A Generalized Cortico-Muscular-Cortical Network to Evaluate the Effects of Three-Week Brain Stimulation

OBJECTIVE

Post-stroke transcranial magnetic stimulation (TMS) has gradually become a brain intervention to assist patients in the recovery of motor function. The long lasting regulatory of TMS may involve the coupling changes between cortex and muscles. However, the effects of multi-day TMS on motor recovery after stroke is unclear.

METHODS

This study proposed to quantify the effects of three-week TMS on brain activity and muscles movement performance based on a generalized cortico-muscular-cortical network (gCMCN). The gCMCN-based features were further extracted and combined with the partial least squares (PLS) method to predict the Fugl-Meyer of upper extremity (FMUE) in stroke patients, thereby establishing an objective rehabilitation method that can evaluate the positive effects of continuous TMS on motor function.

RESULTS

We found that the improvement of motor function after three-week TMS was significantly correlated with the complexity trend of information interaction between hemispheres and the intensity of corticomuscular coupling. In addition, the fitting coefficient ([Formula: see text]) for predicted and actual FMUE before and after TMS were 0.856 and 0.963, respectively, suggesting that the gCMCN-based measurement may be a promising method for evaluating the therapeutic effect of TMS.

CONCLUSION

From the perspective of a novel brain-muscles network with dynamic contraction as the entry point, this work quantified TMS-induced connectivity differences while evaluating the potential efficacy of multi-day TMS.

SIGNIFICANCE

It provides a unique insight for the further application of intervention therapy in the field of brain diseases.

Closed-Loop Construction and Analysis of Cortico-Muscular-Cortical Functional Network After Stroke

Brain networks allow a topological understanding into the pathophysiology of stroke-induced motor deficits, and have been an influential tool for investigating brain functions. Unfortunately, currently applied methods generally lack in the recognition of the dynamic changes in the cortical networks related to muscle activity, which is crucial to clarify the alterations of the cooperative working patterns in the motor control system after stroke. In this study, we integrate corticomuscular and intermuscular interactions to cortico-cortical network and propose a novel closed-loop construction of cortico-muscular-cortical functional network, named closed-loop network (CLN). Directional characteristic in terms of differentiating causal interactions is endowed on basis of the CLN framework, further expanding the definition of functional connectivity (FC) and effective connectivity (EC) dedicated to CLN. Next, CLN is applied to stroke patients to reveal the underlying after-effects mechanism of low frequency repetitive transcranial magnetic stimulation (rTMS) induced alterations of cortical physiologic functions during movement. Results show that the short-term modulation of rTMS is reflected in the enhancement of information interaction within the interhemispheric primary motor regions and inhibition of the coupling between motor cortex and effector muscles. CLN provides a new perspective for the study of motor-related cortical networks with muscle activities involvement instead of being restricted to brain network analysis of behaviors.

Effective Connectivity of the Hippocampus Can Differentiate Patients with Schizophrenia from Healthy Controls: A Spectral DCM Approach

We applied spectral dynamic causal modelling (Friston et al. in Neuroimage 94:396–407. 10.1016/j.neuroimage.2013.12.009, 2014) to analyze the effective connectivity differences between the nodes of three resting state networks (i.e. default mode network, salience network and dorsal attention network) in a dataset of 31 male healthy controls (HC) and 25 male patients with a diagnosis of schizophrenia (SZ). Patients showed increased directed connectivity from the left hippocampus (LHC) to the: dorsal anterior cingulate cortex (DACC), right anterior insula (RAI), left frontal eye fields and the bilateral inferior parietal sulcus (LIPS & RIPS), as well as increased connectivity from the right hippocampus (RHC) to the: bilateral anterior insula (LAI & RAI), right frontal eye fields and RIPS. In SZ, negative symptoms predicted the connectivity strengths from the LHC to: the DACC, the left inferior parietal sulcus (LIPAR) and the RHC, while positive symptoms predicted the connectivity strengths from the LHC to the LIPAR and from the RHC to the LHC. These results reinforce the crucial role of hippocampus dysconnectivity in SZ pathology and its potential as a biomarker of disease severity.

Dynamic Causal Modeling Self-Connectivity Findings in the Functional Magnetic Resonance Imaging Neuropsychiatric Literature

Dynamic causal modeling (DCM) is a method for analyzing functional magnetic resonance imaging (fMRI) and other functional neuroimaging data that provides information about directionality of connectivity between brain regions. A review of the neuropsychiatric fMRI DCM literature suggests that there may be a historical trend to under-report self-connectivity (within brain regions) compared to between brain region connectivity findings. These findings are an integral part of the neurologic model represented by DCM and serve an important neurobiological function in regulating excitatory and inhibitory activity between regions. We reviewed the literature on the topic as well as the past 13 years of available neuropsychiatric DCM literature to find an increasing (but still, perhaps, and inadequate) trend in reporting these results. The focus of this review is fMRI as the majority of published DCM studies utilized fMRI and the interpretation of the self-connectivity findings may vary across imaging methodologies. About 25% of articles published between 2007 and 2019 made any mention of self-connectivity findings. We recommend increased attention toward the inclusion and interpretation of self-connectivity findings in DCM analyses in the neuropsychiatric literature, particularly in forthcoming effective connectivity studies of substance use disorders.

Impact of Machine Learning Pipeline Choices in Autism Prediction From Functional Connectivity Data

Autism Spectrum Disorder (ASD) is a largely prevalent neurodevelopmental condition with a big social and economical impact affecting the entire life of families. There is an intense search for biomarkers that can be assessed as early as possible in order to initiate treatment and preparation of the family to deal with the challenges imposed by the condition. Brain imaging biomarkers have special interest. Specifically, functional connectivity data extracted from resting state functional magnetic resonance imaging (rs-fMRI) should allow to detect brain connectivity alterations. Machine learning pipelines encompass the estimation of the functional connectivity matrix from brain parcellations, feature extraction, and building classification models for ASD prediction. The works reported in the literature are very heterogeneous from the computational and methodological point of view. In this paper, we carry out a comprehensive computational exploration of the impact of the choices involved while building these machine learning pipelines. Specifically, we consider six brain parcellation definitions, five methods for functional connectivity matrix construction, six feature extraction/selection approaches, and nine classifier building algorithms. We report the prediction performance sensitivity to each of these choices, as well as the best results that are comparable with the state of the art.

Acrophobia Quantified by EEG Based on CNN Incorporating Granger Causality

The aim of this study is to quantify acrophobia and provide safety advices for high-altitude workers. Considering that acrophobia is a fuzzy quantity that cannot be accurately evaluated by conventional detection methods, we propose a comprehensive solution to quantify acrophobia. Specifically, this study simulates a virtual reality environment called High-altitude Plank Walking Challenge, which provides a safe and controlled experimental environment for subjects. Besides, a method named Granger Causality Convolutional Neural Network (GCCNN) combining convolutional neural network and Granger causality functional brain network is proposed to analyze the subjects' noninvasive scalp EEG signals. Here, the GCCNN method is used to distinguish the subjects with severe acrophobia, moderate acrophobia, and no acrophobia in a three-class classification task or no acrophobia and acrophobia in a two-class classification task. Compared with the mainstream methods, the GCCNN method achieves better classification performance, with an accuracy of 98.74% for the two-class classification task (no acrophobia versus acrophobia) and of 98.47% for the three-class classification task (no acrophobia versus moderate acrophobia versus severe acrophobia). Consequently, our proposed GCCNN method can provide more accurate quantitative results than the comparative methods, making it to be more competitive in further practical applications.

Characterisation of Haemodynamic Activity in Resting State Networks by Fractal Analysis

Intrinsic brain activity is organized into large-scale networks displaying specific structural-functional architecture, known as resting-state networks (RSNs). RSNs reflect complex neurophysiological processes and interactions, and have a central role in distinct sensory and cognitive functions, making it crucial to understand and quantify their anatomical and functional properties. Fractal dimension (FD) provides a parsimonious way of summarizing self-similarity over different spatial and temporal scales but despite its suitability for functional magnetic resonance imaging (fMRI) signal analysis its ability to characterize and investigate RSNs is poorly understood. We used FD in a large sample of healthy participants to differentiate fMRI RSNs and examine how the FD property of RSNs is linked with their functional roles. We identified two clusters of RSNs, one mainly consisting of sensory networks (C1, including auditory, sensorimotor and visual networks) and the other more related to higher cognitive (HCN) functions (C2, including dorsal default mode network and fronto-parietal networks). These clusters were defined in a completely data-driven manner using hierarchical clustering, suggesting that quantification of Blood Oxygen Level Dependent (BOLD) signal complexity with FD is able to characterize meaningful physiological and functional variability. Understanding the mechanisms underlying functional RSNs, and developing tools to study their signal properties, is essential for assessing specific brain alterations and FD could potentially be used for the early detection and treatment of neurological disorders.

Improved Activity Recognition Combining Inertial Motion Sensors and Electroencephalogram Signals

Human activity recognition and neural activity analysis are the basis for human computational neureoethology research dealing with the simultaneous analysis of behavioral ethogram descriptions and neural activity measurements. Wireless electroencephalography (EEG) and wireless inertial measurement units (IMU) allow the realization of experimental data recording with improved ecological validity where the subjects can be carrying out natural activities while data recording is minimally invasive. Specifically, we aim to show that EEG and IMU data fusion allows improved human activity recognition in a natural setting. We have defined an experimental protocol composed of natural sitting, standing and walking activities, and we have recruited subjects in two sites: in-house ([Formula: see text]) and out-house ([Formula: see text]) populations with different demographics. Experimental protocol data capture was carried out with validated commercial systems. Classifier model training and validation were carried out with scikit-learn open source machine learning python package. EEG features consist of the amplitude of the standard EEG frequency bands. Inertial features were the instantaneous position of the body tracked points after a moving average smoothing to remove noise. We carry out three validation processes: a 10-fold cross-validation process per experimental protocol repetition, (b) the inference of the ethograms, and (c) the transfer learning from each experimental protocol repetition to the remaining repetitions. The in-house accuracy results were lower and much more variable than the out-house sessions results. In general, random forest was the best performing classifier model. Best cross-validation results, ethogram accuracy, and transfer learning were achieved from the fusion of EEG and IMUs data. Transfer learning behaved poorly compared to classification on the same protocol repetition, but it has accuracy still greater than 0.75 on average for the out-house data sessions. Transfer leaning accuracy among repetitions of the same subject was above 0.88 on average. Ethogram prediction accuracy was above 0.96 on average. Therefore, we conclude that wireless EEG and IMUs allow for the definition of natural experimental designs with high ecological validity toward human computational neuroethology research. The fusion of both EEG and IMUs signals improves activity and ethogram recognition.

Discriminative Analysis of Symptom Severity and Ultra-High Risk of Schizophrenia Using Intrinsic Functional Connectivity

Past studies have consistently shown functional dysconnectivity of large-scale brain networks in schizophrenia. In this study, we aimed to further assess whether multivariate pattern analysis (MVPA) could yield a sensitive predictor of patient symptoms, as well as identify ultra-high risk (UHR) stage of schizophrenia from intrinsic functional connectivity of whole-brain networks. We first combined rank-based feature selection and support vector machine methods to distinguish between 43 schizophrenia patients and 52 healthy controls. The constructed classifier was then applied to examine functional connectivity profiles of 18 UHR individuals. The classifier indicated reliable relationship between MVPA measures and symptom severity, with higher classification accuracy in more severely affected schizophrenia patients. The UHR subjects had classification scores falling between those of healthy controls and patients, suggesting an intermediate level of functional brain abnormalities. Moreover, UHR individuals with schizophrenia-like connectivity profiles at baseline presented higher rate of conversion to full-blown illness in the follow-up visits. Spatial maps of discriminative brain regions implicated increases of functional connectivity in the default mode network, whereas decreases of functional connectivity in the cerebellum, thalamus and visual areas in schizophrenia. The findings may have potential utility in the early diagnosis and intervention of schizophrenia.

Deep Support Vector Machines for the Identification of Stress Condition from Electrodermal Activity

Early detection of stress condition is beneficial to prevent long-term mental illness like depression and anxiety. This paper introduces an accurate identification of stress/calm condition from electrodermal activity (EDA) signals. The acquisition of EDA signals from a commercial wearable as well as their storage and processing are presented. Several time-domain, frequency-domain and morphological features are extracted over the skin conductance response of the EDA signals. Afterwards, a classification is undergone by using several classical support vector machines (SVMs) and deep support vector machines (D-SVMs). In addition, several binary classifiers are also compared with SVMs in the stress/calm identification task. Moreover, a series of video clips evoking calm and stress conditions have been viewed by 147 volunteers in order to validate the classification results. The highest F1-score obtained for SVMs and D-SVMs are 83% and 92%, respectively. These results demonstrate that not only classical SVMs are appropriate for classification of biomarker signals, but D-SVMs are very competitive in comparison to other classification techniques. In addition, the results have enabled drawing useful considerations for the future use of SVMs and D-SVMs in the specific case of stress/calm identification.

Dysfunctional Dynamics of Intra- and Inter-network Connectivity in Dementia With Lewy Bodies

Dementia with Lewy bodies (DLB) is characterized by the transient fluctuating cognition and recurrent visual hallucinations, which may be caused by disorders of the intrinsic brain network dynamics. However, little is known regarding the dynamic features of the brain network behind these symptoms in DLB. In the present study, the intra- and inter-brain network dynamics were explored on a time scale in 17 DLB and 20 healthy controls (HC) applying a sliding-window method followed by k-means clustering analysis. To further evaluate the impact of network dynamics on brain performance, the local and global efficiency of the brain network was calculated. Compared with HC, the dynamic functional connectivity variation matrix in DLB patients was represented by a mixed change of intra-network increase and inter-network decrease. DLB patients devoted more time to a negative connectivity pattern, which represents a state of functional separation. Furthermore, the local efficiency of DLB patients was significantly lower compared with HC. These observations indicate an altered dynamic variability and disorders to the time allocation of state sequences in DLB, which might result in a disturbance of the intricate brain network dynamic properties, thereby leading to a lack of integration and flexibility and an ineffective brain function. In conclusion, dynamic functional connectivity analysis could identify differences between DLB and HC, providing evidences for DLB diagnosis and contributing to the understanding of the widespread clinical features and complex treatment strategies in DLB patients.

Multiplex Limited Penetrable Horizontal Visibility Graph from EEG Signals for Driver Fatigue Detection

Driver fatigue is an important contributor to road accidents, and driver fatigue detection has attracted a great deal of attention on account of its significant importance. Numerous methods have been proposed to fulfill this challenging task, though, the characterization of the fatigue mechanism still, to a large extent, remains to be investigated. To address this problem, we, in this work, develop a novel Multiplex Limited Penetrable Horizontal Visibility Graph (Multiplex LPHVG) method, which allows in not only detecting fatigue driving but also probing into the brain fatigue behavior. Importantly, we use the method to construct brain networks from EEG signals recorded from different subjects performing simulated driving tasks under alert and fatigue driving states. We then employ clustering coefficient, global efficiency and characteristic path length to characterize the topological structure of the networks generated from different brain states. In addition, we combine average edge overlap with the network measures to distinguish alert and mental fatigue states. The high-accurate classification results clearly demonstrate and validate the efficacy of our multiplex LPHVG method for the fatigue detection from EEG signals. Furthermore, our findings show a significant increase of the clustering coefficient as the brain evolves from alert state to mental fatigue state, which yields novel insights into the brain behavior associated with fatigue driving.

Strong-Weak Pruning for Brain Network Identification in Connectome-Wide Neuroimaging: Application to Amyotrophic Lateral Sclerosis Disease Stage Characterization

Magnetic resonance imaging allows acquiring functional and structural connectivity data from which high-density whole-brain networks can be derived to carry out connectome-wide analyses in normal and clinical populations. Graph theory has been widely applied to investigate the modular structure of brain connections by using centrality measures to identify the "hub" of human connectomes, and community detection methods to delineate subnetworks associated with diverse cognitive and sensorimotor functions. These analyses typically rely on a preprocessing step (pruning) to reduce computational complexity and remove the weakest edges that are most likely affected by experimental noise. However, weak links may contain relevant information about brain connectivity, therefore, the identification of the optimal trade-off between retained and discarded edges is a subject of active research. We introduce a pruning algorithm to identify edges that carry the highest information content. The algorithm selects both strong edges (i.e. edges belonging to shortest paths) and weak edges that are topologically relevant in weakly connected subnetworks. The newly developed "strong-weak" pruning (SWP) algorithm was validated on simulated networks that mimic the structure of human brain networks. It was then applied for the analysis of a real dataset of subjects affected by amyotrophic lateral sclerosis (ALS), both at the early (ALS2) and late (ALS3) stage of the disease, and of healthy control subjects. SWP preprocessing allowed identifying statistically significant differences in the path length of networks between patients and healthy subjects. ALS patients showed a decrease of connectivity between frontal cortex to temporal cortex and parietal cortex and between temporal and occipital cortex. Moreover, degree of centrality measures revealed significantly different hub and centrality scores between patient subgroups. These findings suggest a widespread alteration of network topology in ALS associated with disease progression.

Empirical Functional PCA for 3D Image Feature Extraction Through Fractal Sampling

Medical image classification is currently a challenging task that can be used to aid the diagnosis of different brain diseases. Thus, exploratory and discriminative analysis techniques aiming to obtain representative features from the images play a decisive role in the design of effective Computer Aided Diagnosis (CAD) systems, which is especially important in the early diagnosis of dementia. In this work, we present a technique that allows using specific time series analysis techniques with 3D images. This is achieved by sampling the image using a fractal-based method which preserves the spatial relationship among voxels. In addition, a method called Empirical functional PCA (EfPCA) is presented, which combines Empirical Mode Decomposition (EMD) with functional PCA to express an image in the space spanned by a basis of empirical functions, instead of using components computed by a predefined basis as in Fourier or Wavelet analysis. The devised technique has been used to classify images from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) and the Parkinson Progression Markers Initiative (PPMI), achieving accuracies up to 93% and 92% differential diagnosis tasks (AD versus controls and PD versus Controls, respectively). The results obtained validate the method, proving that the information retrieved by our methodology is significantly linked to the diseases.

A Novel Wavelet Transform-Homogeneity Model for Sudden Cardiac Death Prediction Using ECG Signals

Sudden cardiac death (SCD) is one of the main causes of death among people. A new methodology is presented for predicting the SCD based on ECG signals employing the wavelet packet transform (WPT), a signal processing technique, homogeneity index (HI), a nonlinear measurement for time series signals, and the Enhanced Probabilistic Neural Network classification algorithm. The effectiveness and usefulness of the proposed method is evaluated using a database of measured ECG data acquired from 20 SCD and 18 normal patients. The proposed methodology presents the following significant advantages: (1) compared with previous works, the proposed methodology achieves a higher accuracy using a single nonlinear feature, HI, thus requiring low computational resource for predicting an SCD onset in real-time, unlike other methodologies proposed in the literature where a large number of nonlinear features are used to predict an SCD event; (2) it is capable of predicting the risk of developing an SCD event up to 20 min prior to the onset with a high accuracy of 95.8%, superseding the prior 12 min prediction time reported recently, and (3) it uses the ECG signal directly without the need for transforming the signal to a heart rate variability signal, thus saving time in the processing.

Aberrant Prefrontal-Thalamic-Cerebellar Circuit in Schizophrenia and Depression: Evidence From a Possible Causal Connectivity

Neuroimaging studies have suggested the presence of abnormalities in the prefrontal-thalamic-cerebellar circuit in schizophrenia (SCH) and depression (DEP). However, the common and distinct structural and causal connectivity abnormalities in this circuit between the two disorders are still unclear. In the current study, structural and resting-state functional magnetic resonance imaging (fMRI) data were acquired from 20 patients with SCH, 20 depressive patients and 20 healthy controls (HC). Voxel-based morphometry analysis was first used to assess gray matter volume (GMV). Granger causality analysis, seeded at regions with altered GMVs, was subsequently conducted. To discover the differences between the groups, ANCOVA and post hoc tests were performed. Then, the relationships between the structural changes, causal connectivity and clinical variables were investigated. Finally, a leave-one-out resampling method was implemented to test the consistency. Statistical analyses showed the GMV and causal connectivity changes in the prefrontal-thalamic-cerebellar circuit. Compared with HC, both SCH and DEP exhibited decreased GMV in middle frontal gyrus (MFG), and a lower GMV in MFG and medial prefrontal cortex (MPFC) in SCH than DEP. Compared with HC, both patient groups showed increased causal flow from the right cerebellum to the MPFC (common causal connectivity abnormalities). And distinct causal connectivity abnormalities (increased causal connectivity from the left thalamus to the MPFC in SCH than HC and DEP, and increased causal connectivity from the right cerebellum to the left thalamus in DEP than HC and SCH). In addition, the structural deficits in the MPFC and its causal connectivity from the cerebellum were associated with the negative symptom severity in SCH. This study found common/distinct structural deficits and aberrant causal connectivity patterns in the prefrontal-thalamic-cerebellar circuit in SCH and DEP, which may provide a potential direction for understanding the convergent and divergent psychiatric pathological mechanisms between SCH and DEP. Furthermore, concomitant structural and causal connectivity deficits in the MPFC may jointly contribute to the negative symptoms of SCH.

Targeted neural network interventions for auditory hallucinations: Can TMS inform DBS?

The debilitating and refractory nature of auditory hallucinations (AH) in schizophrenia and other psychiatric disorders has stimulated investigations into neuromodulatory interventions that target the aberrant neural networks associated with them. Internal or invasive forms of brain stimulation such as deep brain stimulation (DBS) are currently being explored for treatment-refractory schizophrenia. The process of developing and implementing DBS is limited by symptom clustering within psychiatric constructs as well as a scarcity of causal tools with which to predict response, refine targeting or guide clinical decisions. Transcranial magnetic stimulation (TMS), an external or non-invasive form of brain stimulation, has shown some promise as a therapeutic intervention for AH but remains relatively underutilized as an investigational probe of clinically relevant neural networks. In this editorial, we propose that TMS has the potential to inform DBS by adding individualized causal evidence to an evaluation processes otherwise devoid of it in patients. Although there are significant limitations and safety concerns regarding DBS, the combination of TMS with computational modeling of neuroimaging and neurophysiological data could provide critical insights into more robust and adaptable network modulation.