Self-regulation of brain rhythms in the precuneus: a novel BCI paradigm for patients with ALS.

OBJECTIVE: Electroencephalographic (EEG) brain-computer interfaces (BCIs) hold promise in restoring communication for patients with completely locked-in stage amyotrophic lateral sclerosis (ALS). However, these patients cannot use existing EEG-based BCIs, arguably because such systems rely on brain processes that are impaired in the late stages of ALS. In this work, we introduce a novel BCI designed for patients in late stages of ALS based on high-level cognitive processes that are less likely to be affected by ALS. APPROACH: We trained two ALS patients via EEG-based neurofeedback to use self-regulation of theta or gamma oscillations in the precuneus for basic communication. Because there is a tight connection between the precuneus and consciousness, precuneus oscillations are arguably generated by high-level cognitive processes, which are less likely to be affected by ALS than processes linked to the peripheral nervous system. MAIN RESULTS: Both patients learned to self-regulate their precuneus oscillations and achieved stable online decoding accuracy over the course of disease progression. One patient achieved a mean online decoding accuracy in a binary decision task of 70.55% across 26 training sessions, and the other patient achieved 59.44% across 16 training sessions. We provide empirical evidence that these oscillations were cortical in nature and originated from the intersection of the precuneus, cuneus, and posterior cingulate. SIGNIFICANCE: Our results establish that ALS patients can employ self-regulation of precuneus oscillations for communication. Such a BCI is likely to be available to ALS patients as long as their consciousness supports communication.

Exenatide-induced reduction in energy intake is associated with increase in hypothalamic connectivity.

OBJECTIVE: Glucagon-like peptide-1 receptor agonists such as exenatide are known to influence neural activity in the hypothalamus of animals and to reduce energy intake. In humans, however, significant weight loss has been observed in only a subgroup of patients. Why only some individuals respond with weight loss and others do not remains unclear. In this functional magnetic resonance imaging (fMRI) study, we investigated differences in hypothalamic connectivity between "responders" (reduction in energy intake after exenatide infusion) and "nonresponders." RESEARCH DESIGN AND METHODS: We performed a randomized, double-blinded, placebo-controlled, cross-over fMRI study with intravenous administration of exenatide in obese male volunteers. During brain scanning with continuous exenatide or placebo administration, participants rated food and nonfood images. After each scanning session, energy intake was measured using an ad libitum buffet. Functional hypothalamic connectivity was assessed by eigenvector centrality mapping, a measure of connectedness throughout the brain. RESULTS: Responders showed significantly higher connectedness of the hypothalamus, which was specific for the food pictures condition, in the exenatide condition compared with placebo. Nonresponders did not show any significant exenatide-induced changes in hypothalamic connectedness. CONCLUSIONS: Our results demonstrate a central hypothalamic effect of peripherally administered exenatide that occurred only in the group that showed an exenatide-dependent anorexigenic effect. These findings indicate that the hypothalamic response seems to be the crucial factor for the effect of exenatide on energy intake.

Neural language networks at birth.

The ability to learn language is a human trait. In adults and children, brain imaging studies have shown that auditory language activates a bilateral frontotemporal network with a left hemispheric dominance. It is an open question whether these activations represent the complete neural basis for language present at birth. Here we demonstrate that in 2-d-old infants, the language-related neural substrate is fully active in both hemispheres with a preponderance in the right auditory cortex. Functional and structural connectivities within this neural network, however, are immature, with strong connectivities only between the two hemispheres, contrasting with the adult pattern of prevalent intrahemispheric connectivities. Thus, although the brain responds to spoken language already at birth, thereby providing a strong biological basis to acquire language, progressive maturation of intrahemispheric functional connectivity is yet to be established with language exposure as the brain develops.

Auditory what, where, and when: a sensory somatotopy in lateral premotor cortex.

Recent findings have demonstrated that attention to visual events engages the lateral premotor cortex even in the absence of motor planning. Here, we used functional magnetic resonance imaging to explore acoustically triggered activations within the lateral premotor cortex. Temporal (when), object-related (what), and spatial (where) auditory patterns were to be monitored for violations in a serial prediction task. As a result, we found a modality-dependent modulation for auditory events within the inferior ventrolateral premotor cortex, an area engaged in vocal plans. In addition, however, auditory activations were distributed within the entire premotor cortex depending on which stimulus property was attended to. Attention to where patterns was found to engage fields for gaze and reaching (dorsolateral premotor cortex), what patterns to engage fields for hand movements (superior ventrolateral premotor cortex), and when patterns to engage fields for vocal plans. Together, the findings confirm the idea of a sensory somatotopy in lateral premotor cortex, according to which a perceptual pattern triggers representations within that motor effector which would be most appropriate to generate it as an action effect.

Bach speaks: a cortical "language-network" serves the processing of music.

The aim of the present study was the investigation of neural correlates of music processing with fMRI. Chord sequences were presented to the participants, infrequently containing unexpected musical events. These events activated the areas of Broca and Wernicke, the superior temporal sulcus, Heschl's gyrus, both planum polare and planum temporale, as well as the anterior superior insular cortices. Some of these brain structures have previously been shown to be involved in music processing, but the cortical network comprising all these structures has up to now been thought to be domain-specific for language processing. To what extent this network might also be activated by the processing of non-linguistic information has remained unknown. The present fMRI-data reveal that the human brain employs this neuronal network also for the processing of musical information, suggesting that the cortical network known to support language processing is less domain-specific than previously believed.