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1.
Cereb Cortex ; 34(6)2024 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-38836408

RESUMEN

Sense of touch is essential for our interactions with external objects and fine control of hand actions. Despite extensive research on human somatosensory processing, it is still elusive how involved brain regions interact as a dynamic network in processing tactile information. Few studies probed temporal dynamics of somatosensory information flow and reported inconsistent results. Here, we examined cortical somatosensory processing through magnetic source imaging and cortico-cortical coupling dynamics. We recorded magnetoencephalography signals from typically developing children during unilateral pneumatic stimulation. Neural activities underlying somatosensory evoked fields were mapped with dynamic statistical parametric mapping, assessed with spatiotemporal activation analysis, and modeled by Granger causality. Unilateral pneumatic stimulation evoked prominent and consistent activations in the contralateral primary and secondary somatosensory areas but weaker and less consistent activations in the ipsilateral primary and secondary somatosensory areas. Activations in the contralateral primary motor cortex and supramarginal gyrus were also consistently observed. Spatiotemporal activation and Granger causality analysis revealed initial serial information flow from contralateral primary to supramarginal gyrus, contralateral primary motor cortex, and contralateral secondary and later dynamic and parallel information flows between the consistently activated contralateral cortical areas. Our study reveals the spatiotemporal dynamics of cortical somatosensory processing in the normal developing brain.


Asunto(s)
Magnetoencefalografía , Corteza Somatosensorial , Humanos , Masculino , Corteza Somatosensorial/fisiología , Corteza Somatosensorial/crecimiento & desarrollo , Femenino , Niño , Potenciales Evocados Somatosensoriales/fisiología , Mapeo Encefálico , Percepción del Tacto/fisiología , Desarrollo Infantil/fisiología , Imagen por Resonancia Magnética , Red Nerviosa/fisiología , Estimulación Física , Corteza Motora/fisiología , Corteza Motora/crecimiento & desarrollo
2.
Clin Neurophysiol ; 164: 119-129, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38865779

RESUMEN

OBJECTIVE: Giant somatosensory evoked potentials (SEPs) are observed in patients with cortical myoclonus. Short-latency components (SLC), are regarded as evoked epileptic activities or paroxysmal depolarization shifts (PDSs). This study aimed to reveal the electrophysiological significance of the middle-latency component (MLC) P50 of the SEPs. METHODS: Twenty-two patients with cortical myoclonus having giant SEPs (patient group) and 15 healthy controls were included in this study. Waveform changes in SEPs before and after perampanel (PER) treatment were evaluated in the patient group. The wide range, time-frequency properties underlying the waveforms were compared between the groups. RESULTS: After PER treatment, SLC was prolonged and positively correlated with PER concentration, whereas MLC showed no correlation with PER concentration. Time-frequency analysis showed a power increase (156 Hz in all patients, 624 Hz in benign adult familial myoclonus epilepsy patients) underlying SLC and a power decrease (156 Hz, 624 Hz) underlying MLC in the patient group. CONCLUSIONS: The high-frequency power increase in SLCs and decrease in MLCs clearly reflected PDS and subsequent hyperpolarization, respectively. This relationship was similar to that of interictal epileptiform discharges, suggesting that giant SEPs evoke epileptic complexes of excitatory and inhibitory components. SIGNIFICANCE: MLCs of giant SEPs reflected inhibitory components.


Asunto(s)
Potenciales Evocados Somatosensoriales , Humanos , Potenciales Evocados Somatosensoriales/fisiología , Masculino , Femenino , Adulto , Electroencefalografía/métodos , Adulto Joven , Adolescente , Anticonvulsivantes/uso terapéutico , Anticonvulsivantes/farmacología , Persona de Mediana Edad , Piridonas/uso terapéutico , Epilepsias Mioclónicas/fisiopatología , Epilepsias Mioclónicas/diagnóstico , Nitrilos
3.
Orphanet J Rare Dis ; 19(1): 217, 2024 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-38790028

RESUMEN

BACKGROUND: To investigate the peripheral nervous system involvement in S sialidosis with typical features of myoclonus, seizure, and giant waves in somatosensory evoked potentials suggesting hyperexcitability in the central nervous system. METHODS: The clinical presentation of patients with genetically confirmed sialidosis was recorded. Neurophysiological studies, including nerve conduction studies (NCSs), F-wave studies, and needle electromyography (EMG), were performed on these patients. RESULTS: Six patients (M/F: 2:4) were recruited. In addition to the classical presentation, intermittent painful paresthesia was noted in four patients, and three of whom reported it as the earliest symptom. In the NCSs, one patient had reduced compound muscle action potential amplitudes in the right ulnar nerve, while another patient had prolonged distal motor latency in the bilateral tibial and peroneal nerves. Prolonged F-wave latency (83.3%), repeater F-waves (50%), and neurogenic polyphasic waves in EMG (in 2 out of 3 examined patients) were also noted. Interestingly, a very late response was noted in the F-wave study of all patients, probably indicating lesions involving the proximal peripheral nerve or spinal cord. CONCLUSION: In addition to the central nervous system, the peripheral nervous system is also involved in sialidosis, with corresponding clinical symptoms. Further study on these phenomena is indicated.


Asunto(s)
Electromiografía , Mucolipidosis , Humanos , Masculino , Femenino , Adulto , Mucolipidosis/fisiopatología , Conducción Nerviosa/fisiología , Adulto Joven , Nervios Periféricos/fisiopatología , Nervios Periféricos/patología , Adolescente , Sistema Nervioso Periférico/fisiopatología , Potenciales Evocados Somatosensoriales/fisiología , Persona de Mediana Edad , Niño
4.
Biomed Phys Eng Express ; 10(4)2024 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-38744259

RESUMEN

Objective.Detection of the epileptogenic zone is critical, especially for patients with drug-resistant epilepsy. Accurately mapping cortical regions exhibiting high activity during spontaneous seizure events while detecting neural activity up to 500 Hz can assist clinicians' surgical decisions and improve patient outcomes.Approach.We designed, fabricated, and tested a novel hybrid, multi-scale micro-electrocorticography (micro-ECoG) array with a unique embedded configuration. This array was compared to a commercially available microelectrode array (Neuronexus) for recording neural activity in rodent sensory cortex elicited by somatosensory evoked potentials and pilocarpine-induced seizures.Main results.Evoked potentials and spatial maps recorded by the multi-scale array ('micros', 'mesos', and 'macros' refering to the relative electrode sizes, 40 micron, 1 mm, and 4 mm respectively) were comparable to the Neuronexus array. The SSEPs recorded with the micros had higher peak amplitudes and greater signal power than those recorded by the larger mesos and macro. Seizure onset events and high-frequency oscillations (∼450 Hz) were detected on the multi-scale, similar to the commercially available array. The micros had greater SNR than the mesos and macro over the 5-1000 Hz frequency range during seizure monitoring. During cortical stimulation experimentation, the mesos successfully elicited motor effects.Significance.Previous studies have compared macro- and microelectrodes for localizing seizure activity in adjacent regions. The multi-scale design validated here is the first to simultaneously measure macro- and microelectrode signals from the same overlapping cortical area. This enables direct comparison of microelectrode recordings to the macroelectrode recordings used in standard neurosurgical practice. Previous studies have also shown that cortical regions generating high-frequency oscillations are at an increased risk for becoming epileptogenic zones. More accurate mapping of these micro seizures may improve surgical outcomes for epilepsy patients.


Asunto(s)
Electrocorticografía , Potenciales Evocados Somatosensoriales , Microelectrodos , Convulsiones , Electrocorticografía/instrumentación , Electrocorticografía/métodos , Animales , Convulsiones/diagnóstico , Ratas , Masculino , Electrodos Implantados , Corteza Somatosensorial , Diseño de Equipo , Ratas Sprague-Dawley , Mapeo Encefálico/métodos , Pilocarpina , Epilepsia
5.
Eur J Neurosci ; 60(1): 3772-3794, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38726801

RESUMEN

Beside the well-documented involvement of secondary somatosensory area, the cortical network underlying late somatosensory evoked potentials (P60/N60 and P100/N100) is still unknown. Electroencephalogram and magnetoencephalogram source imaging were performed to further investigate the origin of the brain cortical areas involved in late somatosensory evoked potentials, using sensory inputs of different strengths and by testing the correlation between cortical sources. Simultaneous high-density electroencephalograms and magnetoencephalograms were performed in 19 participants, and electrical stimulation was applied to the median nerve (wrist level) at intensity between 1.5 and 9 times the perceptual threshold. Source imaging was undertaken to map the stimulus-induced brain cortical activity according to each individual brain magnetic resonance imaging, during three windows of analysis covering early and late somatosensory evoked potentials. Results for P60/N60 and P100/N100 were compared with those for P20/N20 (early response). According to literature, maximal activity during P20/N20 was found in central sulcus contralateral to stimulation site. During P60/N60 and P100/N100, activity was observed in contralateral primary sensorimotor area, secondary somatosensory area (on both hemispheres) and premotor and multisensory associative cortices. Late responses exhibited similar characteristics but different from P20/N20, and no significant correlation was found between early and late generated activities. Specific clusters of cortical activities were activated with specific input/output relationships underlying early and late somatosensory evoked potentials. Cortical networks, partly common to and distinct from early somatosensory responses, contribute to late responses, all participating in the complex somatosensory brain processing.


Asunto(s)
Electroencefalografía , Potenciales Evocados Somatosensoriales , Magnetoencefalografía , Corteza Somatosensorial , Humanos , Potenciales Evocados Somatosensoriales/fisiología , Magnetoencefalografía/métodos , Masculino , Femenino , Adulto , Electroencefalografía/métodos , Corteza Somatosensorial/fisiología , Corteza Somatosensorial/diagnóstico por imagen , Nervio Mediano/fisiología , Adulto Joven , Estimulación Eléctrica/métodos , Mapeo Encefálico/métodos , Imagen por Resonancia Magnética/métodos
6.
Neuroscience ; 551: 143-152, 2024 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-38735429

RESUMEN

Homeostatic plasticity is a mechanism that stabilizes cortical excitability within a physiological range. Most homeostatic plasticity protocols have primed and tested the homeostatic response of the primary motor cortex (M1). This study investigated if a homeostatic response could be recorded from the primary sensory cortex (S1) after inducing homeostatic plasticity in M1. In 31 healthy participants, homeostatic plasticity was induced over M1 with a priming and testing block of transcranial direct current stimulation (tDCS) in two different sessions (anodal and cathodal). S1 excitability was assessed by early (N20, P25) and middle-latency (N33-P45) somatosensory evoked potentials (SEP) extracted from 4 electrodes (CP5, CP3, P5, P3). Baseline and post-measures (post-priming, 0-min, 10-min, and 20-min after homeostatic induction) were taken. Anodal M1 homeostatic plasticity induction significantly facilitated the N20-P25, P45 peak, and N33-P45 early SEP components up to 20-min post-induction, without any indication of a homeostatic response (i.e., reduced SEP). Cathodal homeostatic induction did not induce any significant effect on early or middle latency SEPs. M1 homeostatic plasticity induction by anodal stimulation protocol to the primary motor cortex did not induce a homeostatic response in SEPs.


Asunto(s)
Potenciales Evocados Somatosensoriales , Homeostasis , Corteza Motora , Plasticidad Neuronal , Corteza Somatosensorial , Estimulación Transcraneal de Corriente Directa , Humanos , Plasticidad Neuronal/fisiología , Potenciales Evocados Somatosensoriales/fisiología , Estimulación Transcraneal de Corriente Directa/métodos , Masculino , Femenino , Corteza Motora/fisiología , Homeostasis/fisiología , Adulto , Adulto Joven , Corteza Somatosensorial/fisiología , Electroencefalografía/métodos
7.
Clin Neurophysiol ; 164: 19-23, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38820667

RESUMEN

OBJECTIVE: Somatosensory evoked spikes (SESs) have been reported only in children aged under 14 years and are considered as an age-dependent phenomenon. However, we detected SESs in adult patients with epilepsy using magnetoencephalography (MEG). The present study investigated whether MEG can detect SESs in normal adults. METHODS: Spontaneous MEG was recorded during measurement of somatosensory evoked fields (SEFs) for bilateral electrical median nerve stimuli in 30 healthy adults. RESULTS: Bilateral SESs were observed in 10 adults but none in the other 20 subjects. SESs consisted of one or two peaks, and the first peak latency corresponded to that of the second peak (M2) of SEFs. The first SES peak was identical to the M2 in isofield map pattern, as well as location and orientation of the equivalent current dipole (ECD). M2 ECD strength in the 10 subjects with SESs was larger (p <0.0001) than in 20 without SESs. CONCLUSIONS: All-or-nothing detection of bilateral SESs by MEG in normal adults must depend on the signal-to-noise issue of symmetrical SEFs and background brain activity. SIGNIFICANCE: Our results further confirm the higher sensitivity of MEG compared to scalp EEG for the detection of focal cortical sources tangential to the scalp such as SESs.


Asunto(s)
Potenciales Evocados Somatosensoriales , Magnetoencefalografía , Humanos , Magnetoencefalografía/métodos , Magnetoencefalografía/normas , Masculino , Potenciales Evocados Somatosensoriales/fisiología , Adulto , Femenino , Adulto Joven , Persona de Mediana Edad , Nervio Mediano/fisiología , Estimulación Eléctrica/métodos , Corteza Somatosensorial/fisiología
8.
World Neurosurg ; 188: 170-176, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38789031

RESUMEN

OBJECTIVE: Intraoperative mapping of the nervous system is used to identify "eloquent" cortical areas. In this technical report, we describe a novel way of mapping the somatosensory cortex so that injury to those critical pathways can be avoided. METHODS: An 8-year-old female with drug resistant epilepsy presented for resection of a right posterior parietal focal cortical dysplasia. Left median nerve stimulation was used to record somatosensory evoked potentials (SEPs) directly from the somatosensory cortex with a strip electrode. A handheld monopolar electrode was also used to record both the median and tibial SEP. Total intravenous anesthesia with propofol and remifentanil was used. RESULTS: SEP recordings were obtained from a 4-contact strip electrode placed across the central sulcus. A phase reversal was identified and the most likely post central gyrus was noted. With the strip electrode left in place, a monopolar handheld electrode was used to record the median nerve SEPs from different locations on the postcentral gyrus. The tibial nerve was also stimulated to record where the highest amplitude tibial nerve SEP was present. This map was used delineate functionally "eloquent" areas to avoid during surgery. During resection, the median nerve SEP was recorded from the strip electrode continuously. No significant change in the SEP was noted, and the patient awoke without any sensory deficits. CONCLUSIONS: Sensory mapping of the cortex is possible with a handheld monopolar electrode. This technique is easy to perform and can help reduce neurological morbidity.


Asunto(s)
Mapeo Encefálico , Potenciales Evocados Somatosensoriales , Nervio Mediano , Corteza Somatosensorial , Humanos , Femenino , Corteza Somatosensorial/cirugía , Potenciales Evocados Somatosensoriales/fisiología , Niño , Mapeo Encefálico/métodos , Nervio Mediano/cirugía , Epilepsia Refractaria/cirugía , Monitorización Neurofisiológica Intraoperatoria/métodos , Nervio Tibial , Estimulación Eléctrica/métodos
9.
PLoS One ; 19(5): e0303086, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38776317

RESUMEN

BACKGROUND: Adolescent idiopathic scoliosis (AIS) is a spinal deformity that affects approximately 4% of the world's population. Several hypotheses regarding the etiology of AIS have been investigated. In the last decades, impaired visual-spatial perception, alterations in spatial body orientation and sensory integration deficits have been documented. OBJECTIVE: We aimed to summarize the neurophysiological, balance, and motion evidence related to AIS published in the last fifteen years, between January 2008 and April 2023. Both observational and interventional studies were considered. Only studies using quantitative assessment methods, such as electroencephalography (EEG), electromyography (EMG), magnetic resonance imaging (MRI), somatosensory evoked potentials, force platform, or motion capture, were included. METHODS: 1250 eligible records identified from online database searching were filtered by duplicate removal, title and abstract screening, and qualitative analysis. 61 articles met the inclusion criteria (i.e., Cobb range 10°-35°, age range 10-18 years) and were summarized. RESULTS: We found significant evidence of impaired standing balance in individuals with AIS who greatly rely on visual and proprioceptive information to stay upright. EMG studies frequently reported an increased activity on the convex side of the intrinsic spinae muscles. EEG data show increased delta and theta power, higher alpha peak frequencies, and significant suppression in the alpha and beta bands in subjects with AIS during standing tasks. MRI studies report changes in white matter structures, differences in the vestibular system, and abnormal cortical activations over motor-related areas in subjects with AIS. Bracing appears to be an effective treatment for AIS, leading to improvements in static balance and gait. Methodological issues prevent reliable conclusions about the effects of other treatment options. CONCLUSIONS: This review underscores the importance of quantitative assessment methods to explore the etiology and pathophysiology of AIS. Further research is needed to measure the impact of physical therapy and orthotic treatments on the neurophysiological mechanisms of the disease.


Asunto(s)
Electroencefalografía , Equilibrio Postural , Escoliosis , Humanos , Escoliosis/fisiopatología , Escoliosis/terapia , Escoliosis/diagnóstico por imagen , Adolescente , Equilibrio Postural/fisiología , Imagen por Resonancia Magnética , Electromiografía , Potenciales Evocados Somatosensoriales/fisiología , Niño , Femenino
10.
J Integr Neurosci ; 23(5): 98, 2024 May 11.
Artículo en Inglés | MEDLINE | ID: mdl-38812396

RESUMEN

OBJECTIVES: In this study, we explored the effects of chiropractic spinal adjustments on resting-state electroencephalography (EEG) recordings and early somatosensory evoked potentials (SEPs) in Alzheimer's and Parkinson's disease. METHODS: In this randomized cross-over study, 14 adults with Alzheimer's disease (average age 67 ± 6 years, 2 females:12 males) and 14 adults with Parkinson's disease (average age 62 ± 11 years, 1 female:13 males) participated. The participants underwent chiropractic spinal adjustments and a control (sham) intervention in a randomized order, with a minimum of one week between each intervention. EEG was recorded before and after each intervention, both during rest and stimulation of the right median nerve. The power-spectra was calculated for resting-state EEG, and the amplitude of the N30 peak was assessed for the SEPs. The source localization was performed on the power-spectra of resting-state EEG and the N30 SEP peak. RESULTS: Chiropractic spinal adjustment significantly reduced the N30 peak in individuals with Alzheimer's by 15% (p = 0.027). While other outcomes did not reach significance, resting-state EEG showed an increase in absolute power in all frequency bands after chiropractic spinal adjustments in individuals with Alzheimer's and Parkinson's disease. The findings revealed a notable enhancement in connectivity within the Default Mode Network (DMN) at the alpha, beta, and theta frequency bands among individuals undergoing chiropractic adjustments. CONCLUSIONS: We found that it is feasible to record EEG/SEP in individuals with Alzheimer's and Parkinson's disease. Additionally, a single session of chiropractic spinal adjustment reduced the somatosensory evoked N30 potential and enhancement in connectivity within the DMN at the alpha, beta, and theta frequency bands in individuals with Alzheimer's disease. Future studies may require a larger sample size to estimate the effects of chiropractic spinal adjustment on brain activity. Given the preliminary nature of our findings, caution is warranted when considering the clinical implications. CLINICAL TRIAL REGISTRATION: The study was registered by the Australian New Zealand Clinical Trials Registry (registration number ACTRN12618001217291 and 12618001218280).


Asunto(s)
Enfermedad de Alzheimer , Estudios Cruzados , Electroencefalografía , Potenciales Evocados Somatosensoriales , Enfermedad de Parkinson , Humanos , Femenino , Masculino , Enfermedad de Parkinson/fisiopatología , Enfermedad de Parkinson/terapia , Anciano , Enfermedad de Alzheimer/fisiopatología , Enfermedad de Alzheimer/terapia , Persona de Mediana Edad , Potenciales Evocados Somatosensoriales/fisiología , Proyectos Piloto , Manipulación Quiropráctica/métodos
11.
Clin Neurophysiol ; 163: 143-151, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38744104

RESUMEN

OBJECTIVE: Temporally extended signal space separation (tSSS) is a powerful method for artifact suppression in magnetoencephalography (MEG). Because tSSS first separates MEG signals coming from inside and outside a certain sphere, definition of the sphere origin is important. For this study, we explored the influence of origin choice on tSSS performance in spontaneous and evoked activity from epilepsy patients. METHODS: Interictal epileptiform discharges (IEDs) and somatosensory evoked fields (SEFs) were processed with two tSSSs: one with the default origin of (0, 0, 40 mm) in the head coordinate, and the other with an individual origin estimated using each patient's anatomical magnetic resonance imaging (MRI). Equivalent current dipoles (ECDs) were calculated for the data. The ECD location and quality of estimation were compared across conditions. RESULTS: MEG data from 21 patients revealed marginal differences in ECD location, but the estimation quality inferred from goodness of fit (GOF) and confidence volume (CV) was better for the tSSS with individual origins. This choice affected IEDs more than it affected SEFs. CONCLUSIONS: Individual sphere model resulted in better GOF and CV. SIGNIFICANCE: Application of tSSS using an individual origin would be more desirable when available. This parameter might influence spontaneous activity more strongly.


Asunto(s)
Epilepsia , Potenciales Evocados Somatosensoriales , Magnetoencefalografía , Humanos , Magnetoencefalografía/métodos , Masculino , Femenino , Adulto , Epilepsia/fisiopatología , Epilepsia/diagnóstico por imagen , Potenciales Evocados Somatosensoriales/fisiología , Adulto Joven , Persona de Mediana Edad , Artefactos , Imagen por Resonancia Magnética/métodos , Adolescente , Encéfalo/fisiopatología , Encéfalo/diagnóstico por imagen
12.
Clin Neurophysiol ; 163: 185-196, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38759514

RESUMEN

OBJECTIVE: Infant hypersensitivity affects daily challenges and parental stress. Although the crucial role of tactile sensation in infants' brain function has been highlighted, hypersensitive infants and their families lack support. Electroencephalography may be useful for understanding hypersensitivity traits. We investigated the relationship between infant perceptual hypersensitivity and parental stress, somatosensory-evoked potential (SEP), and magnitude-squared coherence (MSC) in the general population. METHODS: Infants aged 8 months (n = 63) were evaluated for hypersensitivity and parental stress using a questionnaire and for cortical activity using electroencephalography. Vibration stimuli were applied to the infant's left foot. SEP components that peaked around 150 ms (N2) and at 200 ms (P2) after stimulus onset were evaluated by amplitude and latency at the midline electrode (Cz) and MSC between the midline electrodes (C3-C4). RESULTS: Parental stress was associated with infant hypersensitivity. The latency of Cz was delayed, and C3-C4 delta MSC was high in infants with hypersensitivity. CONCLUSIONS: Increasing inter-hemispheric MSC synchrony in the stimulated condition in infants with hypersensitivity suggested atypical somatosensory cortical function. SIGNIFICANCE: These findings contribute to identifying, understanding the mechanisms of, and developing effective coping strategies for early-stage hypersensitivity.


Asunto(s)
Electroencefalografía , Potenciales Evocados Somatosensoriales , Padres , Estrés Psicológico , Humanos , Masculino , Femenino , Lactante , Electroencefalografía/métodos , Potenciales Evocados Somatosensoriales/fisiología , Padres/psicología , Estrés Psicológico/fisiopatología , Corteza Somatosensorial/fisiopatología , Corteza Somatosensorial/fisiología , Hipersensibilidad/fisiopatología
13.
PLoS One ; 19(4): e0301430, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38578715

RESUMEN

BACKGROUND: SCI is a time-sensitive debilitating neurological condition without treatment options. Although the central nervous system is not programmed for effective endogenous repairs or regeneration, neuroplasticity partially compensates for the dysfunction consequences of SCI. OBJECTIVE AND HYPOTHESIS: The purpose of our study is to investigate whether early induction of hypothermia impacts neuronal tissue compensatory mechanisms. Our hypothesis is that although neuroplasticity happens within the neuropathways, both above (forelimbs) and below (hindlimbs) the site of spinal cord injury (SCI), hypothermia further influences the upper limbs' SSEP signals, even when the SCI is mid-thoracic. STUDY DESIGN: A total of 30 male and female adult rats are randomly assigned to four groups (n = 7): sham group, control group undergoing only laminectomy, injury group with normothermia (37°C), and injury group with hypothermia (32°C +/-0.5°C). METHODS: The NYU-Impactor is used to induce mid-thoracic (T8) moderate (12.5 mm) midline contusive injury in rats. Somatosensory evoked potential (SSEP) is an objective and non-invasive procedure to assess the functionality of selective neuropathways. SSEP monitoring of baseline, and on days 4 and 7 post-SCI are performed. RESULTS: Statistical analysis shows that there are significant differences between the SSEP signal amplitudes recorded when stimulating either forelimb in the group of rats with normothermia compared to the rats treated with 2h of hypothermia on day 4 (left forelimb, p = 0.0417 and right forelimb, p = 0.0012) and on day 7 (left forelimb, p = 0.0332 and right forelimb, p = 0.0133) post-SCI. CONCLUSION: Our results show that the forelimbs SSEP signals from the two groups of injuries with and without hypothermia have statistically significant differences on days 4 and 7. This indicates the neuroprotective effect of early hypothermia and its influences on stimulating further the neuroplasticity within the upper limbs neural network post-SCI. Timely detection of neuroplasticity and identifying the endogenous and exogenous factors have clinical applications in planning a more effective rehabilitation and functional electrical stimulation (FES) interventions in SCI patients.


Asunto(s)
Hipotermia , Traumatismos de la Médula Espinal , Humanos , Ratas , Masculino , Femenino , Animales , Traumatismos de la Médula Espinal/terapia , Potenciales Evocados Somatosensoriales/fisiología , Sistema Nervioso Central , Plasticidad Neuronal/fisiología , Médula Espinal
14.
Resuscitation ; 199: 110207, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38582440

RESUMEN

AIM: To assess the ability of clinical examination, biomarkers, electrophysiology and brain imaging, individually or in combination to predict good neurological outcomes at 6 months after CA. METHODS: This was a retrospective analysis of the Korean Hypothermia Network Prospective Registry 1.0, which included adult out-of-hospital cardiac arrest (OHCA) patients (≥18 years). Good outcome predictors were defined as both pupillary light reflex (PLR) and corneal reflex (CR) at admission, Glasgow Coma Scale Motor score (GCS-M) >3 at admission, neuron-specific enolase (NSE) <17 µg/L at 24-72 h, a median nerve somatosensory evoked potential (SSEP) N20/P25 amplitude >4 µV, continuous background without discharges on electroencephalogram (EEG), and absence of anoxic injury on brain CT and diffusion-weighted imaging (DWI). RESULTS: A total of 1327 subjects were included in the final analysis, and their median age was 59 years; among them, 412 subjects had a good neurological outcome at 6 months. GCS-M >3 at admission had the highest specificity of 96.7% (95% CI 95.3-97.8), and normal brain DWI had the highest sensitivity of 96.3% (95% CI 92.9-98.4). When the two predictors were combined, the sensitivities tended to decrease (ranging from 2.7-81.1%), and the specificities tended to increase, ranging from81.3-100%. Through the explorative variation of the 2021 European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) prognostication strategy algorithms, good outcomes were predicted, with a specificity of 83.2% and a sensitivity of 83.5% in patients by the algorithm. CONCLUSIONS: Clinical examination, biomarker, electrophysiology, and brain imaging predicted good outcomes at 6 months after CA. When the two predictors were combined, the specificity further improved. With the 2021 ERC/ESICM guidelines, the number of indeterminate patients and the uncertainty of prognostication can be reduced by using a good outcome prediction algorithm.


Asunto(s)
Paro Cardíaco Extrahospitalario , Sistema de Registros , Humanos , Paro Cardíaco Extrahospitalario/terapia , Masculino , Femenino , Persona de Mediana Edad , República de Corea/epidemiología , Estudios Prospectivos , Anciano , Pronóstico , Estudios Retrospectivos , Reanimación Cardiopulmonar/métodos , Biomarcadores/sangre , Reflejo Pupilar/fisiología , Escala de Coma de Glasgow , Potenciales Evocados Somatosensoriales/fisiología , Electroencefalografía/métodos , Adulto , Fosfopiruvato Hidratasa/sangre
15.
J Neurosci Methods ; 406: 110131, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38583588

RESUMEN

BACKGROUND: The spinal cord and its interactions with the brain are fundamental for movement control and somatosensation. However, brain and spinal electrophysiology in humans have largely been treated as distinct enterprises, in part due to the relative inaccessibility of the spinal cord. Consequently, there is a dearth of knowledge on human spinal electrophysiology, including the multiple pathologies that affect the spinal cord as well as the brain. NEW METHOD: Here we exploit recent advances in the development of wearable optically pumped magnetometers (OPMs) which can be flexibly arranged to provide coverage of both the spinal cord and the brain in relatively unconstrained environments. This system for magnetospinoencephalography (MSEG) measures both spinal and cortical signals simultaneously by employing custom-made scanning casts. RESULTS: We evidence the utility of such a system by recording spinal and cortical evoked responses to median nerve stimulation at the wrist. MSEG revealed early (10 - 15 ms) and late (>20 ms) responses at the spinal cord, in addition to typical cortical evoked responses (i.e., N20). COMPARISON WITH EXISTING METHODS: Early spinal evoked responses detected were in line with conventional somatosensory evoked potential recordings. CONCLUSION: This MSEG system demonstrates the novel ability for concurrent non-invasive millisecond imaging of brain and spinal cord.


Asunto(s)
Magnetoencefalografía , Médula Espinal , Humanos , Médula Espinal/fisiología , Médula Espinal/diagnóstico por imagen , Magnetoencefalografía/instrumentación , Magnetoencefalografía/métodos , Encéfalo/fisiología , Encéfalo/diagnóstico por imagen , Adulto , Masculino , Femenino , Nervio Mediano/fisiología , Nervio Mediano/diagnóstico por imagen , Potenciales Evocados Somatosensoriales/fisiología , Magnetometría/instrumentación , Magnetometría/métodos , Adulto Joven , Estimulación Eléctrica/instrumentación
16.
Semin Pediatr Neurol ; 49: 101122, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38677801

RESUMEN

Management of pediatric spinal cord injury (SCI) is an essential skill for all pediatric neurocritical care physicians. In this review, we focus on the evaluation and management of pediatric SCI, highlight a novel framework for the monitoring of such patients in the intensive care unit (ICU), and introduce advancements in critical care techniques in monitoring and management. The initial evaluation and characterization of SCI is crucial for improving outcomes as well as prognostication. While physical examination and imaging are the main stays of the work-up, we propose the use of somatosensory evoked potentials (SSEPs) and transcranial magnetic stimulation (TMS) for challenging clinical scenarios. SSEPs allow for functional evaluation of the dorsal columns consisting of tracts associated with hand function, ambulation, and bladder function. Meanwhile, TMS has the potential for informing prognostication as well as response to rehabilitation. Spine stabilization, and in some cases surgical decompression, along with respiratory and hemodynamic management are essential. Emerging research suggests that targeted spinal cerebral perfusion pressure may provide potential benefits. This review aims to increase the pediatric neurocritical care physician's comfort with SCI while providing a novel algorithm for monitoring spinal cord function in the ICU.


Asunto(s)
Cuidados Críticos , Traumatismos de la Médula Espinal , Humanos , Traumatismos de la Médula Espinal/fisiopatología , Traumatismos de la Médula Espinal/terapia , Cuidados Críticos/métodos , Niño , Potenciales Evocados Somatosensoriales/fisiología , Monitorización Neurofisiológica/métodos , Estimulación Magnética Transcraneal
17.
PLoS One ; 19(4): e0301713, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38593141

RESUMEN

Local Field Potential (LFP), despite its name, often reflects remote activity. Depending on the orientation and synchrony of their sources, both oscillations and more complex waves may passively spread in brain tissue over long distances and be falsely interpreted as local activity at such distant recording sites. Here we show that the whisker-evoked potentials in the thalamic nuclei are of local origin up to around 6 ms post stimulus, but the later (7-15 ms) wave is overshadowed by a negative component reaching from cortex. This component can be analytically removed and local thalamic LFP can be recovered reliably using Current Source Density analysis. We used model-based kernel CSD (kCSD) method which allowed us to study the contribution of local and distant currents to LFP from rat thalamic nuclei and barrel cortex recorded with multiple, non-linear and non-regular multichannel probes. Importantly, we verified that concurrent recordings from the cortex are not essential for reliable thalamic CSD estimation. The proposed framework can be used to analyze LFP from other brain areas and has consequences for general LFP interpretation and analysis.


Asunto(s)
Potenciales Evocados Somatosensoriales , Tálamo , Ratas , Animales , Tálamo/fisiología , Potenciales Evocados , Núcleos Talámicos , Corteza Cerebral , Corteza Somatosensorial/fisiología
18.
Acta Neurol Belg ; 124(3): 935-941, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38438636

RESUMEN

BACKGROUND: Pure neuritic leprosy (PNL) is uncommon form of leprosy involving peripheral nerves. Some isolated case reports have shown imaging changes in the central nervous system (CNS) and also impairment in visual evoked potential (VEP), somatosensory evoked potential (SSEP) and brain stem auditory-evoked potentials (BAEPs) parameters in PNL, but there is lack of large study. This prospective observational study evaluates impairment in these central conduction studies among PNL patients. METHODS: We screened patients with leprosy presenting with features of neuropathy and/or thickened nerves. Patients with bacilli-positive nerve biopsies were included in the study and subjected to routine tests along with nerve conduction study (NCS), VEP, tibial SSEP and BAEPs. Parameters of these studies were analyzed based on data from previous studies. RESULTS: Of 76 patients screened for PNL 49 had positive findings in biopsy. Most of patients were male and mean age group was 46.35 ± 15.35 years. Mononeuritis multiplex was most common NCS pattern in 46.93% (23/49) patients. We found abnormal VEP in 13 out of 35 patients (37.14%). Similarly abnormal SSEP and BAEPs among 42.85% and 40% patients respectively. DISCUSSION: This study shows that in PNL significant number of patients have subclinical CNS involvement. Exact pathophysiology of CNS involvement is not known till now but study of VEP, SSEP and BAEPs parameter may help in early diagnosis of PNL.


Asunto(s)
Potenciales Evocados Somatosensoriales , Humanos , Masculino , Femenino , Persona de Mediana Edad , Adulto , Potenciales Evocados Somatosensoriales/fisiología , Anciano , Estudios Prospectivos , Lepra/fisiopatología , Lepra/complicaciones , Potenciales Evocados Visuales/fisiología , Conducción Nerviosa/fisiología , Potenciales Evocados Auditivos del Tronco Encefálico/fisiología , Neuritis/fisiopatología
19.
Eur Spine J ; 33(5): 2129-2137, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38532182

RESUMEN

PURPOSE: The purpose of this study was to establish an animal model capable of simulating the development and decompression process of symptomatic spinal epidural hematoma (SSEH). METHODS: A total of 16 male Bama miniature pigs were included in this study and randomly allocated into four groups: Group A (4 h 20 mmHg hematoma compression), Group B (4 h 24 mmHg hematoma compression), Group C (4 h 28 mmHg hematoma compression), and Group Sham (control). Real-time intra-wound hematoma compression values were obtained using the principle of connectors. Electrophysiological analyses, including the latency and amplitude of somatosensory evoked potentials (SSEP) and motor evoked potentials (MEP), along with behavioral observations (Tarlov score), were performed to assess this model. RESULTS: ANOVA tests demonstrated significant differences in the latency and relative amplitude of SSEP and MEP between Groups C and Sham after 4 h of hematoma compression and one month after surgery (P < 0.01). Behavioral assessments 8 h after surgery indicated that animals subjected to 28 mmHg hematoma compression suffered the most severe spinal cord injury. Pearson correlation coefficient test suggested a negative correlation between the epidural pressure and Tarlov score (r = -0.700, p < 0.001). With the progression of compression and the escalation of epidural pressure, the latency of SSEP and MEP gradually increased, while the relative amplitude gradually decreased. CONCLUSIONS: When the epidural pressure reaches approximately 24 mmHg, the spinal cord function occurs progressive dysfunction. Monitoring epidural pressure would be an effective approach to assist to identify the occurrence of postoperative SSEH.


Asunto(s)
Modelos Animales de Enfermedad , Potenciales Evocados Motores , Potenciales Evocados Somatosensoriales , Hematoma Espinal Epidural , Animales , Porcinos , Masculino , Hematoma Espinal Epidural/cirugía , Hematoma Espinal Epidural/diagnóstico por imagen , Hematoma Espinal Epidural/fisiopatología , Potenciales Evocados Somatosensoriales/fisiología , Potenciales Evocados Motores/fisiología , Porcinos Enanos
20.
STAR Protoc ; 5(2): 102972, 2024 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-38502685

RESUMEN

Studies on sensory information processing typically focus on whisker-related tactile information, overlooking the question of how sensory inputs from other body areas are processed at cortical levels. Here, we present a protocol for stimulating specific rodent limb receptive fields while recording in vivo somatosensory-evoked activity. We describe steps for localizing cortical-hindlimb coordinates using acute peripheral stimulation, electrode placement, and the application of electrical stimulation. This protocol overcomes the challenge of inducing a reproducible and consistent stimulation of specific limbs. For complete details on the use and execution of this protocol, please refer to Miguel-Quesada et al.1.


Asunto(s)
Estimulación Eléctrica , Potenciales Evocados Somatosensoriales , Corteza Somatosensorial , Animales , Potenciales Evocados Somatosensoriales/fisiología , Estimulación Eléctrica/métodos , Corteza Somatosensorial/fisiología , Ratas , Ratones , Extremidades/fisiología , Roedores , Miembro Posterior/fisiología , Vibrisas/fisiología
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