Moving magnetoencephalography towards real-world applications with a wearable system.

Imaging human brain function with techniques such as magnetoencephalography typically requires a subject to perform tasks while their head remains still within a restrictive scanner. This artificial environment makes the technique inaccessible to many people, and limits the experimental questions that can be addressed. For example, it has been difficult to apply neuroimaging to investigation of the neural substrates of cognitive development in babies and children, or to study processes in adults that require unconstrained head movement (such as spatial navigation). Here we describe a magnetoencephalography system that can be worn like a helmet, allowing free and natural movement during scanning. This is possible owing to the integration of quantum sensors, which do not rely on superconducting technology, with a system for nulling background magnetic fields. We demonstrate human electrophysiological measurement at millisecond resolution while subjects make natural movements, including head nodding, stretching, drinking and playing a ball game. Our results compare well to those of the current state-of-the-art, even when subjects make large head movements. The system opens up new possibilities for scanning any subject or patient group, with myriad applications such as characterization of the neurodevelopmental connectome, imaging subjects moving naturally in a virtual environment and investigating the pathophysiology of movement disorders.

Enabling ambulatory movement in wearable magnetoencephalography with matrix coil active magnetic shielding.

The ability to collect high-quality neuroimaging data during ambulatory participant movement would enable a wealth of neuroscientific paradigms. Wearable magnetoencephalography (MEG) based on optically pumped magnetometers (OPMs) has the potential to allow participant movement during a scan. However, the strict zero magnetic field requirement of OPMs means that systems must be operated inside a magnetically shielded room (MSR) and also require active shielding using electromagnetic coils to cancel residual fields and field changes (due to external sources and sensor movements) that would otherwise prevent accurate neuronal source reconstructions. Existing active shielding systems only compensate fields over small, fixed regions and do not allow ambulatory movement. Here we describe the matrix coil, a new type of active shielding system for OPM-MEG which is formed from 48 square unit coils arranged on two planes which can compensate magnetic fields in regions that can be flexibly placed between the planes. Through the integration of optical tracking with OPM data acquisition, field changes induced by participant movement are cancelled with low latency (25 ms). High-quality MEG source data were collected despite the presence of large (65 cm translations and 270° rotations) ambulatory participant movements.

More about being fun: Making friends to maximize social status.

OBJECTIVE: Children perceived by peers as someone who is fun reap interpersonal rewards, but little is known about what makes someone fun or how being fun leads to social success. The present study is designed to identify what qualities makes someone fun and how being fun leads to social success. METHOD: Two studies of children in primary and middle school are reported. Participants in the present investigation attended a public-school representative of Florida school children in terms of ethnicity and income. In the first study, 351 (179 girls, 172 boys) students (8-11 years old) completed surveys twice (M = 8.5 weeks apart) during an academic year, describing the qualities of "someone who is fun." RESULTS: At both time points, kindness and humor were rated as more important than buffoonery. In the second study, 394 (210 girls, 184 boys) students (8-13 years old) completed peer nomination surveys thrice (M = 8.5 weeks apart) during an academic year. Replicating previous findings, being fun predicted increases in social status (i.e., likeability and popularity). CONCLUSIONS: Unique to this study, full longitudinal mediation analyses indicated that being perceived as fun early in the school year predicted friend gain from the beginning to the middle of the school year, which, in turn, predicted increases in perceived likeability and popularity from the middle to the end of the school year. The findings were unique to being fun. Kindness and humor did not predict friend gain.

Naturalistic Hyperscanning with Wearable Magnetoencephalography.

The evolution of human cognitive function is reliant on complex social interactions which form the behavioural foundation of who we are. These social capacities are subject to dramatic change in disease and injury; yet their supporting neural substrates remain poorly understood. Hyperscanning employs functional neuroimaging to simultaneously assess brain activity in two individuals and offers the best means to understand the neural basis of social interaction. However, present technologies are limited, either by poor performance (low spatial/temporal precision) or an unnatural scanning environment (claustrophobic scanners, with interactions via video). Here, we describe hyperscanning using wearable magnetoencephalography (MEG) based on optically pumped magnetometers (OPMs). We demonstrate our approach by simultaneously measuring brain activity in two subjects undertaking two separate tasks-an interactive touching task and a ball game. Despite large and unpredictable subject motion, sensorimotor brain activity was delineated clearly, and the correlation of the envelope of neuronal oscillations between the two subjects was demonstrated. Our results show that unlike existing modalities, OPM-MEG combines high-fidelity data acquisition and a naturalistic setting and thus presents significant potential to investigate neural correlates of social interaction.

The Perils of Not Being Attractive or Athletic: Pathways to Adolescent Adjustment Difficulties Through Escalating Unpopularity.

Adolescents who lack traits valued by peers are at risk for adjustment difficulties but the mechanisms responsible for deteriorating well-being have yet to be identified. The present study examines processes whereby low athleticism and low attractiveness give rise to adolescent adjustment difficulties. Participants were public middle school students (ages 10 to 13 years, Mage = 11.54, SDage = 1.00) in the USA and Lithuania (300 girls, 280 boys; 52.7% girls). Self-reports of alcohol misuse and loneliness were collected three times during an academic year (M = 12.3 week intervals). Athleticism, attractiveness, unpopularity, and peer rejection were assessed through peer nominations. Full longitudinal mediation analyses examined direct and indirect pathways from stigmatized traits (i.e., low athleticism, low attractiveness) to adjustment difficulties (i.e., alcohol misuse, loneliness) through two indices of low peer status: unpopularity and rejection. The results indicated that the possession of stigmatized traits predicted escalating unpopularity, which, in turn, predicted increasing adjustment difficulties. Similar indirect associations did not emerge with rejection as a mediator, underscoring the unique role of power and prominence (and the lack thereof) in socioemotional development. The findings underscore the adjustment risks and interpersonal challenges that confront children and adolescents who lack traits valued by peers.

Triaxial detection of the neuromagnetic field using optically-pumped magnetometry: feasibility and application in children.

Optically-pumped magnetometers (OPMs) are an established alternative to superconducting sensors for magnetoencephalography (MEG), offering significant advantages including flexibility to accommodate any head size, uniform coverage, free movement during scanning, better data quality and lower cost. However, OPM sensor technology remains under development; there is flexibility regarding OPM design and it is not yet clear which variant will prove most effective for MEG. Most OPM-MEG implementations have either used single-axis (equivalent to conventional MEG) or dual-axis magnetic field measurements. Here we demonstrate use of a triaxial OPM formulation, able to characterise the full 3D neuromagnetic field vector. We show that this novel sensor is able to characterise magnetic fields with high accuracy and sensitivity that matches conventional (dual-axis) OPMs. We show practicality via measurement of biomagnetic fields from both the heart and the brain. Using simulations, we demonstrate how triaxial measurement offers improved cortical coverage, especially in infants. Finally, we introduce a new 3D-printed child-friendly OPM-helmet and demonstrate feasibility of triaxial measurement in a five-year-old. In sum, the data presented demonstrate that triaxial OPMs offer a significant improvement over dual-axis variants and are likely to become the sensor of choice for future MEG systems, particularly for deployment in paediatric populations.

Theoretical advantages of a triaxial optically pumped magnetometer magnetoencephalography system.

The optically pumped magnetometer (OPM) is a viable means to detect magnetic fields generated by human brain activity. Compared to conventional detectors (superconducting quantum interference devices) OPMs are small, lightweight, flexible, and operate without cryogenics. This has led to a step change in instrumentation for magnetoencephalography (MEG), enabling a "wearable" scanner platform, adaptable to fit any head size, able to acquire data whilst subjects move, and offering improved data quality. Although many studies have shown the efficacy of 'OPM-MEG', one relatively untapped advantage relates to improved array design. Specifically, OPMs enable the simultaneous measurement of magnetic field components along multiple axes (distinct from a single radial orientation, as used in most conventional MEG systems). This enables characterisation of the magnetic field vector at all sensors, affording extra information which has the potential to improve source reconstruction. Here, we conduct a theoretical analysis of the critical parameters that should be optimised for effective source reconstruction. We show that these parameters can be optimised by judicious array design incorporating triaxial MEG measurements. Using simulations, we demonstrate how a triaxial array offers a dramatic improvement on our ability to differentiate real brain activity from sources of magnetic interference (external to the brain). Further, a triaxial system is shown to offer a marked improvement in the elimination of artefact caused by head movement. Theoretical results are supplemented by an experimental recording demonstrating improved interference reduction. These findings offer new insights into how future OPM-MEG arrays can be designed with improved performance.

Measuring functional connectivity with wearable MEG.

Optically-pumped magnetometers (OPMs) offer the potential for a step change in magnetoencephalography (MEG) enabling wearable systems that provide improved data quality, accommodate any subject group, allow data capture during movement and potentially reduce cost. However, OPM-MEG is a nascent technology and, to realise its potential, it must be shown to facilitate key neuroscientific measurements, such as the characterisation of brain networks. Networks, and the connectivities that underlie them, have become a core area of neuroscientific investigation, and their importance is underscored by many demonstrations of their disruption in brain disorders. Consequently, a demonstration of network measurements using OPM-MEG would be a significant step forward. Here, we aimed to show that a wearable 50-channel OPM-MEG system enables characterisation of the electrophysiological connectome. To this end, we measured connectivity in the resting state and during a visuo-motor task, using both OPM-MEG and a state-of-the-art 275-channel cryogenic MEG device. Our results show that resting-state connectome matrices from OPM and cryogenic systems exhibit a high degree of similarity, with correlation values >70%. In addition, in task data, similar differences in connectivity between individuals (scanned multiple times) were observed in cryogenic and OPM-MEG data, again demonstrating the fidelity of the OPM-MEG device. This is the first demonstration of network connectivity measured using OPM-MEG, and results add weight to the argument that OPMs will ultimately supersede cryogenic sensors for MEG measurement.

Precision magnetic field modelling and control for wearable magnetoencephalography.

Optically-pumped magnetometers (OPMs) are highly sensitive, compact magnetic field sensors, which offer a viable alternative to cryogenic sensors (superconducting quantum interference devices - SQUIDs) for magnetoencephalography (MEG). With the promise of a wearable system that offers lifespan compliance, enables movement during scanning, and provides higher quality data, OPMs could drive a step change in MEG instrumentation. However, this potential can only be realised if background magnetic fields are appropriately controlled, via a combination of optimised passive magnetic screening (i.e. enclosing the system in layers of high-permeability materials), and electromagnetic coils to further null the remnant magnetic field. In this work, we show that even in an OPM-optimised passive shield with extremely low (<2 nT) remnant magnetic field, head movement generates significant artefacts in MEG data that manifest as low-frequency interference. To counter this effect we introduce a magnetic field mapping technique, in which the participant moves their head to sample the background magnetic field using a wearable sensor array; resulting data are compared to a model to derive coefficients representing three uniform magnetic field components and five magnetic field gradient components inside the passive shield. We show that this technique accurately reconstructs the magnitude of known magnetic fields. Moreover, by feeding the obtained coefficients into a bi-planar electromagnetic coil system, we were able to reduce the uniform magnetic field experienced by the array from a magnitude of 1.3±0.3 nT to 0.29±0.07 nT. Most importantly, we show that this field compensation generates a five-fold reduction in motion artefact at 0‒2 Hz, in a visual steady-state evoked response experiment using 6 Hz stimulation. We suggest that this technique could be used in future OPM-MEG experiments to improve the quality of data, especially in paradigms seeking to measure low-frequency oscillations, or in experiments where head movement is encouraged.

Mouth magnetoencephalography: A unique perspective on the human hippocampus.

Traditional magnetoencephalographic (MEG) brain imaging scanners consist of a rigid sensor array surrounding the head; this means that they are maximally sensitive to superficial brain structures. New technology based on optical pumping means that we can now consider more flexible and creative sensor placement. Here we explored the magnetic fields generated by a model of the human hippocampus not only across scalp but also at the roof of the mouth. We found that simulated hippocampal sources gave rise to dipolar field patterns with one scalp surface field extremum at the temporal lobe and a corresponding maximum or minimum at the roof of the mouth. We then constructed a fitted dental mould to accommodate an Optically Pumped Magnetometer (OPM). We collected data using a previously validated hippocampal-dependant task to test the empirical utility of a mouth-based sensor, with an accompanying array of left and right temporal lobe OPMs. We found that the mouth sensor showed the greatest task-related theta power change. We found that this sensor had a mild effect on the reconstructed power in the hippocampus (~10% change) but that coherence images between the mouth sensor and reconstructed source images showed a global maximum in the right hippocampus. We conclude that augmenting a scalp-based MEG array with sensors in the mouth shows unique promise for both basic scientists and clinicians interested in interrogating the hippocampus.

The Development and Psychometric Evaluation of the Exercise Overvaluation Scale.

While regular exercise is associated with a number of physical and mental health benefits, basing one's self-esteem largely on exercise is likely associated with negative outcomes. In the present studies, the authors developed a novel measure of this construct, something they term "exercise overvaluation." In Study 1, 820 participants completed an online survey measuring self-esteem, exercise attitudes and behaviors, and eating disorder symptoms. Exploratory and confirmatory factor analysis were employed to develop the 14-item Exercise Overvaluation Scale. The results provided evidence of discriminant and convergent validity and internal consistency reliability of scale scores. In Study 2, the Exercise Overvaluation Scale was administered to 134 university athletes, including those who participated in intramural sports, club sports, and collegiate athletics. The results from Study 2 supported the criterion validity and test-retest reliability of scale scores. This scale offers researchers a new tool to help understand the relationships among exercise, self-esteem, and physical and mental health outcomes.

Multi-channel whole-head OPM-MEG: Helmet design and a comparison with a conventional system.

Magnetoencephalography (MEG) is a powerful technique for functional neuroimaging, offering a non-invasive window on brain electrophysiology. MEG systems have traditionally been based on cryogenic sensors which detect the small extracranial magnetic fields generated by synchronised current in neuronal assemblies, however, such systems have fundamental limitations. In recent years, non-cryogenic quantum-enabled sensors, called optically-pumped magnetometers (OPMs), in combination with novel techniques for accurate background magnetic field control, have promised to lift those restrictions offering an adaptable, motion-robust MEG system, with improved data quality, at reduced cost. However, OPM-MEG remains a nascent technology, and whilst viable systems exist, most employ small numbers of sensors sited above targeted brain regions. Here, building on previous work, we construct a wearable OPM-MEG system with 'whole-head' coverage based upon commercially available OPMs, and test its capabilities to measure alpha, beta and gamma oscillations. We design two methods for OPM mounting; a flexible (EEG-like) cap and rigid (additively-manufactured) helmet. Whilst both designs allow for high quality data to be collected, we argue that the rigid helmet offers a more robust option with significant advantages for reconstruction of field data into 3D images of changes in neuronal current. Using repeat measurements in two participants, we show signal detection for our device to be highly robust. Moreover, via application of source-space modelling, we show that, despite having 5 times fewer sensors, our system exhibits comparable performance to an established cryogenic MEG device. While significant challenges still remain, these developments provide further evidence that OPM-MEG is likely to facilitate a step change for functional neuroimaging.

Using optically pumped magnetometers to measure magnetoencephalographic signals in the human cerebellum.

KEY POINTS: The application of conventional cryogenic magnetoencephalography (MEG) to the study of cerebellar functions is highly limited because typical cryogenic sensor arrays are far away from the cerebellum and naturalistic movement is not allowed in the recording. A new generation of MEG using optically pumped magnetometers (OPMs) that can be worn on the head during movement has opened up an opportunity to image the cerebellar electrophysiological activity non-invasively. We use OPMs to record human cerebellar MEG signals elicited by air-puff stimulation to the eye. We demonstrate robust responses in the cerebellum. OPMs pave the way for studying the neurophysiology of the human cerebellum. ABSTRACT: We test the feasibility of an optically pumped magnetometer-based magnetoencephalographic (OP-MEG) system for the measurement of human cerebellar activity. This is to our knowledge the first study investigating the human cerebellar electrophysiology using optically pumped magnetometers. As a proof of principle, we use an air-puff stimulus to the eyeball in order to elicit cerebellar activity that is well characterized in non-human models. In three subjects, we observe an evoked component at approx. 50 ms post-stimulus, followed by a second component at approx. 85-115 ms post-stimulus. Source inversion localizes both components in the cerebellum, while control experiments exclude potential sources elsewhere. We also assess the induced oscillations, with time-frequency decompositions, and identify additional sources in the occipital lobe, a region expected to be active in our paradigm, and in the neck muscles. Neither of these contributes to the stimulus-evoked responses at 50-115 ms. We conclude that OP-MEG technology offers a promising way to advance the understanding of the information processing mechanisms in the human cerebellum.

Going for the Gold: A Description of the Centers of Excellence Designation by the Infectious Diseases Society of America.

Antimicrobial stewardship programs (ASPs) are recommended by the Centers for Disease Control and Prevention and World Health Organization and mandated by the Joint Commission to curb antimicrobial resistance. However, <50% of institutions have optimal ASPs in place. Building on its experience of antimicrobial stewardship (AMS) advocacy, the Infectious Diseases Society of America (IDSA) developed the AMS Centers of Excellence (CoE) program, which will serve as a conduit to share best practices and highlight the standards for other hospitals to achieve in order to advance the field of AMS. A designation of CoE signifies that these institutions deliver high-quality care consistently, serve as the "gold" standard for executing novel AMS principles, and demonstrate commitment to their ASP. Here, we describe the process and purpose of designating institutions as AMS CoEs, provide awareness to clinicians on opportunities available through IDSA with this CoE designation, and discuss the evolution of the program.

Imaging the human hippocampus with optically-pumped magnetoencephalography.

Optically-pumped (OP) magnetometers allow magnetoencephalography (MEG) to be performed while a participant's head is unconstrained. To fully leverage this new technology, and in particular its capacity for mobility, the activity of deep brain structures which facilitate explorative behaviours such as navigation, must be detectable using OP-MEG. One such crucial brain region is the hippocampus. Here we had three healthy adult participants perform a hippocampal-dependent task - the imagination of novel scene imagery - while being scanned using OP-MEG. A conjunction analysis across these three participants revealed a significant change in theta power in the medial temporal lobe. The peak of this activated cluster was located in the anterior hippocampus. We repeated the experiment with the same participants in a conventional SQUID-MEG scanner and found similar engagement of the medial temporal lobe, also with a peak in the anterior hippocampus. These OP-MEG findings indicate exciting new opportunities for investigating the neural correlates of a range of crucial cognitive functions in naturalistic contexts including spatial navigation, episodic memory and social interactions.

Optically pumped magnetometers: From quantum origins to multi-channel magnetoencephalography.

Optically Pumped Magnetometers (OPMs) have emerged as a viable and wearable alternative to cryogenic, superconducting MEG systems. This new generation of sensors has the advantage of not requiring cryogenic cooling and as a result can be flexibly placed on any part of the body. The purpose of this review is to provide a neuroscience audience with the theoretical background needed to understand the physical basis for the signal observed by OPMs. Those already familiar with the physics of MRI and NMR should note that OPMs share much of the same theory as the operation of OPMs rely on magnetic resonance. This review establishes the physical basis for the signal equation for OPMs. We re-derive the equations defining the bounds on OPM performance and highlight the important trade-offs between quantities such as bandwidth, sensor size and sensitivity. These equations lead to a direct upper bound on the gain change due to cross-talk for a multi-channel OPM system.

Wearable neuroimaging: Combining and contrasting magnetoencephalography and electroencephalography.

One of the most severe limitations of functional neuroimaging techniques, such as magnetoencephalography (MEG), is that participants must maintain a fixed head position during data acquisition. This imposes restrictions on the characteristics of the experimental cohorts that can be scanned and the experimental questions that can be addressed. For these reasons, the use of 'wearable' neuroimaging, in which participants can move freely during scanning, is attractive. The most successful example of wearable neuroimaging is electroencephalography (EEG), which employs lightweight and flexible instrumentation that makes it useable in almost any experimental setting. However, EEG has major technical limitations compared to MEG, and therefore the development of wearable MEG, or hybrid MEG/EEG systems, is a compelling prospect. In this paper, we combine and compare EEG and MEG measurements, the latter made using a new generation of optically-pumped magnetometers (OPMs). We show that these new second generation commercial OPMs, can be mounted on the scalp in an 'EEG-like' cap, enabling the acquisition of high fidelity electrophysiological measurements. We show that these sensors can be used in conjunction with conventional EEG electrodes, offering the potential for the development of hybrid MEG/EEG systems. We compare concurrently measured signals, showing that, whilst both modalities offer high quality data in stationary subjects, OPM-MEG measurements are less sensitive to artefacts produced when subjects move. Finally, we show using simulations that OPM-MEG offers a fundamentally better spatial specificity than EEG. The demonstrated technology holds the potential to revolutionise the utility of functional brain imaging, exploiting the flexibility of wearable systems to facilitate hitherto impractical experimental paradigms.

Towards OPM-MEG in a virtual reality environment.

Virtual reality (VR) provides an immersive environment in which a participant can experience a feeling of presence in a virtual world. Such environments generate strong emotional and physical responses and have been used for wide-ranging applications. The ability to collect functional neuroimaging data whilst a participant is immersed in VR would represent a step change for experimental paradigms; unfortunately, traditional brain imaging requires participants to remain still, limiting the scope of naturalistic interaction within VR. Recently however, a new type of magnetoencephalography (MEG) device has been developed, that employs scalp-mounted optically-pumped magnetometers (OPMs) to measure brain electrophysiology. Lightweight OPMs, coupled with precise control of the background magnetic field, enables participant movement during data acquisition. Here, we exploit this technology to acquire MEG data whilst a participant uses a virtual reality head-mounted display (VRHMD). We show that, despite increased magnetic interference from the VRHMD, we were able to measure modulation of alpha-band oscillations, and the visual evoked field. Moreover, in a VR experiment in which a participant had to move their head to look around a virtual wall and view a visual stimulus, we showed that the measured MEG signals map spatially in accordance with the known organisation of primary visual cortex. This technique could transform the type of neuroscientific experiment that can be undertaken using functional neuroimaging.

Data-driven model optimization for optically pumped magnetometer sensor arrays.

Optically pumped magnetometers (OPMs) have reached sensitivity levels that make them viable portable alternatives to traditional superconducting technology for magnetoencephalography (MEG). OPMs do not require cryogenic cooling and can therefore be placed directly on the scalp surface. Unlike cryogenic systems, based on a well-characterised fixed arrays essentially linear in applied flux, OPM devices, based on different physical principles, present new modelling challenges. Here, we outline an empirical Bayesian framework that can be used to compare between and optimise sensor arrays. We perturb the sensor geometry (via simulation) and with analytic model comparison methods estimate the true sensor geometry. The width of these perturbation curves allows us to compare different MEG systems. We test this technique using simulated and real data from SQUID and OPM recordings using head-casts and scanner-casts. Finally, we show that given knowledge of underlying brain anatomy, it is possible to estimate the true sensor geometry from the OPM data themselves using a model comparison framework. This implies that the requirement for accurate knowledge of the sensor positions and orientations a priori may be relaxed. As this procedure uses the cortical manifold as spatial support there is no co-registration procedure or reliance on scalp landmarks.

Essential Resources and Strategies for Antibiotic Stewardship Programs in the Acute Care Setting.

Background: Antibiotic stewardship programs improve clinical outcomes and patient safety and help combat antibiotic resistance. Specific guidance on resources needed to structure stewardship programs is lacking. This manuscript describes results of a survey of US stewardship programs and resultant recommendations regarding potential staffing structures in the acute care setting. Methods: A cross-sectional survey of members of 3 infectious diseases subspecialty societies actively involved in antibiotic stewardship was conducted. Survey responses were analyzed with descriptive statistics. Logistic regression models were used to investigate the relationship between stewardship program staffing levels and self-reported effectiveness and to determine which strategies mediate effectiveness. Results: Two-hundred forty-four respondents from a variety of acute care settings completed the survey. Prior authorization for select antibiotics, antibiotic reviews with prospective audit and feedback, and guideline development were common strategies. Eighty-five percent of surveyed programs demonstrated effectiveness in at least 1 outcome in the prior 2 years. Each 0.50 increase in pharmacist and physician full-time equivalent (FTE) support predicted a 1.48-fold increase in the odds of demonstrating effectiveness. The effect was mediated by the ability to perform prospective audit and feedback. Most programs noted significant barriers to success. Conclusions: Based on our survey's results, we propose an FTE-to-bed ratio that can be used as a starting point to guide discussions regarding necessary resources for antibiotic stewardship programs with executive leadership. Prospective audit and feedback should be the cornerstone of stewardship programs, and both physician leadership and pharmacists with expertise in stewardship are crucial for success.