggests a different amygdala subnuclei engagement depending on the aetiology and lateralization of epilepsy. Furthermore, the logistic regression analysis indicated that the basolateral complex and the medial nucleus of amygdala can be helpful to differentiate temporal lobe epilepsy with hippocampal sclerosis and with MRI negative, respectively, versus controls with a consequent potential clinical yield. Finally, the present results contribute to the literature about the amygdala enlargement in temporal lobe epilepsy, suggesting that the increased volume of amygdala can be regarded as epilepsy-related structural changes common across different syndromes whose meaning should be clarified.
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Affiliation(s)
- Alice Ballerini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia , Modena 41125 , Italy
| | | | - Francesca Talami
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia , Modena 41125 , Italy
| | | | - Elisa Micalizzi
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia , Modena 41121 , Italy
| | - Giada Giovannini
- Neurology Unit, OCB Hospital, AOU Modena , Modena 41126 , Italy
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia , Modena 41121 , Italy
| | - Giulia Turchi
- Neurology Unit, OCB Hospital, AOU Modena , Modena 41126 , Italy
| | - Marcella Malagoli
- Neuroradiology Unit, OCB Hospital, AOU Modena , Modena 41126 , Italy
| | - Maurilio Genovese
- Neuroradiology Unit, OCB Hospital, AOU Modena , Modena 41126 , Italy
| | - Stefano Meletti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia , Modena 41125 , Italy
- Neurology Unit, OCB Hospital, AOU Modena , Modena 41126 , Italy
| | - Anna Elisabetta Vaudano
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia , Modena 41125 , Italy
- Neurology Unit, OCB Hospital, AOU Modena , Modena 41126 , Italy
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16
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Pizzo F, Carron R, Bartolomei F. Letter to Brain-responsive corticothalamic stimulation in the pulvinar nucleus for the treatment of regional neocortical epilepsy: A case series. Epilepsia Open 2022; 7:541-542. [PMID: 35917183 PMCID: PMC9436297 DOI: 10.1002/epi4.12611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/09/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Francesca Pizzo
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France.,APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France
| | - Romain Carron
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France.,APHM, Timone Hospital, Stereotactic and Functional Neurosurgery, Marseille, France
| | - Fabrice Bartolomei
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France.,APHM, Timone Hospital, Epileptology and Cerebral Rhythmology, Marseille, France
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17
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Ilyas A, Tandon N, Lhatoo SD. Thalamic neuromodulation for epilepsy: A clinical perspective. Epilepsy Res 2022; 183:106942. [PMID: 35580382 DOI: 10.1016/j.eplepsyres.2022.106942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/12/2022] [Accepted: 05/06/2022] [Indexed: 11/29/2022]
Abstract
Thalamic neuromodulation can be an effective therapeutic option for select patients with medically refractory epilepsy. However, successful outcome depends on several factors, beginning with appropriate patient and thalamic target selection. Among thalamic targets, the anterior (ANT) and centromedian (CeM) nuclei have the greatest clinical evidence for efficacy. However, the place of thalamic neuromodulation in the treatment armamentarium for intractable seizures is at the tail end of a long list of options. It's relative efficacy, if any, in relation to other treatment modalities however, can be inferred. As we will discuss, considerable work remains to be done in optimal targeting of thalamic nuclei, appropriate to the epilepsy syndrome and seizure type of the individual patient, which may change our current understanding of the place of thalamic neuromodulation on a range of treatment modality efficacies. Currently, it appears that ANT DBS is most efficacious for limbic epilepsies whereas CM, for generalized, multifocal (especially frontotemporal) epilepsies. Based on controlled studies, the efficacy of ANT and CeM DBS is roughly in line with other neuromodulatory therapies (i.e. RNS, VNS) when assessed within the cohort of patients for which the therapy is indicated. Much improvement is needed to render thalamic DBS more efficacious, and use of optimal targeting strategies, especially direct targeting, can positively affect outcomes. Thalamic neuromodulation is still in its infancy; however, clinical advances in this therapy are being realized.
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Affiliation(s)
- Adeel Ilyas
- Department of Neurological Surgery, University of Alabama at Birmingham, Birmingham, AL, USA; Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, TX, USA; Texas Institute for Restorative Neurotechnologies, The University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Nitin Tandon
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, TX, USA; Texas Institute for Restorative Neurotechnologies, The University of Texas Health Science Center at Houston, Houston, TX, USA; Department of Neurology, McGovern Medical School at UT Health Houston, Houston, TX, USA; Memorial Hermann Hospital, Texas Medical Center, Houston, TX, USA
| | - Samden D Lhatoo
- Texas Institute for Restorative Neurotechnologies, The University of Texas Health Science Center at Houston, Houston, TX, USA; Department of Neurology, McGovern Medical School at UT Health Houston, Houston, TX, USA; Memorial Hermann Hospital, Texas Medical Center, Houston, TX, USA
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18
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Leow YN, Zhou B, Sullivan HA, Barlowe AR, Wickersham IR, Sur M. Brain-wide mapping of inputs to the mouse lateral posterior (LP/Pulvinar) thalamus-anterior cingulate cortex network. J Comp Neurol 2022; 530:1992-2013. [PMID: 35383929 PMCID: PMC9167239 DOI: 10.1002/cne.25317] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 02/24/2022] [Accepted: 03/01/2022] [Indexed: 01/29/2023]
Abstract
The rodent homolog of the primate pulvinar, the lateral posterior (LP) thalamus, is extensively interconnected with multiple cortical areas. While these cortical interactions can span the entire LP, subdivisions of the LP are characterized by differential connections with specific cortical regions. In particular, the medial LP has reciprocal connections with frontoparietal cortical areas, including the anterior cingulate cortex (ACC). The ACC plays an integral role in top‐down sensory processing and attentional regulation, likely exerting some of these functions via the LP. However, little is known about how ACC and LP interact, and about the information potentially integrated in this reciprocal network. Here, we address this gap by employing a projection‐specific monosynaptic rabies tracing strategy to delineate brain‐wide inputs to bottom‐up LP→ACC and top‐down ACC→LP neurons. We find that LP→ACC neurons receive inputs from widespread cortical regions, including primary and higher order sensory and motor cortical areas. LP→ACC neurons also receive extensive subcortical inputs, particularly from the intermediate and deep layers of the superior colliculus (SC). Sensory inputs to ACC→LP neurons largely arise from visual cortical areas. In addition, ACC→LP neurons integrate cross‐hemispheric prefrontal cortex inputs as well as inputs from higher order medial cortex. Our brain‐wide anatomical mapping of inputs to the reciprocal LP‐ACC pathways provides a roadmap for understanding how LP and ACC communicate different sources of information to mediate attentional control and visuomotor functions.
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Affiliation(s)
- Yi Ning Leow
- Department of Brain and Cognitive Sciences, Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Blake Zhou
- Department of Brain and Cognitive Sciences, Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Heather A Sullivan
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Alexandria R Barlowe
- Department of Brain and Cognitive Sciences, Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Ian R Wickersham
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Mriganka Sur
- Department of Brain and Cognitive Sciences, Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
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19
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Dissecting neuropathic from poststroke pain: the white matter within. Pain 2022; 163:765-778. [PMID: 35302975 DOI: 10.1097/j.pain.0000000000002427] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/27/2021] [Indexed: 12/13/2022]
Abstract
ABSTRACT Poststroke pain (PSP) is a heterogeneous term encompassing both central neuropathic (ie, central poststroke pain [CPSP]) and nonneuropathic poststroke pain (CNNP) syndromes. Central poststroke pain is classically related to damage in the lateral brainstem, posterior thalamus, and parietoinsular areas, whereas the role of white matter connecting these structures is frequently ignored. In addition, the relationship between stroke topography and CNNP is not completely understood. In this study, we address these issues comparing stroke location in a CPSP group of 35 patients with 2 control groups: 27 patients with CNNP and 27 patients with stroke without pain. Brain MRI images were analyzed by 2 complementary approaches: an exploratory analysis using voxel-wise lesion symptom mapping, to detect significant voxels damaged in CPSP across the whole brain, and a hypothesis-driven, region of interest-based analysis, to replicate previously reported sites involved in CPSP. Odds ratio maps were also calculated to demonstrate the risk for CPSP in each damaged voxel. Our exploratory analysis showed that, besides known thalamic and parietoinsular areas, significant voxels carrying a high risk for CPSP were located in the white matter encompassing thalamoinsular connections (one-tailed threshold Z > 3.96, corrected P value <0.05, odds ratio = 39.7). These results show that the interruption of thalamocortical white matter connections is an important component of CPSP, which is in contrast with findings from nonneuropathic PSP and from strokes without pain. These data can aid in the selection of patients at risk to develop CPSP who could be candidates to pre-emptive or therapeutic interventions.
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20
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Abouelleil M, Deshpande N, Ali R. Emerging Trends in Neuromodulation for Treatment of Drug-Resistant Epilepsy. FRONTIERS IN PAIN RESEARCH 2022; 3:839463. [PMID: 35386582 PMCID: PMC8977768 DOI: 10.3389/fpain.2022.839463] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/21/2022] [Indexed: 01/12/2023] Open
Abstract
Epilepsy is a neurological disorder that affects more than 70 million people globally. A considerable proportion of epilepsy is resistant to anti-epileptic drugs (AED). For patients with drug-resistant epilepsy (DRE), who are not eligible for resective or ablative surgery, neuromodulation has been a palliative option. Since the approval of vagus nerve stimulation (VNS) in 1997, expansion to include other modalities, such as deep brain stimulation (DBS) and responsive neurostimulation (RNS), has led to improved seizure control in this population. In this article, we discuss the current updates and emerging trends on neuromodulation for epilepsy.
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Affiliation(s)
- Mohamed Abouelleil
- Division of Neurological Surgery, Spectrum Health, Grand Rapids, MI, United States
| | - Nachiket Deshpande
- College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Rushna Ali
- Division of Neurological Surgery, Spectrum Health, Grand Rapids, MI, United States
- *Correspondence: Rushna Ali
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21
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Karakis I. Using stereo-electroencephalography to unlock the ictal secrets of the thalamus. Clin Neurophysiol 2022; 137:177-178. [DOI: 10.1016/j.clinph.2022.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 11/03/2022]
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22
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Paulk AC, Zelmann R, Crocker B, Widge AS, Dougherty DD, Eskandar EN, Weisholtz DS, Richardson RM, Cosgrove GR, Williams ZM, Cash SS. Local and distant cortical responses to single pulse intracranial stimulation in the human brain are differentially modulated by specific stimulation parameters. Brain Stimul 2022; 15:491-508. [PMID: 35247646 PMCID: PMC8985164 DOI: 10.1016/j.brs.2022.02.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Electrical neuromodulation via direct electrical stimulation (DES) is an increasingly common therapy for a wide variety of neuropsychiatric diseases. Unfortunately, therapeutic efficacy is inconsistent, likely due to our limited understanding of the relationship between the massive stimulation parameter space and brain tissue responses. OBJECTIVE To better understand how different parameters induce varied neural responses, we systematically examined single pulse-induced cortico-cortico evoked potentials (CCEP) as a function of stimulation amplitude, duration, brain region, and whether grey or white matter was stimulated. METHODS We measured voltage peak amplitudes and area under the curve (AUC) of intracranially recorded stimulation responses as a function of distance from the stimulation site, pulse width, current injected, location relative to grey and white matter, and brain region stimulated (N = 52, n = 719 stimulation sites). RESULTS Increasing stimulation pulse width increased responses near the stimulation location. Increasing stimulation amplitude (current) increased both evoked amplitudes and AUC nonlinearly. Locally (<15 mm), stimulation at the boundary between grey and white matter induced larger responses. In contrast, for distant sites (>15 mm), white matter stimulation consistently produced larger responses than stimulation in or near grey matter. The stimulation location-response curves followed different trends for cingulate, lateral frontal, and lateral temporal cortical stimulation. CONCLUSION These results demonstrate that a stronger local response may require stimulation in the grey-white boundary while stimulation in the white matter could be needed for network activation. Thus, stimulation parameters tailored for a specific anatomical-functional outcome may be key to advancing neuromodulatory therapy.
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Affiliation(s)
- Angelique C Paulk
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
| | - Rina Zelmann
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Britni Crocker
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Harvard-MIT Health Sciences and Technology, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Alik S Widge
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Darin D Dougherty
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Emad N Eskandar
- Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - Daniel S Weisholtz
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, 02114, USA
| | - R Mark Richardson
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - G Rees Cosgrove
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, 02114, USA
| | - Ziv M Williams
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA; Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - Sydney S Cash
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
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23
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Shahabi H, Taylor K, Hirfanoglu T, Koneru S, Bingaman W, Kobayashi K, Kobayashi M, Joshi A, Leahy RM, Mosher JC, Bulacio J, Nair D. Effective connectivity differs between focal cortical dysplasia types I and II. Epilepsia 2021; 62:2753-2765. [PMID: 34541666 DOI: 10.1111/epi.17064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine whether brain connectivity differs between focal cortical dysplasia (FCD) types I and II. METHODS We compared cortico-cortical evoked potentials (CCEPs) as measures of effective brain connectivity in 25 FCD patients with drug-resistant focal epilepsy who underwent intracranial evaluation with stereo-electroencephalography (SEEG). We analyzed the amplitude and latency of CCEP responses following ictal-onset single-pulse electrical stimulation (iSPES). RESULTS In comparison to FCD type II, patients with type I demonstrated significantly larger responses in the electrodes near the ictal-onset zone (<50 mm). These findings persisted when controlling for the location of the epileptogenic zone, as noted in patients with temporal lobe epilepsies, as well as controlling for seizure type, as noted in patients with focal to bilateral tonic-clonic seizures (FBTCS). In type II, the root mean square (RMS) of CCEP responses dropped substantially from the early segment (10-60 ms) to the middle and late segments (60-600 ms). The middle and late CCEP latency segments showed the largest differences between FCD types I and II. SIGNIFICANCE Focal cortical dysplasia type I may have a greater degree of cortical hyperexcitability as compared with FCD type II. In addition, FCD type II displays a more restrictive area of hyperexcitability in both temporal and spatial domains. In patients with FBTCS and type I FCD, the increased amplitudes of RMS in the middle and late CCEP periods appear consistent with the cortico-thalamo-cortical network involvement of FBTCS. The notable differences in degree and extent of hyperexcitability may contribute to the different postsurgical seizure outcomes noted between these two pathological substrates.
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Affiliation(s)
- Hossein Shahabi
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA, USA
| | - Kenneth Taylor
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Tugba Hirfanoglu
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.,Department of Pediatric Neurology, School of Medicine, Gazi University, Ankara, Turkey
| | - Shreekanth Koneru
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - William Bingaman
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Katsuya Kobayashi
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Masako Kobayashi
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Anand Joshi
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA, USA
| | - Richard M Leahy
- Signal and Image Processing Institute, University of Southern California, Los Angeles, CA, USA
| | - John C Mosher
- University of Texas Health Sciences Center, Houston, TX, USA
| | - Juan Bulacio
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Dileep Nair
- Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
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Zhang Y, Ichinose F, Maeda T, Nakamura T, Matsuo M. A pediatric case of transient periictal MRI abnormalities after repeated seizures. Brain Dev 2021; 43:809-813. [PMID: 33958241 DOI: 10.1016/j.braindev.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/29/2021] [Accepted: 04/04/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Transient periictal MRI abnormalities (TPMA) are caused by seizures, and may completely or partially reverse within a few days following seizure. Although TPMA are usually observed in patients with status epilepticus (SE), they have also been rarely reported after isolated/recurrent seizures not fulfilling the criteria for SE. Herein, we present a case of a 1-year-old girl with TPMA. CASE A 1-year-old girl with Apert syndrome and epilepsy showed MRI abnormalities in the cortico-subcortical areas of the left temporal, occipital and parietal lobes, as well as the left thalamus. These abnormalities showed as a hyperintense signal on diffusion-weighted imaging and a hypointense signal on apparent-diffusion coefficient maps. On follow-up MRI after 3 days, the abnormal signals were completely reversed. We confirmed TPMA after eliminating other possibilities. When treatment was withdrawn, the patient regained consciousness immediately and did not show any abnormality on subsequent MRI. CONCLUSION TPMA may occur in young children; recognizing this possibility is important for making the diagnosis and conducting appropriate treatment. As a previous study revealed, the distribution of signal changes in cortico-subcortical areas and the ipsilateral thalamus may be a characteristic feature of TPMA.
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Affiliation(s)
- Yumeng Zhang
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan; Department of Pediatrics, Saga-Ken Medical Center Koseikan, Saga, Japan
| | - Fumio Ichinose
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Toshiyuki Maeda
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan; Department of Pediatrics, Saga-Ken Medical Center Koseikan, Saga, Japan
| | - Takuji Nakamura
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Muneaki Matsuo
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan.
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Kagan I, Gibson L, Spanou E, Wilke M. Effective connectivity and spatial selectivity-dependent fMRI changes elicited by microstimulation of pulvinar and LIP. Neuroimage 2021; 240:118283. [PMID: 34147628 DOI: 10.1016/j.neuroimage.2021.118283] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 05/04/2021] [Accepted: 06/16/2021] [Indexed: 11/30/2022] Open
Abstract
The thalamic pulvinar and the lateral intraparietal area (LIP) share reciprocal anatomical connections and are part of an extensive cortical and subcortical network involved in spatial attention and oculomotor processing. The goal of this study was to compare the effective connectivity of dorsal pulvinar (dPul) and LIP and to probe the dependency of microstimulation effects on task demands and spatial tuning properties of a given brain region. To this end, we applied unilateral electrical microstimulation in the dPul (mainly medial pulvinar) and LIP in combination with event-related BOLD fMRI in monkeys performing fixation and memory-guided saccade tasks. Microstimulation in both dPul and LIP enhanced task-related activity in monosynaptically-connected fronto-parietal cortex and along the superior temporal sulcus (STS) including putative face patch locations, as well as in extrastriate cortex. LIP microstimulation elicited strong activity in the opposite homotopic LIP while no homotopic activation was found with dPul stimulation. Both dPul and LIP stimulation also elicited activity in several heterotopic cortical areas in the opposite hemisphere, implying polysynaptic propagation of excitation. Despite extensive activation along the intraparietal sulcus evoked by LIP stimulation, there was a difference in frontal and occipital connectivity elicited by posterior and anterior LIP stimulation sites. Comparison of dPul stimulation with the adjacent but functionally dissimilar ventral pulvinar also showed distinct connectivity. On the level of single trial timecourses within each region of interest (ROI), most ROIs did not show task-dependence of stimulation-elicited response modulation. Across ROIs, however, there was an interaction between task and stimulation, and task-specific correlations between the initial spatial selectivity and the magnitude of stimulation effect were observed. Consequently, stimulation-elicited modulation of task-related activity was best fitted by an additive model scaled down by the initial response amplitude. In summary, we identified overlapping and distinct patterns of thalamocortical and corticocortical connectivity of pulvinar and LIP, highlighting the dorsal bank and fundus of STS as a prominent node of shared circuitry. Spatial task-specific and partly polysynaptic modulations of cue and saccade planning delay period activity in both hemispheres exerted by unilateral pulvinar and parietal stimulation provide insight into the distributed interhemispheric processing underlying spatial behavior.
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Affiliation(s)
- Igor Kagan
- Decision and Awareness Group, Cognitive Neuroscience Laboratory, German Primate Center, Leibniz Institute for Primate Research, Kellnerweg 4, Goettingen 37077, Germany; Department of Cognitive Neurology, University of Goettingen, Robert-Koch-Str. 40, Goettingen 37075, Germany; Leibniz ScienceCampus Primate Cognition, Kellnerweg 4, Goettingen 37077, Germany.
| | - Lydia Gibson
- Decision and Awareness Group, Cognitive Neuroscience Laboratory, German Primate Center, Leibniz Institute for Primate Research, Kellnerweg 4, Goettingen 37077, Germany; Department of Cognitive Neurology, University of Goettingen, Robert-Koch-Str. 40, Goettingen 37075, Germany
| | - Elena Spanou
- Decision and Awareness Group, Cognitive Neuroscience Laboratory, German Primate Center, Leibniz Institute for Primate Research, Kellnerweg 4, Goettingen 37077, Germany
| | - Melanie Wilke
- Decision and Awareness Group, Cognitive Neuroscience Laboratory, German Primate Center, Leibniz Institute for Primate Research, Kellnerweg 4, Goettingen 37077, Germany; Department of Cognitive Neurology, University of Goettingen, Robert-Koch-Str. 40, Goettingen 37075, Germany; Leibniz ScienceCampus Primate Cognition, Kellnerweg 4, Goettingen 37077, Germany
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26
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Kizawa R, Sato T, Umehara T, Komatsu T, Omoto S, Iguchi Y. [A case of epileptic seizure that required differentiation from hyper-acute ischemic stroke: usefulness of comparing DWI and FLAIR]. Rinsho Shinkeigaku 2021; 61:166-171. [PMID: 33627578 DOI: 10.5692/clinicalneurol.cn-001496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 60-year-old man developed aphasia and transient right upper limb paresis in the presence of chronic subdural hematoma and was transferred to our hospital at an early stage. Cranial MRI within an hour after onset showed diffusion-weighted image (DWI) hyperintensity in the left parietal, temporal, and insular cortex and the pulvinar, and decreased apparent diffusion coefficient (ADC) in the left parietal cortex and pulvinar, suggesting a differential diagnosis of hyper-acute ischemic stroke. However, the distribution and timing of the MRI abnormalities were considered to be atypical for hyper-acute ischemic stroke. The area with both DWI hyperintensity and decreased ADC included the cerebral cortex adjacent to the hematoma and the ipsilateral pulvinar, and fluid-attenuated inversion recovery (FLAIR) hyperintensity co-existed with DWI hyperintensity within only an hour from onset. Furthermore, FLAIR images showed infiltration of the hematoma content into the subarachnoid space, which might have triggered the attack. These findings collectively led us to diagnose an epileptic seizure. The present case suggests that the distribution and timing of MRI abnormalities are essential to differentiate epileptic seizures from hyper-acute ischemic stroke.
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Affiliation(s)
| | - Takeo Sato
- Department of Neurology, The Jikei University School of Medicine
| | - Tadashi Umehara
- Department of Neurology, The Jikei University School of Medicine
| | - Teppei Komatsu
- Department of Neurology, The Jikei University School of Medicine
| | - Shusaku Omoto
- Department of Neurology, The Jikei University School of Medicine
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine
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27
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A multisensory perspective onto primate pulvinar functions. Neurosci Biobehav Rev 2021; 125:231-243. [PMID: 33662442 DOI: 10.1016/j.neubiorev.2021.02.043] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 02/18/2021] [Accepted: 02/25/2021] [Indexed: 02/08/2023]
Abstract
Perception in ambiguous environments relies on the combination of sensory information from various sources. Most associative and primary sensory cortical areas are involved in this multisensory active integration process. As a result, the entire cortex appears as heavily multisensory. In this review, we focus on the contribution of the pulvinar to multisensory integration. This subcortical thalamic nucleus plays a central role in visual detection and selection at a fast time scale, as well as in the regulation of visual processes, at a much slower time scale. However, the pulvinar is also densely connected to cortical areas involved in multisensory integration. In spite of this, little is known about its multisensory properties and its contribution to multisensory perception. Here, we review the anatomical and functional organization of multisensory input to the pulvinar. We describe how visual, auditory, somatosensory, pain, proprioceptive and olfactory projections are differentially organized across the main subdivisions of the pulvinar and we show that topography is central to the organization of this complex nucleus. We propose that the pulvinar combines multiple sources of sensory information to enhance fast responses to the environment, while also playing the role of a general regulation hub for adaptive and flexible cognition.
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28
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Chaitanya G, Romeo AK, Ilyas A, Irannejad A, Toth E, Elsayed G, Bentley JN, Riley KO, Pati S. Robot-assisted stereoelectroencephalography exploration of the limbic thalamus in human focal epilepsy: implantation technique and complications in the first 24 patients. Neurosurg Focus 2021; 48:E2. [PMID: 32234983 DOI: 10.3171/2020.1.focus19887] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 01/24/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Despite numerous imaging studies highlighting the importance of the thalamus in a patient's surgical prognosis, human electrophysiological studies involving the limbic thalamic nuclei are limited. The objective of this study was to evaluate the safety and accuracy of robot-assisted stereotactic electrode placement in the limbic thalamic nuclei of patients with suspected temporal lobe epilepsy (TLE). METHODS After providing informed consent, 24 adults with drug-resistant, suspected TLE undergoing evaluation with stereoelectroencephalography (SEEG) were enrolled in the prospective study. The trajectory of one electrode planned for clinical sampling of the operculoinsular cortex was modified to extend it to the thalamus, thereby preventing the need for additional electrode placement for research. The anterior nucleus of the thalamus (ANT) (n = 13) and the medial group of thalamic nuclei (MED) (n = 11), including the mediodorsal and centromedian nuclei, were targeted. The postimplantation CT scan was coregistered to the preoperative MR image, and Morel's thalamic atlas was used to confirm the accuracy of implantation. RESULTS Ten (77%) of 13 patients in the ANT group and 10 (91%) of 11 patients in the MED group had electrodes accurately placed in the thalamic nuclei. None of the patients had a thalamic hemorrhage. However, trace asymptomatic hemorrhages at the cortical-level entry site were noted in 20.8% of patients, who did not require additional surgical intervention. SEEG data from all the patients were interpretable and analyzable. The trajectories for the ANT implant differed slightly from those of the MED group at the entry point-i.e., the precentral gyrus in the former and the postcentral gyrus in the latter. CONCLUSIONS Using judiciously planned robot-assisted SEEG, the authors demonstrate the safety of electrophysiological sampling from various thalamic nuclei for research recordings, presenting a technique that avoids implanting additional depth electrodes or compromising clinical care. With these results, we propose that if patients are fully informed of the risks involved, there are potential benefits of gaining mechanistic insights to seizure genesis, which may help to develop neuromodulation therapies.
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Affiliation(s)
- Ganne Chaitanya
- 1Department of Neurology.,2Epilepsy and Cognitive Neurophysiology Laboratory, and
| | - Andrew K Romeo
- 3Department of Neurosurgery, University of Alabama at Birmingham, Alabama
| | - Adeel Ilyas
- 2Epilepsy and Cognitive Neurophysiology Laboratory, and.,3Department of Neurosurgery, University of Alabama at Birmingham, Alabama
| | - Auriana Irannejad
- 1Department of Neurology.,2Epilepsy and Cognitive Neurophysiology Laboratory, and
| | - Emilia Toth
- 1Department of Neurology.,2Epilepsy and Cognitive Neurophysiology Laboratory, and
| | - Galal Elsayed
- 3Department of Neurosurgery, University of Alabama at Birmingham, Alabama
| | - J Nicole Bentley
- 3Department of Neurosurgery, University of Alabama at Birmingham, Alabama
| | - Kristen O Riley
- 3Department of Neurosurgery, University of Alabama at Birmingham, Alabama
| | - Sandipan Pati
- 1Department of Neurology.,2Epilepsy and Cognitive Neurophysiology Laboratory, and
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Gronlier E, Vendramini E, Volle J, Wozniak-Kwasniewska A, Antón Santos N, Coizet V, Duveau V, David O. Single-pulse electrical stimulation methodology in freely moving rat. J Neurosci Methods 2021; 353:109092. [PMID: 33549638 DOI: 10.1016/j.jneumeth.2021.109092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/15/2021] [Accepted: 02/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cortico-cortical evoked potentials (CCEP) are becoming popular to infer brain connectivity and cortical excitability in implanted refractory epilepsy patients. Our goal was to transfer this methodology to the freely moving rodent. NEW METHOD CCEP were recorded on freely moving Sprague-Dawley rats, from cortical and subcortical areas using depth electrodes. Electrical stimulation was applied using 1 ms biphasic current pulse, cathodic first, at a frequency of 0.5 Hz, with intensities ranging from 0.2 to 0.8 mA. Data were then processed in a similar fashion to human clinical studies, which included epoch selection, artefact correction and smart averaging. RESULTS For a large range of tested intensities, we recorded CCEPs with very good signal to noise ratio and reproducibility between animals, without any behavioral modification. The CCEP were composed of different components according to recorded and stimulated sites, similarly to human recordings. COMPARISON WITH EXISTING METHODS We minimally adapted a clinically-motivated methodology to a freely moving rodent model to achieve high translational relevance of future preclinical studies. CONCLUSIONS Our results indicate that the CCEP methodology can be applied to freely moving rodents and transferred to preclinical research. This will be of interest to address various neuroscientific questions, in physiological and pathological conditions.
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Affiliation(s)
- Eloïse Gronlier
- SynapCell SAS, Saint-Ismier, France; Univ. Grenoble Alpes, Inserm, GIN, Grenoble Institut des Neurosciences, Grenoble, France.
| | - Estelle Vendramini
- Univ. Grenoble Alpes, Inserm, GIN, Grenoble Institut des Neurosciences, Grenoble, France
| | | | | | - Noelia Antón Santos
- Univ. Grenoble Alpes, Inserm, GIN, Grenoble Institut des Neurosciences, Grenoble, France
| | - Véronique Coizet
- Univ. Grenoble Alpes, Inserm, GIN, Grenoble Institut des Neurosciences, Grenoble, France
| | | | - Olivier David
- Univ. Grenoble Alpes, Inserm, GIN, Grenoble Institut des Neurosciences, Grenoble, France; Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France
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30
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Tak K, Lee S, Choi E, Suh SW, Oh DJ, Moon W, Kim HS, Byun S, Bae JB, Han JW, Kim JH, Kim KW. Magnetic Resonance Imaging Texture of Medial Pulvinar in Dementia with Lewy Bodies. Dement Geriatr Cogn Disord 2021; 49:8-15. [PMID: 32259816 DOI: 10.1159/000506798] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 02/24/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Executive dysfunction is common in dementia with Lewy bodies (DLB). The pulvinar nucleus plays a role in executive control and synchronizes with cortical regions in the salience network that are vulnerable to Lewy pathology. OBJECTIVE We investigated the pulvinar subregions in patients with mild DLB and their associations with executive function. METHODS The sample consisted of 38 DLB patients and 38 age- and sex-matched normal controls. We evaluated cognitive function using the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet. We obtained four pulvinar nuclei using preprocessed T1-weighted magnetic resonance images. We compared volumes and textures of the DLB patients and the normal controls for each nucleus. We used a linear regression to determine the association of textures and neuropsychological test scores. RESULTS The DLB patients showed comparable volumes to the normal controls in all pulvinar nuclei. However, the DLB patients showed different texture of the left medial pulvinar (PuM) from the normal controls. The entropy, contrast, and cluster shade were lower but autocorrelation of left PuM was higher in the DLB patients compared to the normal controls. These texture features of the left PuM were associated with the set-shifting performance measured by the Trail Making Test. CONCLUSIONS In DLB, the left PuM may be altered from early stage, which may contribute to the development of executive dysfunction.
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Affiliation(s)
- Kayeong Tak
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Subin Lee
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Euna Choi
- National Institute of Dementia, Seongnam, Republic of Korea
| | - Seung Wan Suh
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Dae Jong Oh
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Woori Moon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hye Sung Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seonjeong Byun
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jae Hyoung Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ki Woong Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea, .,Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea, .,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea,
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Ohtomo S, Otsubo H, Arai H, Shimoda Y, Homma Y, Tominaga T. Hyperperfusion in the thalamus on arterial spin labelling indicates non-convulsive status epilepticus. Brain Commun 2020; 3:fcaa223. [PMID: 33501426 PMCID: PMC7811763 DOI: 10.1093/braincomms/fcaa223] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/04/2020] [Accepted: 11/24/2020] [Indexed: 12/15/2022] Open
Abstract
Non-convulsive status epilepticus describes the syndrome of unexplained impaired consciousness in critically ill patients. Non-convulsive status epilepticus is very likely to lead to delayed diagnosis and poor outcomes because of the absence of convulsive symptoms. EEG is essential for the diagnosis of non-convulsive status epilepticus to establish the association between periodic discharges and rhythmic delta activity in addition to ictal epileptiform discharges according to the Salzburg criteria. Arterial spin labelling, a type of perfusion MRI, has been applied for rapid and non-invasive evaluation of the ictal state. Ictal cerebral cortical hyperperfusion is the most common finding to demonstrate focal onset seizures. Hyperperfusion of the thalamus on single photon emission computed tomography was found in patients with impaired awareness seizures. We hypothesized that thalamocortical hyperperfusion on arterial spin labelling identifies non-convulsive status epilepticus and such thalamic hyperperfusion specifically associates with periodic/rhythmic discharges producing impaired consciousness without convulsion. We identified 27 patients (17 females; age, 39-91 years) who underwent both arterial spin labelling and EEG within 24 h of suspected non-convulsive status epilepticus. We analysed 28 episodes of suspected non-convulsive status epilepticus and compared hyperperfusion on arterial spin labelling with periodic/rhythmic discharges. We evaluated 21 episodes as a positive diagnosis of non-convulsive status epilepticus according to the Salzburg criteria. We identified periodic discharges in 15 (12 lateralized and 3 bilateral independent) episodes and rhythmic delta activity in 13 (10 lateralized, 1 bilateral independent and 2 generalized) episodes. Arterial spin labelling showed thalamic hyperperfusion in 16 (11 unilateral and 5 bilateral) episodes and cerebral cortical hyperperfusion in 24 (20 unilateral and 4 bilateral) episodes. Thalamic hyperperfusion was significantly associated with non-convulsive status epilepticus (P = 0.0007; sensitivity, 76.2%; specificity, 100%), periodic discharges (P < 0.0001; 93.3%; 84.6%), and rhythmic delta activity (P = 0.0006; 92.3%; 73.3%). Cerebral cortical hyperperfusion was significantly associated with non-convulsive status epilepticus (P = 0.0017; 100%; 57.1%) and periodic discharges (P = 0.0349; 100%; 30.8%), but not with rhythmic delta activity. Thalamocortical hyperperfusion could be a new biomarker of non-convulsive status epilepticus according to the Salzburg criteria in critically ill patients. Specific thalamic hyperexcitability might modulate the periodic discharges and rhythmic delta activity associated with non-convulsive status epilepticus. Impaired consciousness without convulsions could be caused by predominant thalamic hyperperfusion together with cortical hyperperfusion but without ictal epileptiform discharges.
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Affiliation(s)
- Satoru Ohtomo
- Department of Neurosurgery, South Miyagi Medical Center, Shibata-gun, Miyagi, Japan
| | - Hiroshi Otsubo
- Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Hiroaki Arai
- Department of Neurosurgery, South Miyagi Medical Center, Shibata-gun, Miyagi, Japan
| | - Yoshiteru Shimoda
- Department of Neurosurgery, South Miyagi Medical Center, Shibata-gun, Miyagi, Japan
| | - Yoichiro Homma
- Department of General Internal Medicine, Seirei-Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Pizzo F, Roehri N, Giusiano B, Lagarde S, Carron R, Scavarda D, McGonigal A, Filipescu C, Lambert I, Bonini F, Trebuchon A, Bénar CG, Bartolomei F. The Ictal Signature of Thalamus and Basal Ganglia in Focal Epilepsy: A SEEG Study. Neurology 2020; 96:e280-e293. [PMID: 33024023 DOI: 10.1212/wnl.0000000000011003] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 08/26/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the involvement of subcortical regions in human epilepsy by analyzing direct recordings from these regions during epileptic seizures using stereo-EEG (SEEG). METHODS We studied the SEEG recordings of a large series of patients (74 patients, 157 seizures) with an electrode sampling the thalamus and in some cases also the basal ganglia (caudate nucleus, 22 patients; and putamen, 4 patients). We applied visual analysis and signal quantification methods (Epileptogenicity Index [EI]) to their ictal recordings and compared electrophysiologic with clinical data. RESULTS We found that in 86% of patients, thalamus was involved during seizures (visual analysis) and 20% showed high values of epileptogenicity (EI >0.3). Basal ganglia may also disclose high values of epileptogenicity (9% in caudate nucleus) but to a lesser degree than thalamus (p < 0.01). We observed different seizure onset patterns including low voltage high frequency activities. We found high values of thalamic epileptogenicity in different epilepsy localizations, including opercular and motor epilepsies. We found no difference between epilepsy etiologies (cryptogenic vs malformation of cortical development, p = 0.77). Thalamic epileptogenicity was correlated with the extension of epileptogenic networks (p = 0.02, ρ 0.32). We found a significant effect (p < 0.05) of thalamic epileptogenicity regarding the postsurgical outcome (higher thalamic EI corresponding to higher probability of surgical failure). CONCLUSIONS Thalamic involvement during seizures is common in different seizure types. The degree of thalamic epileptogenicity is a possible marker of the epileptogenic network extension and of postsurgical prognosis.
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Affiliation(s)
- Francesca Pizzo
- From the Epileptology Department (F.P., S.L., A.M., I.L., F. Bonini, A.T., F. Bartolomei), Functional and Stereotactic Neurosurgery (R.C.), and Pediatric Neurosurgery (D.S.), APHM, Timone Hospital, Institut de Neurosciences des Systèmes (F.P., N.R., B.G., S.L., R.C., D.S., A.M., I.L., F. Bonini, A.T., C.-G.B, F. Bartolomei), INSERM, Aix Marseille Universite; and Psychiatrie et Neurosciences (C.F.), GHU Paris, St Anne, Paris.
| | - Nicolas Roehri
- From the Epileptology Department (F.P., S.L., A.M., I.L., F. Bonini, A.T., F. Bartolomei), Functional and Stereotactic Neurosurgery (R.C.), and Pediatric Neurosurgery (D.S.), APHM, Timone Hospital, Institut de Neurosciences des Systèmes (F.P., N.R., B.G., S.L., R.C., D.S., A.M., I.L., F. Bonini, A.T., C.-G.B, F. Bartolomei), INSERM, Aix Marseille Universite; and Psychiatrie et Neurosciences (C.F.), GHU Paris, St Anne, Paris
| | - Bernard Giusiano
- From the Epileptology Department (F.P., S.L., A.M., I.L., F. Bonini, A.T., F. Bartolomei), Functional and Stereotactic Neurosurgery (R.C.), and Pediatric Neurosurgery (D.S.), APHM, Timone Hospital, Institut de Neurosciences des Systèmes (F.P., N.R., B.G., S.L., R.C., D.S., A.M., I.L., F. Bonini, A.T., C.-G.B, F. Bartolomei), INSERM, Aix Marseille Universite; and Psychiatrie et Neurosciences (C.F.), GHU Paris, St Anne, Paris
| | - Stanislas Lagarde
- From the Epileptology Department (F.P., S.L., A.M., I.L., F. Bonini, A.T., F. Bartolomei), Functional and Stereotactic Neurosurgery (R.C.), and Pediatric Neurosurgery (D.S.), APHM, Timone Hospital, Institut de Neurosciences des Systèmes (F.P., N.R., B.G., S.L., R.C., D.S., A.M., I.L., F. Bonini, A.T., C.-G.B, F. Bartolomei), INSERM, Aix Marseille Universite; and Psychiatrie et Neurosciences (C.F.), GHU Paris, St Anne, Paris
| | - Romain Carron
- From the Epileptology Department (F.P., S.L., A.M., I.L., F. Bonini, A.T., F. Bartolomei), Functional and Stereotactic Neurosurgery (R.C.), and Pediatric Neurosurgery (D.S.), APHM, Timone Hospital, Institut de Neurosciences des Systèmes (F.P., N.R., B.G., S.L., R.C., D.S., A.M., I.L., F. Bonini, A.T., C.-G.B, F. Bartolomei), INSERM, Aix Marseille Universite; and Psychiatrie et Neurosciences (C.F.), GHU Paris, St Anne, Paris
| | - Didier Scavarda
- From the Epileptology Department (F.P., S.L., A.M., I.L., F. Bonini, A.T., F. Bartolomei), Functional and Stereotactic Neurosurgery (R.C.), and Pediatric Neurosurgery (D.S.), APHM, Timone Hospital, Institut de Neurosciences des Systèmes (F.P., N.R., B.G., S.L., R.C., D.S., A.M., I.L., F. Bonini, A.T., C.-G.B, F. Bartolomei), INSERM, Aix Marseille Universite; and Psychiatrie et Neurosciences (C.F.), GHU Paris, St Anne, Paris
| | - Aileen McGonigal
- From the Epileptology Department (F.P., S.L., A.M., I.L., F. Bonini, A.T., F. Bartolomei), Functional and Stereotactic Neurosurgery (R.C.), and Pediatric Neurosurgery (D.S.), APHM, Timone Hospital, Institut de Neurosciences des Systèmes (F.P., N.R., B.G., S.L., R.C., D.S., A.M., I.L., F. Bonini, A.T., C.-G.B, F. Bartolomei), INSERM, Aix Marseille Universite; and Psychiatrie et Neurosciences (C.F.), GHU Paris, St Anne, Paris
| | - Cristina Filipescu
- From the Epileptology Department (F.P., S.L., A.M., I.L., F. Bonini, A.T., F. Bartolomei), Functional and Stereotactic Neurosurgery (R.C.), and Pediatric Neurosurgery (D.S.), APHM, Timone Hospital, Institut de Neurosciences des Systèmes (F.P., N.R., B.G., S.L., R.C., D.S., A.M., I.L., F. Bonini, A.T., C.-G.B, F. Bartolomei), INSERM, Aix Marseille Universite; and Psychiatrie et Neurosciences (C.F.), GHU Paris, St Anne, Paris
| | - Isabelle Lambert
- From the Epileptology Department (F.P., S.L., A.M., I.L., F. Bonini, A.T., F. Bartolomei), Functional and Stereotactic Neurosurgery (R.C.), and Pediatric Neurosurgery (D.S.), APHM, Timone Hospital, Institut de Neurosciences des Systèmes (F.P., N.R., B.G., S.L., R.C., D.S., A.M., I.L., F. Bonini, A.T., C.-G.B, F. Bartolomei), INSERM, Aix Marseille Universite; and Psychiatrie et Neurosciences (C.F.), GHU Paris, St Anne, Paris
| | - Francesca Bonini
- From the Epileptology Department (F.P., S.L., A.M., I.L., F. Bonini, A.T., F. Bartolomei), Functional and Stereotactic Neurosurgery (R.C.), and Pediatric Neurosurgery (D.S.), APHM, Timone Hospital, Institut de Neurosciences des Systèmes (F.P., N.R., B.G., S.L., R.C., D.S., A.M., I.L., F. Bonini, A.T., C.-G.B, F. Bartolomei), INSERM, Aix Marseille Universite; and Psychiatrie et Neurosciences (C.F.), GHU Paris, St Anne, Paris
| | - Agnes Trebuchon
- From the Epileptology Department (F.P., S.L., A.M., I.L., F. Bonini, A.T., F. Bartolomei), Functional and Stereotactic Neurosurgery (R.C.), and Pediatric Neurosurgery (D.S.), APHM, Timone Hospital, Institut de Neurosciences des Systèmes (F.P., N.R., B.G., S.L., R.C., D.S., A.M., I.L., F. Bonini, A.T., C.-G.B, F. Bartolomei), INSERM, Aix Marseille Universite; and Psychiatrie et Neurosciences (C.F.), GHU Paris, St Anne, Paris
| | - Christian-George Bénar
- From the Epileptology Department (F.P., S.L., A.M., I.L., F. Bonini, A.T., F. Bartolomei), Functional and Stereotactic Neurosurgery (R.C.), and Pediatric Neurosurgery (D.S.), APHM, Timone Hospital, Institut de Neurosciences des Systèmes (F.P., N.R., B.G., S.L., R.C., D.S., A.M., I.L., F. Bonini, A.T., C.-G.B, F. Bartolomei), INSERM, Aix Marseille Universite; and Psychiatrie et Neurosciences (C.F.), GHU Paris, St Anne, Paris
| | - Fabrice Bartolomei
- From the Epileptology Department (F.P., S.L., A.M., I.L., F. Bonini, A.T., F. Bartolomei), Functional and Stereotactic Neurosurgery (R.C.), and Pediatric Neurosurgery (D.S.), APHM, Timone Hospital, Institut de Neurosciences des Systèmes (F.P., N.R., B.G., S.L., R.C., D.S., A.M., I.L., F. Bonini, A.T., C.-G.B, F. Bartolomei), INSERM, Aix Marseille Universite; and Psychiatrie et Neurosciences (C.F.), GHU Paris, St Anne, Paris.
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He X, Chaitanya G, Asma B, Caciagli L, Bassett DS, Tracy JI, Sperling MR. Disrupted basal ganglia-thalamocortical loops in focal to bilateral tonic-clonic seizures. Brain 2020; 143:175-190. [PMID: 31860076 DOI: 10.1093/brain/awz361] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 08/16/2019] [Accepted: 09/24/2019] [Indexed: 02/07/2023] Open
Abstract
Focal to bilateral tonic-clonic seizures are associated with lower quality of life, higher risk of seizure-related injuries, increased chance of sudden unexpected death, and unfavourable treatment outcomes. Achieving greater understanding of their underlying circuitry offers better opportunity to control these seizures. Towards this goal, we provide a network science perspective of the interactive pathways among basal ganglia, thalamus and cortex, to explore the imprinting of secondary seizure generalization on the mesoscale brain network in temporal lobe epilepsy. Specifically, we parameterized the functional organization of both the thalamocortical network and the basal ganglia-thalamus network with resting state functional MRI in three groups of patients with different focal to bilateral tonic-clonic seizure histories. Using the participation coefficient to describe the pattern of thalamocortical connections among different cortical networks, we showed that, compared to patients with no previous history, those with positive histories of focal to bilateral tonic-clonic seizures, including both remote (none for >1 year) and current (within the past year) histories, presented more uniform distribution patterns of thalamocortical connections in the ipsilateral medial-dorsal thalamic nuclei. As a sign of greater thalamus-mediated cortico-cortical communication, this result comports with greater susceptibility to secondary seizure generalization from the epileptogenic temporal lobe to broader brain networks in these patients. Using interregional integration to characterize the functional interaction between basal ganglia and thalamus, we demonstrated that patients with current history presented increased interaction between putamen and globus pallidus internus, and decreased interaction between the latter and the thalamus, compared to the other two patient groups. Importantly, through a series of 'disconnection' simulations, we showed that these changes in interactive profiles of the basal ganglia-thalamus network in the current history group mainly depended upon the direct but not the indirect basal ganglia pathway. It is intuitively plausible that such disruption in the striatum-modulated tonic inhibition of the thalamus from the globus pallidus internus could lead to an under-suppressed thalamus, which in turn may account for their greater vulnerability to secondary seizure generalization. Collectively, these findings suggest that the broken balance between basal ganglia inhibition and thalamus synchronization can inform the presence and effective control of focal to bilateral tonic-clonic seizures. The mechanistic underpinnings we uncover may shed light on the development of new treatment strategies for patients with temporal lobe epilepsy.
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Affiliation(s)
- Xiaosong He
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ganne Chaitanya
- Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Burcu Asma
- Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Lorenzo Caciagli
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Danielle S Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Electrical and Systems Engineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Santa Fe Institute, Santa Fe, New Mexico, USA
| | - Joseph I Tracy
- Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Michael R Sperling
- Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Khoo CS, Kim SE, Lee BI, Shin KJ, Ha SY, Park J, Park KM, Bae SY, Lee D, Kim BJ, Bae MJ, Kim SE. Characteristics of Perfusion Computed Tomography Imaging in Patients with Seizures Mimicking Acute Stroke. Eur Neurol 2020; 83:56-64. [DOI: 10.1159/000506591] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 02/15/2020] [Indexed: 11/19/2022]
Abstract
Introduction: Seizures as acute stroke mimics are a diagnostic challenge. Objective: The aim of the study was to characterize the perfusion patterns on perfusion computed tomography (PCT) in patients with seizures masquerading as acute stroke. Methods: We conducted a study on patients with acute seizures as stroke mimics. The inclusion criteria for this study were patients (1) initially presenting with stroke-like symptoms but finally diagnosed to have seizures and (2) with PCT performed within 72 h of seizures. The PCT of seizure patients (n = 27) was compared with that of revascularized stroke patients (n = 20) as the control group. Results: Among the 27 patients with seizures as stroke mimics, 70.4% (n = 19) showed characteristic PCT findings compared with the revascularized stroke patients, which were as follows: (1) multi-territorial cortical hyperperfusion {(73.7% [14/19] vs. 0% [0/20], p = 0.002), sensitivity of 73.7%, negative predictive value (NPV) of 80%}, (2) involvement of the ipsilateral thalamus {(57.9% [11/19] vs. 0% [0/20], p = 0.007), sensitivity of 57.9%, NPV of 71.4%}, and (3) reduced perfusion time {(84.2% [16/19] vs. 0% [0/20], p = 0.001), sensitivity of 84.2%, NPV of 87%}. These 3 findings had 100% specificity and positive predictive value in predicting patients with acute seizures in comparison with reperfused stroke patients. Older age was strongly associated with abnormal perfusion changes (p = 0.038), with a mean age of 66.8 ± 14.5 years versus 49.2 ± 27.4 years (in seizure patients with normal perfusion scan). Conclusions: PCT is a reliable tool to differentiate acute seizures from acute stroke in the emergency setting.
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Novitskaya Y, Dümpelmann M, Vlachos A, Reinacher PC, Schulze-Bonhage A. In vivo-assessment of the human temporal network: Evidence for asymmetrical effective connectivity. Neuroimage 2020; 214:116769. [PMID: 32217164 DOI: 10.1016/j.neuroimage.2020.116769] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/22/2020] [Accepted: 03/19/2020] [Indexed: 11/16/2022] Open
Abstract
The human temporal lobe is a multimodal association area which plays a key role in various aspects of cognition, particularly in memory formation and spatial navigation. Functional and anatomical connectivity of temporal structures is thus a subject of intense research, yet by far underexplored in humans due to ethical and technical limitations. We assessed intratemporal cortico-cortical interactions in the living human brain by means of single pulse electrical stimulation, an invasive method allowing mapping effective intracortical connectivity with a high spatiotemporal resolution. Eighteen subjects with normal anterior-mesial temporal MR imaging undergoing intracranial presurgical epilepsy diagnostics with multiple depth electrodes were included. The investigated structures were temporal pole, hippocampus, amygdala and parahippocampal gyrus. Intratemporal cortical connectivity was assessed as a function of amplitude of the early component of the cortico-cortical evoked potentials (CCEP). While the analysis revealed robust interconnectivity between all explored structures, a clear asymmetry in bidirectional connectivity was detected for the hippocampal network and for the connections between the temporal pole and parahippocampal gyrus. The amygdala showed bidirectional asymmetry only to the hippocampus. The provided evidence of asymmetrically weighed intratemporal effective connectivity in humans in vivo is important for understanding of functional interactions within the temporal lobe since asymmetries in the brain connectivity define hierarchies in information processing. The findings are in exact accord with the anatomical tracing studies in non-human primates and open a translational route for interventions employing modulation of temporal lobe function.
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Affiliation(s)
- Yulia Novitskaya
- Epilepsy Center, Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany.
| | - Matthias Dümpelmann
- Epilepsy Center, Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany
| | - Andreas Vlachos
- Department of Neuroanatomy, Institute of Anatomy and Cell Biology, Faculty of Medicine, University of Freiburg, Albert Strasse 17, 79104, Freiburg, Germany; Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany
| | - Peter Christoph Reinacher
- Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany
| | - Andreas Schulze-Bonhage
- Epilepsy Center, Department of Neurosurgery, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany; Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany
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36
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Khoo CS, Lee D, Park KM, In Lee B, Kim SE. A rare but treatable cause of recurrent chest pain - Ictal chest pain. BMC Neurol 2019; 19:348. [PMID: 31888520 PMCID: PMC6936059 DOI: 10.1186/s12883-019-1575-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 12/15/2019] [Indexed: 11/10/2022] Open
Abstract
Background Chest pain as the primary manifestation of epilepsy is extremely rare and has only been reported once to date. Case presentation We herein describe a 47-year-old woman with recurrent chest pain for 3 years. The cause of her chest pain remained elusive despite extensive investigations including comprehensive cardiac work-up. She was referred to the neurology clinic for one episode of confusion. Video-electroencephalographic monitoring detected unequivocal ictal changes during her habitual chest pain events. She has remained chest pain (seizure) free with a single antiseizure drug. Conclusions This case underlines the importance of epilepsy as a rare yet treatable cause of recurrent chest pain. Further studies are required to determine the pathophysiology of ictal chest pain.
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Affiliation(s)
- Ching Soong Khoo
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 612896, Republic of Korea. .,Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
| | - Dongah Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 612896, Republic of Korea
| | - Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 612896, Republic of Korea
| | - Byung In Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 612896, Republic of Korea
| | - Sung Eun Kim
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 612896, Republic of Korea
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Yu T, Wang X, Li Y, Zhang G, Worrell G, Chauvel P, Ni D, Qiao L, Liu C, Li L, Ren L, Wang Y. High-frequency stimulation of anterior nucleus of thalamus desynchronizes epileptic network in humans. Brain 2019; 141:2631-2643. [PMID: 29985998 DOI: 10.1093/brain/awy187] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 05/26/2018] [Indexed: 12/14/2022] Open
Abstract
Epilepsy has been classically seen as a brain disorder resulting from abnormally enhanced neuronal excitability and synchronization. Although it has been described since antiquity, there are still significant challenges achieving the therapeutic goal of seizure freedom. Deep brain stimulation of the anterior nucleus of the thalamus has emerged as a promising therapy for focal drug-resistant epilepsy; the basic mechanism of action, however, remains unclear. Here, we show that desynchronization is a potential mechanism of deep brain stimulation of the anterior nucleus of the thalamus by studying local field potentials recordings from the cortex during high-frequency stimulation (130 Hz) of the anterior nucleus of the thalamus in nine patients with drug-resistant focal epilepsy. We demonstrate that high-frequency stimulation applied to the anterior nucleus of the thalamus desynchronizes ipsilateral hippocampal background electrical activity over a broad frequency range, and reduces pathological epileptic discharges including interictal spikes and high-frequency oscillations. Furthermore, high-frequency stimulation of the anterior nucleus of the thalamus is capable of decoupling large-scale neural activity involving the hippocampus and distributed cortical areas. We found that stimulation frequencies ranging from 15 to 45 Hz were associated with synchronization of hippocampal local field potentials, whereas higher frequencies (>45 Hz) promoted desynchronization of ipsilateral hippocampal activity. Moreover, reciprocal effective connectivity between the anterior nucleus of the thalamus and the hippocampus was demonstrated by hippocampal-thalamic evoked potentials and thalamic-hippocampal evoked potentials. In summary, high-frequency stimulation of the anterior nucleus of the thalamus is shown to desynchronize focal and large-scale epileptic networks, and here is proposed as the mechanism for reducing seizure generation and propagation. Our data also demonstrate position-specific correlation between deep brain stimulation applied to the anterior nucleus of the thalamus and patients with temporal lobe epilepsy and seizure onset zone within the Papaz circuit or limbic system. Our observation may prove useful for guiding electrode implantation to increase clinical efficacy.
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Affiliation(s)
- Tao Yu
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China
| | - Xueyuan Wang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China
| | - Yongjie Li
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China
| | - Guojun Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China
| | - Gregory Worrell
- Mayo Systems Electrophysiology Laboratory, Departments of Neurology and Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
| | - Patrick Chauvel
- UMR 1106 INSERM, Institut de Neurosciences des Systemes, Aix-Marseille University, Marseille, France; Epilepsy Center, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Duanyu Ni
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China
| | - Liang Qiao
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China
| | - Chang Liu
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China
| | - Liping Li
- Comprehensive Epilepsy Center of Beijing, The Beijing Key Laboratory of Neuromodulation, Department of Neurology, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China
| | - Liankun Ren
- Comprehensive Epilepsy Center of Beijing, The Beijing Key Laboratory of Neuromodulation, Department of Neurology, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China
| | - Yuping Wang
- Comprehensive Epilepsy Center of Beijing, The Beijing Key Laboratory of Neuromodulation, Department of Neurology, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China
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Filipescu C, Lagarde S, Lambert I, Pizzo F, Trébuchon A, McGonigal A, Scavarda D, Carron R, Bartolomei F. The effect of medial pulvinar stimulation on temporal lobe seizures. Epilepsia 2019; 60:e25-e30. [DOI: 10.1111/epi.14677] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/02/2019] [Accepted: 01/29/2019] [Indexed: 01/08/2023]
Affiliation(s)
- Cristina Filipescu
- Clinical Neurophysiology and Epileptology Department Timone Hospital Assitance Publique Hôpitaux de Marseille Marseille France
| | - Stanislas Lagarde
- Clinical Neurophysiology and Epileptology Department Timone Hospital Assitance Publique Hôpitaux de Marseille Marseille France
- National Institute of Health and Medical Research Institut de Neurosciences des Systèmes Aix‐Marseille University Marseille France
| | - Isabelle Lambert
- Clinical Neurophysiology and Epileptology Department Timone Hospital Assitance Publique Hôpitaux de Marseille Marseille France
- National Institute of Health and Medical Research Institut de Neurosciences des Systèmes Aix‐Marseille University Marseille France
| | - Francesca Pizzo
- Clinical Neurophysiology and Epileptology Department Timone Hospital Assitance Publique Hôpitaux de Marseille Marseille France
- National Institute of Health and Medical Research Institut de Neurosciences des Systèmes Aix‐Marseille University Marseille France
| | - Agnès Trébuchon
- Clinical Neurophysiology and Epileptology Department Timone Hospital Assitance Publique Hôpitaux de Marseille Marseille France
- National Institute of Health and Medical Research Institut de Neurosciences des Systèmes Aix‐Marseille University Marseille France
| | - Aileen McGonigal
- Clinical Neurophysiology and Epileptology Department Timone Hospital Assitance Publique Hôpitaux de Marseille Marseille France
- National Institute of Health and Medical Research Institut de Neurosciences des Systèmes Aix‐Marseille University Marseille France
| | - Didier Scavarda
- National Institute of Health and Medical Research Institut de Neurosciences des Systèmes Aix‐Marseille University Marseille France
- Pediatric Neurosurgery Department Timone Hospital Assitance Publique Hôpitaux de Marseille Marseille France
| | - Romain Carron
- National Institute of Health and Medical Research Institut de Neurosciences des Systèmes Aix‐Marseille University Marseille France
- Functional and Stereotactic Neurosurgery Assitance Publique Hôpitaux de Marseille Marseille France
| | - Fabrice Bartolomei
- Clinical Neurophysiology and Epileptology Department Timone Hospital Assitance Publique Hôpitaux de Marseille Marseille France
- National Institute of Health and Medical Research Institut de Neurosciences des Systèmes Aix‐Marseille University Marseille France
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Park KM, Lee BI, Shin KJ, Ha SY, Park J, Kim SE, Kim SE. Pivotal Role of Subcortical Structures as a Network Hub in Focal Epilepsy: Evidence from Graph Theoretical Analysis Based on Diffusion-Tensor Imaging. J Clin Neurol 2019; 15:68-76. [PMID: 30618219 PMCID: PMC6325361 DOI: 10.3988/jcn.2019.15.1.68] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/24/2018] [Accepted: 08/24/2018] [Indexed: 12/02/2022] Open
Abstract
Background and Purpose There is accumulating evidence that epilepsy is caused by network dysfunction. We evaluated the hub reorganization of subcortical structures in patients with focal epilepsy using graph theoretical analysis based on diffusion-tensor imaging (DTI). In addition, we investigated differences in the values of diffusion tensors and scalars, fractional anisotropy (FA), and mean diffusivity (MD) of subcortical structures between patients with focal epilepsy and healthy subjects. Methods One hundred patients with focal epilepsy and normal magnetic resonance imaging (MRI) findings and 80 age- and sex-matched healthy subjects were recruited prospectively. All subjects underwent DTI to obtain data suitable for graph theoretical analysis. We investigated the differences in the node strength, cluster coefficient, eigenvector centrality, page-rank centrality measures, FA, and MD of subcortical structures between patients with epilepsy and healthy subjects. Results After performing multiple corrections, the cluster coefficient and the eigenvector centrality of the globus pallidus were higher in patients with epilepsy than in healthy subjects (p=0.006 and p=0.008, respectively). In addition, the strength and the page-rank centrality of the globus pallidus tended to be higher in patients with epilepsy than in healthy subjects (p=0.092 and p=0.032, respectively). The cluster coefficient of the putamen was lower in patients with epilepsy than in healthy subjects (p=0.004). The FA values of the caudate nucleus and thalamus were significantly lower in patients with epilepsy than in healthy subjects (p=0.009 and p=0.007, respectively), whereas the MD value of the thalamus was higher than that in healthy subjects (p=0.005). Conclusions We discovered the presence of hub reorganization of subcortical structures in focal epilepsy patients with normal MRI findings, suggesting that subcortical structures play a pivotal role as a hub in the epilepsy network. These findings further reinforce the idea that epilepsy is a network disease.
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Affiliation(s)
- Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Byung In Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Kyong Jin Shin
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sam Yeol Ha
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - JinSe Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Si Eun Kim
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sung Eun Kim
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
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Chen C, Li H, Ding F, Yang L, Huang P, Wang S, Jin B, Xu C, Wang Y, Ding M, Chen Z, Wang S. Alterations in the hippocampal-thalamic pathway underlying secondarily generalized tonic-clonic seizures in mesial temporal lobe epilepsy: A diffusion tensor imaging study. Epilepsia 2018; 60:121-130. [PMID: 30478929 DOI: 10.1111/epi.14614] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 11/05/2018] [Accepted: 11/05/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Cong Chen
- Department of Neurology; Epilepsy Center; Second Affiliated Hospital; School of Medicine; Zhejiang University; Hangzhou China
| | - Hong Li
- Department of Radiology; Second Affiliated Hospital; School of Medicine; Zhejiang University; Hangzhou China
| | - Fang Ding
- Department of Neurology; Epilepsy Center; Second Affiliated Hospital; School of Medicine; Zhejiang University; Hangzhou China
| | - Linglin Yang
- Department of Neurology; Epilepsy Center; Second Affiliated Hospital; School of Medicine; Zhejiang University; Hangzhou China
| | - Peiyu Huang
- Department of Radiology; Second Affiliated Hospital; School of Medicine; Zhejiang University; Hangzhou China
| | - Shan Wang
- Department of Neurology; Epilepsy Center; Second Affiliated Hospital; School of Medicine; Zhejiang University; Hangzhou China
| | - Bo Jin
- Department of Neurology; Epilepsy Center; Second Affiliated Hospital; School of Medicine; Zhejiang University; Hangzhou China
| | - Cenglin Xu
- Key Laboratory of Medical Neurobiology of the Ministry of Health of China; Zhejiang Province Key Laboratory of Neurobiology; Department of Pharmacology; College of Pharmaceutical Sciences; Zhejiang University; Hangzhou China
| | - Yi Wang
- Key Laboratory of Medical Neurobiology of the Ministry of Health of China; Zhejiang Province Key Laboratory of Neurobiology; Department of Pharmacology; College of Pharmaceutical Sciences; Zhejiang University; Hangzhou China
| | - Meiping Ding
- Department of Neurology; Epilepsy Center; Second Affiliated Hospital; School of Medicine; Zhejiang University; Hangzhou China
| | - Zhong Chen
- Department of Neurology; Epilepsy Center; Second Affiliated Hospital; School of Medicine; Zhejiang University; Hangzhou China
- Key Laboratory of Medical Neurobiology of the Ministry of Health of China; Zhejiang Province Key Laboratory of Neurobiology; Department of Pharmacology; College of Pharmaceutical Sciences; Zhejiang University; Hangzhou China
| | - Shuang Wang
- Department of Neurology; Epilepsy Center; Second Affiliated Hospital; School of Medicine; Zhejiang University; Hangzhou China
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Delayed high-frequency suppression after automated single-pulse electrical stimulation identifies the seizure onset zone in patients with refractory epilepsy. Clin Neurophysiol 2018; 129:2466-2474. [DOI: 10.1016/j.clinph.2018.06.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/14/2018] [Accepted: 06/27/2018] [Indexed: 11/19/2022]
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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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Aracri P, de Curtis M, Forcaia G, Uva L. Enhanced thalamo-hippocampal synchronization during focal limbic seizures. Epilepsia 2018; 59:1774-1784. [DOI: 10.1111/epi.14521] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 07/05/2018] [Accepted: 07/05/2018] [Indexed: 01/21/2023]
Affiliation(s)
- Patrizia Aracri
- Epilepsy Unit; Fondazione Istituto Neurologico Carlo Besta; Milano Italy
| | - Marco de Curtis
- Epilepsy Unit; Fondazione Istituto Neurologico Carlo Besta; Milano Italy
| | - Greta Forcaia
- Epilepsy Unit; Fondazione Istituto Neurologico Carlo Besta; Milano Italy
| | - Laura Uva
- Epilepsy Unit; Fondazione Istituto Neurologico Carlo Besta; Milano Italy
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Top-down, contextual entrainment of neuronal oscillations in the auditory thalamocortical circuit. Proc Natl Acad Sci U S A 2018; 115:E7605-E7614. [PMID: 30037997 PMCID: PMC6094129 DOI: 10.1073/pnas.1714684115] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Our results indicate that nonhuman primates detect complex repeating acoustic sequences in a continuous auditory stream, which is an important precursor for human speech learning and perception. We demonstrate that oscillatory entrainment, known to support the attentive perception of rhythmic stimulus sequences, can occur for rhythms defined solely by stimulus context rather than physical boundaries. As opposed to acoustically driven entrainment by rhythmic tone sequences demonstrated previously, this form of entrainment relies on the brain’s ability to group auditory inputs based on their statistical regularities. The internally initiated, context-driven modulation of excitability in the medial pulvinar prior to A1 supports the notion of top-down entrainment. Prior studies have shown that repetitive presentation of acoustic stimuli results in an alignment of ongoing neuronal oscillations to the sequence rhythm via oscillatory entrainment by external cues. Our study aimed to explore the neural correlates of the perceptual parsing and grouping of complex repeating auditory patterns that occur based solely on statistical regularities, or context. Human psychophysical studies suggest that the recognition of novel auditory patterns amid a continuous auditory stimulus sequence occurs automatically halfway through the first repetition. We hypothesized that once repeating patterns were detected by the brain, internal rhythms would become entrained, demarcating the temporal structure of these repetitions despite lacking external cues defining pattern on- or offsets. To examine the neural correlates of pattern perception, neuroelectric activity of primary auditory cortex (A1) and thalamic nuclei was recorded while nonhuman primates passively listened to streams of rapidly presented pure tones and bandpass noise bursts. At arbitrary intervals, random acoustic patterns composed of 11 stimuli were repeated five times without any perturbance of the constant stimulus flow. We found significant delta entrainment by these patterns in the A1, medial geniculate body, and medial pulvinar. In A1 and pulvinar, we observed a statistically significant, pattern structure-aligned modulation of neuronal firing that occurred earliest in the pulvinar, supporting the idea that grouping and detecting complex auditory patterns is a top-down, context-driven process. Besides electrophysiological measures, a pattern-related modulation of pupil diameter verified that, like humans, nonhuman primates consciously detect complex repetitive patterns that lack physical boundaries.
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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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Santyr BG, Lau JC, Mirsattari SM, Burneo JG, de Ribaupierre S, Steven DA, Parrent AG, MacDougall K, Khan AR. Novel connectivity map normalization procedure for improved quantitative investigation of structural thalamic connectivity in temporal lobe epilepsy patients. J Magn Reson Imaging 2018; 48:1529-1539. [PMID: 29570898 DOI: 10.1002/jmri.26013] [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: 10/13/2017] [Accepted: 03/01/2018] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Connectivity studies targeting the thalamus have revealed patterns of atrophy and deafferentiation in temporal lobe epilepsy (TLE). The thalamus can be parcellated using probabilistic tractography to demonstrate regions of cortical connectivity; however, sensitivity to smaller or less connected regions is low. PURPOSE/HYPOTHESIS To investigate thalamic structural connectivity in a wider range of cortical and limbic structures in TLE patients using a novel connectivity map normalization procedure. STUDY TYPE Retrospective. POPULATION/SUBJECTS Patients (N = 23) with medication-resistant TLE and 34 healthy age-matched controls. FIELD STRENGTH/SEQUENCE For T1 and diffusion weighting a spoiled gradient sequence was used (41 gradient directions [b = 1000]). For T2 mapping balanced steady-state free precession was used. Images were acquired at 3T. ASSESSMENT Probabilistic tractography and a novel normalization procedure allowed comparison of groups with respect to thalamic connected volume, quantitative MRI, and diffusion tensor imaging (DTI) metrics. STATISTICAL TESTS Independent samples t-test, Cohen's d, and Mann-Whitney tests. RESULTS Following normalization, significant differences in thalamic connected volumes were found in left TLE vs. controls bilaterally within the posterior parahippocampal gyrus (L: P = 0.007, confidence interval [CI]: [173.306,1044.41], effect size [ES] = 1.072; R: P = 0.017, CI: [98.677,947.653], ES = 0.945), and contralaterally in the anterior temporal neocortex (P = 0.01, CI: (-2348.09, -333.719), ES = -1.021). This procedure revealed differences in thalamic connected volumes, where previously published procedures could not, and provided a basis for exploratory analysis of quantitative MRI and DTI metrics. DATA CONCLUSION The novel connectivity map normalization scheme proposed here successfully allowed comparison between a wider range of cortical and limbic structures. Multiple volumetric and quantitative MRI and DTI-related differences between TLE patients and controls were revealed following normalization. With validation from a larger cohort, thalamo-temporal connection aberrancies may become useful biomarkers of disease states and probabilistic tractography as a procedure for identification of thalamic targets in modulatory therapies for TLE. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;48:1529-1539.
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Affiliation(s)
- Brendan G Santyr
- Imaging Research Laboratories, Robarts Research Institute - Western University, London, Ontario, Canada
| | - Jonathan C Lau
- Imaging Research Laboratories, Robarts Research Institute - Western University, London, Ontario, Canada.,Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine - Western University, London, Ontario, Canada
| | - Seyed M Mirsattari
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine - Western University, London, Ontario, Canada
| | - Jorge G Burneo
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine - Western University, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine - Western University, London, Ontario, Canada
| | - Sandrine de Ribaupierre
- Imaging Research Laboratories, Robarts Research Institute - Western University, London, Ontario, Canada.,Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine - Western University, London, Ontario, Canada
| | - David A Steven
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine - Western University, London, Ontario, Canada
| | - Andrew G Parrent
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine - Western University, London, Ontario, Canada
| | - Keith MacDougall
- Epilepsy Program, Department of Clinical Neurological Sciences, Schulich School of Medicine - Western University, London, Ontario, Canada
| | - Ali R Khan
- Imaging Research Laboratories, Robarts Research Institute - Western University, London, Ontario, Canada.,Departments of Medical Biophysics and Medical Imaging - Western University, London, Ontario, Canada
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Wilke M, Schneider L, Dominguez-Vargas AU, Schmidt-Samoa C, Miloserdov K, Nazzal A, Dechent P, Cabral-Calderin Y, Scherberger H, Kagan I, Bähr M. Reach and grasp deficits following damage to the dorsal pulvinar. Cortex 2018; 99:135-149. [DOI: 10.1016/j.cortex.2017.10.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 07/17/2017] [Accepted: 10/02/2017] [Indexed: 10/18/2022]
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48
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Kotkowski E, Price LR, Mickle Fox P, Vanasse TJ, Fox PT. The hippocampal network model: A transdiagnostic metaconnectomic approach. NEUROIMAGE-CLINICAL 2018; 18:115-129. [PMID: 29387529 PMCID: PMC5789756 DOI: 10.1016/j.nicl.2018.01.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/05/2018] [Accepted: 01/06/2018] [Indexed: 12/14/2022]
Abstract
Purpose The hippocampus plays a central role in cognitive and affective processes and is commonly implicated in neurodegenerative diseases. Our study aimed to identify and describe a hippocampal network model (HNM) using trans-diagnostic MRI data from the BrainMap® database. We used meta-analysis to test the network degeneration hypothesis (NDH) (Seeley et al., 2009) by identifying structural and functional covariance in this hippocampal network. Methods To generate our network model, we used BrainMap's VBM database to perform a region-to-whole-brain (RtWB) meta-analysis of 269 VBM experiments from 165 published studies across a range of 38 psychiatric and neurological diseases reporting hippocampal gray matter density alterations. This step identified 11 significant gray matter foci, or nodes. We subsequently used meta-analytic connectivity modeling (MACM) to define edges of structural covariance between nodes from VBM data as well as functional covariance using the functional task-activation database, also from BrainMap. Finally, we applied a correlation analysis using Pearson's r to assess the similarities and differences between the structural and functional covariance models. Key findings Our hippocampal RtWB meta-analysis reported consistent and significant structural covariance in 11 key regions. The subsequent structural and functional MACMs showed a strong correlation between HNM nodes with a significant structural-functional covariance correlation of r = .377 (p = .000049). Significance This novel method of studying network covariance using VBM and functional meta-analytic techniques allows for the identification of generalizable patterns of functional and structural abnormalities pertaining to the hippocampus. In accordance with the NDH, this framework could have major implications in studying and predicting spatial disease patterns using network-based assays. We derived regions that structurally co-vary with the hippocampus in a network model using a transdiagnostic meta-analytic approach. We used meta-analytic connectivity mapping to assess inter-regional connectivity from BrainMap's structural and functional databases. We tested the network degeneration hypothesis by identifying network correlations between structural and functional networks.
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Affiliation(s)
- Eithan Kotkowski
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| | - Larry R Price
- Department of Mathematics, Texas State University, San Marcos, TX, USA; College of Education, Texas State University, San Marcos, TX, USA
| | - P Mickle Fox
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Thomas J Vanasse
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Institute for Neuroscience & Neurotechnology, Shenzhen University, Shenzen, China
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49
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Kuchcinski G, Munsch F, Lopes R, Bigourdan A, Su J, Sagnier S, Renou P, Pruvo JP, Rutt BK, Dousset V, Sibon I, Tourdias T. Thalamic alterations remote to infarct appear as focal iron accumulation and impact clinical outcome. Brain 2017; 140:1932-1946. [PMID: 28549087 DOI: 10.1093/brain/awx114] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 03/28/2017] [Indexed: 11/12/2022] Open
Abstract
See Duering and Schmidt (doi:10.1093/awx135) for a scientific commentary on this article.Thalamic alterations have been observed in infarcts initially sparing the thalamus but interrupting thalamo-cortical or cortico-thalamic projections. We aimed at extending this knowledge by demonstrating with in vivo imaging sensitive to iron accumulation, one marker of neurodegeneration, that (i) secondary thalamic alterations are focally located in specific thalamic nuclei depending on the initial infarct location; and (ii) such secondary alterations can contribute independently to the long-term outcome. To tackle this issue, 172 patients with an infarct initially sparing the thalamus were prospectively evaluated clinically and with magnetic resonance imaging to quantify iron through R2* map at 24-72 h and at 1-year follow-up. An asymmetry index was used to compare R2* within the thalamus ipsilateral versus contralateral to infarct and we focused on the 95th percentile of R2* as a metric of high iron content. Spatial distribution within the thalamus was analysed on an average R2* map from the entire cohort. The asymmetry index of the 95th percentile within individual nuclei (medio-dorsal, pulvinar, lateral group) were compared according to the initial infarct location in simple and multiple regression analyses and using voxel-based lesion-symptom mapping. Associations between the asymmetry index of the 95th percentile and functional, cognitive and emotional outcome were calculated in multiple regression models. We showed that R2* was not modified at 24-72 h but showed heterogeneous increase at 1 year mainly within the medio-dorsal and pulvinar nuclei. The asymmetry index of the 95th percentile within the medio-dorsal nucleus was significantly associated with infarcts involving anterior areas (frontal P = 0.05, temporal P = 0.02, lenticular P = 0.01) while the asymmetry index of the 95th percentile within the pulvinar nucleus was significantly associated with infarcts involving posterior areas (parietal P = 0.046, temporal P < 0.001) independently of age, gender and infarct volume, which was confirmed by voxel-based lesion-symptom mapping. The asymmetry index of the 95th percentile within the entire thalamus at 1 year was independently associated with poor functional outcome (P = 0.04), poor cognitive outcome (P = 0.03), post-stroke anxiety (P = 0.04) and post-stroke depression (P = 0.02). We have therefore identified that iron accumulates within the thalamus ipsilateral to infarct after a delay with a focal distribution that is strongly linked to the initial infarct location (in relation with the pattern of connectivity between thalamic nuclei and cortical areas or deep nuclei), which independently contributes to functional, cognitive and emotional outcome.
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Affiliation(s)
- Grégory Kuchcinski
- University of Lille, CHU Lille, Department of Neuroradiology, F-5900 Lille, France
| | - Fanny Munsch
- University of Bordeaux, CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, F-33076 Bordeaux, France.,INSERM, U1215, Neurocentre Magendie, F-33076 Bordeaux, France
| | - Renaud Lopes
- University of Lille, CHU Lille, Department of Neuroradiology, F-5900 Lille, France
| | - Antoine Bigourdan
- University of Bordeaux, CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, F-33076 Bordeaux, France
| | - Jason Su
- Richard M. Lucas Center for Imaging, Radiology Department, Stanford University, Stanford, CA 94305-5488, USA
| | - Sharmila Sagnier
- University of Bordeaux, CHU de Bordeaux, Unité neurovasculaire, F-33076 Bordeaux, France
| | - Pauline Renou
- University of Bordeaux, CHU de Bordeaux, Unité neurovasculaire, F-33076 Bordeaux, France
| | - Jean-Pierre Pruvo
- University of Lille, CHU Lille, Department of Neuroradiology, F-5900 Lille, France
| | - Brian K Rutt
- Richard M. Lucas Center for Imaging, Radiology Department, Stanford University, Stanford, CA 94305-5488, USA
| | - Vincent Dousset
- University of Bordeaux, CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, F-33076 Bordeaux, France.,INSERM, U1215, Neurocentre Magendie, F-33076 Bordeaux, France
| | - Igor Sibon
- University of Bordeaux, CHU de Bordeaux, Unité neurovasculaire, F-33076 Bordeaux, France
| | - Thomas Tourdias
- University of Bordeaux, CHU de Bordeaux, Neuroimagerie Diagnostique et Thérapeutique, F-33076 Bordeaux, France.,INSERM, U1215, Neurocentre Magendie, F-33076 Bordeaux, France
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50
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Dmochowski JP, Koessler L, Norcia AM, Bikson M, Parra LC. Optimal use of EEG recordings to target active brain areas with transcranial electrical stimulation. Neuroimage 2017; 157:69-80. [PMID: 28578130 PMCID: PMC5777160 DOI: 10.1016/j.neuroimage.2017.05.059] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 05/11/2017] [Accepted: 05/27/2017] [Indexed: 12/14/2022] Open
Abstract
To demonstrate causal relationships between brain and behavior, investigators would like to guide brain stimulation using measurements of neural activity. Particularly promising in this context are electroencephalography (EEG) and transcranial electrical stimulation (TES), as they are linked by a reciprocity principle which, despite being known for decades, has not led to a formalism for relating EEG recordings to optimal stimulation parameters. Here we derive a closed-form expression for the TES configuration that optimally stimulates (i.e., targets) the sources of recorded EEG, without making assumptions about source location or distribution. We also derive a duality between TES targeting and EEG source localization, and demonstrate that in cases where source localization fails, so does the proposed targeting. Numerical simulations with multiple head models confirm these theoretical predictions and quantify the achieved stimulation in terms of focality and intensity. We show that constraining the stimulation currents automatically selects optimal montages that involve only a few (4-7) electrodes, with only incremental loss in performance when targeting focal activations. The proposed technique allows brain scientists and clinicians to rationally target the sources of observed EEG and thus overcomes a major obstacle to the realization of individualized or closed-loop brain stimulation.
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Affiliation(s)
- Jacek P Dmochowski
- Department of Biomedical Engineering, Steinman Hall 460 City College of New York, New York, NY 10031, USA.
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