Analysis of the alpha activity envelope in electroencephalography in relation to the ratio of excitatory to inhibitory neural activity.

Alpha waves, one of the major components of resting and awake cortical activity in human electroencephalography (EEG), are known to show waxing and waning, but this phenomenon has rarely been analyzed. In the present study, we analyzed this phenomenon from the viewpoint of excitation and inhibition. The alpha wave envelope was subjected to secondary differentiation. This gave the positive (acceleration positive, Ap) and negative (acceleration negative, An) values of acceleration and their ratio (Ap-An ratio) at each sampling point of the envelope signals for 60 seconds. This analysis was performed on 36 participants with Alzheimer's disease (AD), 23 with frontotemporal dementia (FTD) and 29 age-matched healthy participants (NC) whose data were provided as open datasets. The mean values of the Ap-An ratio for 60 seconds at each EEG electrode were compared between the NC and AD/FTD groups. The AD (1.41 ±0.01 (SD)) and FTD (1.40 ±0.02) groups showed a larger Ap-An ratio than the NC group (1.38 ±0.02, p<0.05). A significant correlation between the envelope amplitude of alpha activity and the Ap-An ratio was observed at most electrodes in the NC group (Pearson's correlation coefficient, r = -0.92 ±0.15, mean for all electrodes), whereas the correlation was disrupted in AD (-0.09 ±0.21, p<0.05) and disrupted in the frontal region in the FTD group. The present method analyzed the envelope of alpha waves from a new perspective, that of excitation and inhibition, and it could detect properties of the EEG, Ap-An ratio, that have not been revealed by existing methods. The present study proposed a new method to analyze the alpha activity envelope in electroencephalography, which could be related to excitatory and inhibitory neural activity.

Connectivity of neural signals to the primary motor area during preparatory periods for movement following external and internal cues.

PURPOSE: We investigated the connectivity of neural signals from movement-related cortical areas to the primary motor area (M1) in the hemisphere contralateral to the movement side during the period of movement-related magnetic fields before movement. MATERIALS AND METHODS: Participants were 13 healthy adults, and nerual signals were recorded using magnetoencephalography. Spontaneous extension of the right wrist was performed at the participant's own pace and following a visual cue in internal (IC) and external (EC) cue tasks. The connectivity of neural signals to M1 from each movement-related motor area was assessed by Granger causality analysis (GCA). The GCA was performed on the neural activity elicited in a frequency band between 7.8 and 46.9 Hz during the pre-movement periods, which occurred durng the readiness field (RF) and the negative slope prime (NSp). F-values, as connectivity values obtained by GCA, were compared between the EC and IC cue tasks. RESULTS: For NSp periods, the connectivity of neural signals from the left superior frontal area (SF-L) to M1 was dominant in the IC task, whereas that from the left superior parietal area (SP-L) to M1 was dominant in the EC task. The F value in the GCA from SP-L to M1 was greater in the EC task during RF than in the IC task during equivalent periods. CONSLUSIONS: In the present study, there were differences in the connectivity of neural signals to M1 between IC and EC tasks. The present results suggested that the pattern of pre-movement neural activity that resulted in a movement was not uniform but differed between movement tasks just before the movement.

Movement-related cortical magnetic fields were assessed with Granger causality analysisConnectivity of neural signals to M1 was different between internal and external cue tasks.Connectivity of neural signals from the frontal area was dominant to M1 in the internal cue task.Connectivity of neural signals to M1 from the parietal area was observed in the external cue task.

Cerebellar and thalamic connector hubs facilitate the involvement of visual and cognitive networks in essential tremor.

INTRODUCTION: Connector hubs are specialized brain regions that connect multiple brain networks and therefore have the potential to affect the functions of multiple systems. This study aims to examine the involvement of connector hub regions in essential tremor. METHODS: We examined whole-brain functional connectivity alterations across multiple brain networks in 27 patients with essential tremor and 27 age- and sex-matched healthy controls to identify affected hub regions using a network metric called functional connectivity overlap ratio estimated from resting-state functional MRI. We also evaluated the relationships of affected hubs with cognitive and tremor scores in all patients and with motor function improvement scores in 15 patients who underwent postoperative follow-up evaluations after focused ultrasound thalamotomy. RESULTS: We have identified affected connector hubs in the cerebellum and thalamus. Specifically, the dentate nucleus in the cerebellum and the dorsomedial thalamus exhibited more extensive connections with the sensorimotor network in patients. Moreover, the connections of the thalamic pulvinar with the visual network were also significantly widespread in the patient group. The connections of these connector hub regions with cognitive networks were negatively associated (FDR q < 0.05) with cognitive, tremor, and motor function improvement scores. CONCLUSION: In patients with essential tremor, connector hub regions within the cerebellum and thalamus exhibited widespread functional connections with sensorimotor and visual networks, leading to alternative pathways outside the classical tremor axis. Their connections with cognitive networks also affect patients' cognitive function.

Connectivity alteration in thalamic nuclei and default mode network-related area in memory processes in mesial temporal lobe epilepsy using magnetoencephalography.

This work aimed to investigate the involvement of the thalamic nuclei in mesial temporal lobe epilepsy (MTLE) and identify the influence of interictal epileptic discharges on the neural basis of memory processing by evaluating the functional connectivity (FC) between the thalamic nuclei and default mode network-related area (DMNRA) using magnetoencephalography. Preoperative datasets of nine patients with MTLE with seizure-free status after surgery and those of nine healthy controls were analyzed. The FC between the thalamic nuclei (anterior nucleus [ANT], mediodorsal nucleus [MD], intralaminar nuclei [IL]), hippocampus, and DMNRA was examined for each of the resting, pre-spike, spike, and post-spike periods in the delta to ripple bands using magnetoencephalography. The FC between the ANT, MD, hippocampus, and medial prefrontal cortex increased in the gamma to ripple bands, whereas the FC between the ANT, IL, and DMNRA decreased in the delta to beta bands, compared with that of the healthy controls at rest. Compared with the rest period, the pre-spike period had significantly decreased FC between the ANT, MD, and DMNRA in the ripple band. Different FC changes between the thalamic nuclei, hippocampus, and DMNRA of specific connections in a particular band may reflect impairment or compensation in the memory processes.

Functional connector hubs in the cerebellum.

Accumulating evidence from anatomical and neuroimaging studies suggests that the cerebellum is engaged in a variety of motor and cognitive tasks. Given its various functions, a key question is whether the cerebellum also plays an important role in the brain's integrative functions. Here, we hypothesize the existence of connector regions, also known as connector hubs, where multiple resting state networks converged in the cerebellum. To verify this, we employed a recently developed voxel-level network measure called functional connectivity overlap ratio (FCOR), which could be used to quantify the spatial extent of a region's connection to several large-scale cortical networks. Using resting state functional MRI data from 101 healthy participants, cerebellar FCOR maps were constructed and used to identify the locations of connector hubs in the cerebellum. Results showed that a number of cerebellar regions exhibited strong connectivity with multiple functional networks, verifying our hypothesis. These highly connected regions were located in the posterior cerebellum, especially in lobules VI, VII, and IX, and mainly connected to the core neurocognitive networks such as default mode and executive control networks. Regions associated with the sensorimotor network were also localized in lobule V, VI, and VIII, albeit in small clusters. These cerebellar connector hubs may play an essential role in the processing of information across the core neurocognitive networks.

Reserve and Maintenance in the Aging Brain: A Longitudinal Study of Healthy Older Adults.

The aging brain undergoes structural changes even in very healthy individuals. Quantifying these changes could help disentangle pathologic changes from those associated with the normal human aging process. Using longitudinal magnetic resonance imaging (MRI) data from 227 carefully selected healthy human cohort with age ranging from 50 to 80 years old at baseline scan, we quantified age-related volumetric changes in the brain of healthy human older adults. Longitudinally, the rates of tissue loss in total gray matter (GM) and white matter (WM) were 2497.5 and 2579.8 mm3 per year, respectively. Across the whole brain, the rates of GM decline varied with regions in the frontal and parietal lobes having faster rates of decline, whereas some regions in the occipital and temporal lobes appeared relatively preserved. In contrast, cross-sectional changes were mainly observed in the temporal-occipital regions. Similar longitudinal atrophic changes were also observed in subcortical regions including thalamus, hippocampus, putamen, and caudate, whereas the pallidum showed an increasing volume with age. Overall, regions maturing late in development (frontal, parietal) are more vulnerable to longitudinal decline, whereas those that fully mature in the early stage (temporal, occipital) are mainly affected by cross-sectional changes in healthy older cohort. This may suggest that, for a successful healthy aging, the former needs to be maximally developed at an earlier age to compensate for the longitudinal decline later in life and the latter to remain relatively preserved even in old age, consistent with both concepts of reserve and brain maintenance.

Relationship Between Psychological Factors and Wound Occurrence in Patients With Peripheral Arterial Disease in the Leg.

This prospective study investigated psychological factors affecting wound healing in patients with peripheral arterial disease (PAD). Fifty patients with PAD in a local hospital were enrolled. The Geriatric Depression Scale short version, Type-D scale 14, Medical Outcome Study 36-Item Short-Form Health Survey (SF-36), Functional Independence Measure, Self-efficacy for Managing Chronic Disease Scale, Barriers Self-Efficacy Scale, and Mini Nutritional Assessment were applied to assess physical and psychological factors. Wound occurrence and healing were evaluated at 6 months after discharge, and 34 and 30 patients could be followed, respectively. The patient group with wound occurrence showed poorer mental component score (MCS) and better role/social component score (RCS) category scores of SF-36, and a higher stage in the Fontaine classification, than those without wound occurrence. On comparing Fontaine classification-matched subgroups, patients with wound occurrence showed poorer general health factor and MCS and better RCS of SF-36 than those without wound occurrence. Logistic analysis showed that MCS and RCS predicted wound occurrence and needs for local medical treatment, respectively. Among the psychological factors tested, MCS was a major factor associated with wound occurrence in the present study, with wide variation in clinical conditions and factors associated with PAD. Psychological factors were important as biological, physical, and social factors for patients with PAD during the long-term follow-up period, and an appropriate battery to evaluate psychological factors focused on patients with PAD should be developed.

Resting State Networks Related to the Maintenance of Good Cognitive Performance During Healthy Aging.

Purpose: Maintenance of cognitive performance is important for healthy aging. This study aims to elucidate the relationship between brain networks and cognitive function in subjects maintaining relatively good cognitive performance. Methods: A total of 120 subjects, with equal number of participants from each age group between 20 and 70 years, were included in this study. Only participants with Addenbrooke's Cognitive Examination - Revised (ACE-R) total score greater than 83 were included. Anatomical T1-weighted MR images and resting-state functional MR images (rsfMRIs) were taken from all participants using a 3-tesla MRI scanner. After preprocessing, several factors associated with age including the ACE-R total score, scores of five domains, sub-scores of ACE-R, and brain volumes were tested. Morphometric changes associated with age were analyzed using voxel based morphometry (VBM) and changes in resting state networks (RSNs) were examined using dual regression analysis. Results: Significant negative correlations with age were seen in the total gray matter volume (GMV, r = -0.58), and in the memory, attention, and visuospatial domains. Among the different sub-scores, the score of the delayed recall (DR) showed the highest negative correlation with age (r = -0.55, p < 0.001). In VBM analysis, widespread regions demonstrated negative correlation with age, but none with any of the cognitive scores. Quadratic approximations of cognitive scores as functions of age showed relatively delayed decline compared to total GMV loss. In dual regression analysis, some cognitive networks, including the dorsal default mode network, the lateral dorsal attention network, the right / left executive control network, the posterior salience network, and the language network, did not demonstrate negative correlation with age. Some regions in the sensorimotor networks showed positive correlation with the DR, memory, and fluency scores. Conclusion: Some domains of the cognitive test did not correlate with age, and even the highly correlated sub-scores such as the DR score, showed delayed decline compared to the loss of total GMV. Some RSNs, especially involving cognitive control regions, were relatively maintained with age. Furthermore, the scores of memory, fluency, and the DR were correlated with the within-network functional connectivity values of the sensorimotor network, which supported the importance of exercise for maintenance of cognition.

Bridging large-scale cortical networks: Integrative and function-specific hubs in the thalamus.

The thalamus is critical for the brain's integrative hub functions; however, the localization and characterization of the different thalamic hubs remain unclear. Using a voxel-level network measure called functional connectivity overlap ratio (FCOR), we examined the thalamus' association with large-scale resting-state networks (RSNs) to elucidate its connector hub roles. Connections to the core-neurocognitive networks were localized in the anterior and medial parts, such as the anteroventral and mediodorsal nuclei areas. Regions functionally connected to the sensorimotor network were distinctively located around the lateral pulvinar nucleus but to a limited extent. Prominent connector hubs include the anteroventral, ventral lateral, and mediodorsal nuclei with functional connections to multiple RSNs. These findings suggest that the thalamus, with extensive connections to most of the RSNs, is well placed as a critical integrative functional hub and could play an important role for functional integration facilitating brain functions associated with primary processing and higher cognition.

Pre-stimulus alpha oscillation and post-stimulus cortical activity differ in localization between consciously perceived and missed near-threshold somatosensory stimuli.

Conscious perception of a near-threshold (NT) stimulus is characterized by the pre- and post-stimulus brain state. However, the power of pre-stimulus neural oscillations and strength of post-stimulus cortical activity that lead to conscious perception have rarely been examined in individual cortical areas. This is because most previous electro- and magnetoencephalography (EEG and MEG, respectively) studies involved scalp- and sensor-level analyses. Therefore, we recorded MEG during a continuous NT somatosensory stimulus detection task and applied the reconstructed source data in order to identify cortical areas where the post-stimulus cortical activity and pre-stimulus alpha oscillation predict the conscious perception of NT somatosensory stimuli. We found that the somatosensory hierarchical processing areas, prefrontal areas and cortical areas belonging to the default mode network showed stronger cortical activity for consciously perceived trials in the post-stimulus period, but the cortical activity in primary somatosensory area (SI) is independent of conscious perception during the early stage of NT stimulus processing. In addition, we revealed that the pre-stimulus alpha oscillation only in SI is predictive of conscious perception. These findings suggest that the bottom-up stream of somatosensory information flow following SI and pre-stimulus alpha activity fluctuation in SI as a top-down modulation are crucial constituents of conscious perception.

Chronic pain-related cortical neural activity in patients with complex regional pain syndrome.

Quantitative objective measurement of chronic pain is important. We elucidated chronic pain-related cortical neural activity and neural connectivity among pain-related brain regions in complex regional pain syndrome (CRPS). Resting-state magnetoencephalography recordings were performed. Cortical current density and neural connectivity, revealed by amplitude envelope correlation (AEC), were estimated on standardized brain magnetic resonance imaging. Intra-experiment pain was assessed subjectively using a visual analogue scale (VAS). The correlation between current density and VAS scores was calculated for the occipital areas and pain-related cortices. Current density in the primary (SI) and secondary (SII) somatosensory cortex and precuneus in both hemispheres was negatively correlated with the pain VAS score. The AEC and VAS values were significantly correlated for the SII and the precuneus and for the SII and insular cortex in the alpha frequency band in the right hemisphere. In the theta frequency band, the AEC and VAS values correlated for the SII and posterior cingulate cortex in the right hemisphere. Our results suggested that disruption of pain processes and functions in the default mode network occurs in CRPS. Our method targeting the neural mechanism of pain has the potential to offer a clinically objective means of evaluating it.

Relationship between lower limb function and functional connectivity assessed by EEG among motor-related areas after stroke.

Background: Neural connectivity in brain has been known as indicators for neural function and recovery of brain. Although previous studies reported that neural connectivity predicted the recovery of upper limb function after stroke, the relationship between neural connectivity and lower limb function has not been clear.Objectives: To clarify whether functional connectivity (FC) assessed by electroencephalographiy (EEG) with five electrodes placed on motor-related areas could be related to the functional motor recovery of the lower limbs in patients after stroke.Methods: Twenty-four patients with stroke during the recovery phase were recruited. Motor function of the lower limbs was assessed using Fugl-Meyer Assessment lower limb section (FMAL). EEG signals were recorded by five electrodes (C3, C4, FC3, FC4, and FCz) at rest and during ankle movement. Amplitude envelope correlations, as values for FC, were calculated in α (8-12 Hz), ß (13-30 Hz), low-ß (13-19 Hz), and high-ß (20-30 Hz) frequency bands. The predictive regression equation of the FMAL score in the eighth week after stroke (8 W) was created by FCs in the fourth week (4 W).Results: The higher intra-hemispheric FC in both hemispheres in the resting state and during the ankle movement at 4 W was related to a higher lower limb function at 8 W. Additionally, the higher inter-hemispheric FC between M1 on both sides during the ankle movement was related to a higher function recovery.Conclusions: The intra- and inter-hemispheric FC among motor-related areas at 4 W after stroke might be related to the functional recovery of the lower limbs at 8 W.

Effects of Head Motion on the Evaluation of Age-related Brain Network Changes Using Resting State Functional MRI.

PURPOSE: The estimation of functional connectivity (FC) measures using resting state functional MRI (fMRI) is often affected by head motion during functional imaging scans. Head motion is more common in the elderly than in young participants and could therefore affect the evaluation of age-related changes in brain networks. Thus, this study aimed to investigate the influence of head motion in FC estimation when evaluating age-related changes in brain networks. METHODS: This study involved 132 healthy volunteers divided into 3 groups: elderly participants with high motion (OldHM, mean age (±SD) = 69.6 (±5.31), N = 44), elderly participants with low motion (OldLM, mean age (±SD) = 68.7 (±4.59), N = 43), and young adult participants with low motion (YugLM, mean age (±SD) = 27.6 (±5.26), N = 45). Head motion was quantified using the mean of the framewise displacement of resting state fMRI data. After preprocessing all resting state fMRI datasets, several resting state networks (RSNs) were extracted using independent component analysis (ICA). In addition, several network metrics were also calculated using network analysis. These FC measures were then compared among the 3 groups. RESULTS: In ICA, the number of voxels with significant differences in RSNs was higher in YugLM vs. OldLM comparison than in YugLM vs. OldHM. In network analysis, all network metrics showed significant (P < 0.05) differences in comparisons involving low vs. high motion groups (OldHM vs. OldLM and OldHM vs. YugLM). However, there was no significant (P > 0.05) difference in the comparison involving the low motion groups (OldLM vs. YugLM). CONCLUSION: Our findings showed that head motion during functional imaging could significantly affect the evaluation of age-related brain network changes using resting state fMRI data.

Aging Impacts the Overall Connectivity Strength of Regions Critical for Information Transfer Among Brain Networks.

Recent studies have demonstrated that connector hubs, regions considered critical for the flow of information across neural systems, are mostly involved in neurodegenerative dementia. Considering that aging can significantly affect the brain's intrinsic connectivity, identifying aging's impact on these regions' overall connection strength is important to differentiate changes associated with healthy aging from neurodegenerative disorders. Using resting state functional magnetic resonance imaging data from a carefully selected cohort of 175 healthy volunteers aging from 21 to 86 years old, we computed an intrinsic connectivity contrast (ICC) metric, which quantifies a region's overall connectivity strength, for whole brain, short-range, and long-range connections and examined age-related changes of this metric over the adult lifespan. We have identified a limited number of hub regions with ICC values that showed significant negative relationship with age. These include the medial precentral/midcingulate gyri and insula with both their short-range and long-range (and thus whole-brain) ICC values negatively associated with age, and the angular, middle frontal, and posterior cingulate gyri with their long-range ICC values mainly involved. Seed-based connectivity analyses further confirmed that these regions are connector hubs with connectivity profile that strongly overlapped with multiple large-scale brain networks. General cognitive performance was not associated with these hubs' ICC values. These findings suggest that even healthy aging could negatively impact the efficiency of regions critical for facilitating information transfer among different functional brain networks. The extent of the regions involved, however, was limited.

Identifying the brain's connector hubs at the voxel level using functional connectivity overlap ratio.

Neuroimaging studies have shown that the brain is functionally organized into several large-scale brain networks. Within these networks are regions that are widely connected to several other regions within and/or outside the network. Regions that connect to several other networks, known as connector hubs, are believed to be crucial for information transfer and between-network communication within the brain. To identify regions with high between-network connectivity at the voxel level, we introduced a novel metric called functional connectivity overlap ratio (FCOR), which quantifies the spatial extent of a region's connection to a given network. Using resting state functional magnetic resonance imaging data, FCOR maps were generated for several well-known large-scale resting state networks (RSNs) and used to examine the relevant associations among different RSNs, identify connector hub regions in the cerebral cortex, and elucidate the hierarchical functional organization of the brain. Constructed FCOR maps revealed a strong association among the core neurocognitive networks (default mode, salience, and executive control) as well as among primary processing networks (sensorimotor, auditory, and visual). Prominent connector hubs were identified in the bilateral middle frontal gyrus, posterior cingulate, lateral parietal, middle temporal, dorsal anterior cingulate, and anterior insula, among others, regions mostly associated with the core neurocognitive networks. Finally, clustering the whole brain using FCOR features yielded a topological organization that arranges brain regions into a hierarchy of information processing systems with the primary processing systems at one end and the heteromodal systems comprising connector hubs at the other end.

Changes in white matter fiber density and morphology across the adult lifespan: A cross-sectional fixel-based analysis.

White matter (WM) fiber bundles change dynamically with age. These changes could be driven by alterations in axonal diameter, axonal density, and myelin content. In this study, we applied a novel fixel-based analysis (FBA) framework to examine these changes throughout the adult lifespan. Using diffusion-weighted images from a cohort of 293 healthy volunteers (89 males/204 females) from ages 21 to 86 years old, we performed FBA to analyze age-related changes in microscopic fiber density (FD) and macroscopic fiber morphology (fiber cross section [FC]). Our results showed significant and widespread age-related alterations in FD and FC across the whole brain. Interestingly, some fiber bundles such as the anterior thalamic radiation, corpus callosum, and superior longitudinal fasciculus only showed significant negative relationship with age in FD values, but not in FC. On the other hand, some segments of the cerebello-thalamo-cortical pathway only showed significant negative relationship with age in FC, but not in FD. Analysis at the tract-level also showed that major fiber tract groups predominantly distributed in the frontal lobe (cingulum, forceps minor) exhibited greater vulnerability to the aging process than the others. Differences in FC and the combined measure of FD and cross section values observed between sexes were mostly driven by differences in brain sizes although male participants tended to exhibit steeper negative linear relationship with age in FD as compared to female participants. Overall, these findings provide further insights into the structural changes the brain's WM undergoes due to the aging process.

Disturbance of somatotopic spatial cognition and extra-territorial pain in carpal tunnel syndrome.

BACKGROUND: Several studies on carpal tunnel syndrome have reported pain that exists beyond the median nerve territory of the affected hand. However, the mechanism is unknown. PURPOSE: We investigated the cause of extra-territorial pain by the analysis of clinical assessments and cortical activity using magnetoencephalography. METHODS: To compare patients with and without extra-territorial pain, fourteen patients with carpal tunnel syndrome were assessed using clinical examination, such as patients' profile, paresthesia, physical tests, and psychological tests. The physical assessment included tactile threshold and static and moving two-point discrimination sensations on digital pulp. Neural activation in the cerebral cortex was also measured using z-scores calculated by magnetoencephalography. RESULTS: Among fourteen patients, ten patients had pain in the affected median nerve territory only and four patients had extra-territorial pain. When comparing the groups, the static and moving two-point discrimination sensation values in patients with extra-territorial pain were larger than those of patients without the pain (p < 0.05). The supra-marginal gyrus, mid-part of the precentral sulcus, angular gyrus in the left hemisphere, bilateral sensorimotor areas for legs, and bilateral isthmus-cingulate areas showed larger z-scores in patients with extra-territorial pain than in patients without the pain (p < 0.05). CONCLUSIONS: The static and moving two-point discrimination sensations signify the ability of tactile spatial acuity. Bilateral sensorimotor areas were activated in sites that were not the hand. Furthermore, the inferior parietal lobule in the left hemisphere, which synthesizes and integrates multiple sensations showed high activation. Our findings suggested that the mechanism of extra-territorial pain was associated with dysfunction of spatial cognition.

Distributed source analysis of magnetoencephalography using a volume head model combined with statistical methods improves focus diagnosis in epilepsy surgery.

Deep-seated epileptic focus estimation using magnetoencephalography is challenging because of its low signal-to-noise ratio and the ambiguity of current sources estimated by interictal epileptiform discharge (IED). We developed a distributed source (DS) analysis method using a volume head model as the source space of the forward model and standardized low-resolution brain electromagnetic tomography combined with statistical methods (permutation tests between IEDs and baselines and false discovery rate between voxels to reduce variation). We aimed to evaluate the efficacy of the combined DS (cDS) analysis in surgical cases. In total, 19 surgical cases with adult and pediatric focal epilepsy were evaluated. Both cDS and equivalent current dipole (ECD) analyses were performed in all cases. The concordance rates of the two methods with surgically identified epileptic foci were calculated and compared with surgical outcomes. Concordance rates from the cDS analysis were significantly higher than those from the ECD analysis (68.4% vs. 26.3%), especially in cases with deep-seated lesions, such as in the interhemispheric, fronto-temporal base, and mesial temporal structures (81.8% vs. 9.1%). Furthermore, the concordance rate correlated well with surgical outcomes. In conclusion, cDS analysis has better diagnostic performance in focal epilepsy, especially with deep-seated epileptic focus, and potentially leads to good surgical outcomes.

Electroencephalographic Functional Connectivity With the Tacit Learning System Prosthetic Hand: A Case Series Using Motor Imagery.

We previously created a prosthetic hand with a tacit learning system (TLS) that automatically supports the control of forearm pronosupination. This myoelectric prosthetic hand enables sensory feedback and flexible motor output, which allows users to move efficiently with minimal burden. In this study, we investigated whether electroencephalography can be used to analyze the influence of the auxiliary function of the TLS on brain function. Three male participants who had sustained below-elbow amputations and were myoelectric prosthesis users performed a series of physical movement trials with the TLS inactivated and activated. Trials were video recorded and a sequence of videos was prepared to represent each individual's own use while the system was inactivated and activated. In a subsequent motor imagery phase during which electroencephalography (EEG) signals were collected, each participant was asked to watch both videos of themself while actively imagining the physical movement depicted. Differences in mean cortical current and amplitude envelope correlation (AEC) values between supplementary motor areas (SMA) and each vertex were calculated. For all participants, there were differences in the mean cortical current generated by the motor imagery tasks when the TLS inactivated and activated conditions were compared. The AEC values were higher during the movement imagery task with TLS activation, although their distribution on the cortex varied between the three individuals. In both S1 and other brain areas, AEC values increased in conditions with the TLS activated. Evidence from this case series indicates that, in addition to motor control, TLS may change sensory stimulus recognition.

Subsecond EEG-fMRI analysis for presurgical evaluation in focal epilepsy.

OBJECTIVE: The authors recently reported a novel subsecond analysis method of analyzing EEG-functional MRI (fMRI) to improve the detection rate of epileptic focus. This study aims to validate the utility of this method for presurgical evaluation in pharmacoresistant focal epilepsy. METHODS: Among 13 patients with focal epilepsy undergoing presurgical examinations including simultaneous EEG-fMRI at 3T, 11 patients had interictal epileptiform discharges (IEDs) during fMRI. The authors used the sequence of topographic maps during the IEDs as a reference to obtain subsecond fMRI activation maps with the same temporal resolution as the EEG data, and constructed "spike-and-slow-wave-activation-summary" (SSWAS) maps that showed the activation frequency of voxels during IEDs. Clusters were defined by thresholding the SSWAS maps (voxel value > 10), and those containing voxels with the top 3 highest activation frequencies were considered significant. Significant hemodynamic responses using conventional event-related (ER) analysis and SSWAS maps were compared with the resection areas and surgical outcomes at 1 year after surgery. RESULTS: Using ER analysis, 4 (36%) of 11 patients had significant hemodynamic responses. One of 4 patients had significant hemodynamic responses in the resection area and good surgical outcome. Using SSWAS maps, 10 (91%) of 11 patients had significant hemodynamic responses. Six of 10 patients had significant hemodynamic responses in the resection area, and 5 of the 6 patients achieved good surgical outcomes. The remaining 4 patients had significant hemodynamic responses distant from the resection area, and only 1 of the 4 patients achieved good surgical outcomes. The sensitivity, specificity, positive predictive value, and negative predictive value of SSWAS maps were 83.3%, 75.0%, 83.3%, and 75.0%, respectively. CONCLUSIONS: This study demonstrated the clinical utility of SSWAS maps for presurgical evaluation of pharmacoresistant focal epilepsy. The findings indicated that subsecond EEG-fMRI analysis may help surgeons choose the resection areas that could lead to good surgical outcomes.