Coherent neural oscillations predict future motor and language improvement after stroke.

Recent findings have demonstrated that stroke lesions affect neural communication in the entire brain. However, it is less clear whether network interactions are also relevant for plasticity and repair. This study investigated whether the coherence of neural oscillations at language or motor nodes is associated with future clinical improvement. Twenty-four stroke patients underwent high-density EEG recordings and standardized motor and language tests at 2-3 weeks (T0) and 3 months (T1) after stroke onset. In addition, EEG and motor assessments were obtained from a second population of 18 stroke patients. The graph theoretical measure of weighted node degree at language and motor areas was computed as the sum of absolute imaginary coherence with all other brain regions and compared to the amount of clinical improvement from T0 to T1. At T0, beta-band weighted node degree at the ipsilesional motor cortex was linearly correlated with better subsequent motor improvement, while beta-band weighted node degree at Broca's area was correlated with better language improvement. Clinical recovery was further associated with contralesional theta-band weighted node degree. These correlations were each specific to the corresponding brain area and independent of initial clinical severity, age, and lesion size. Findings were reproduced in the second stroke group. Conversely, later coherence increases occurring between T0 and T1 were associated with less clinical improvement. Improvement of language and motor functions after stroke is therefore associated with inter-regional synchronization of neural oscillations in the first weeks after stroke. A better understanding of network mechanisms of plasticity may lead to new prognostic biomarkers and therapeutic targets.See Ward (doi:10.1093/brain/awv265) for a scientific commentary on this article.

Two intrinsic coupling types for resting-state integration in the human brain.

Recent findings indicate that synchronous neural activity at rest influences human performance in subsequent tasks. Synchronization can occur in form of phase coupling or amplitude correlation. It is unknown whether these coupling types have differing behavioral significance at rest. To address this, we performed resting-state electroencephalography (EEG) and source connectivity analysis in several populations of healthy subjects and patients with brain lesions. We systematically compared different types and frequencies of neural synchronization and investigated their association with behavioral performance in verbal and spatial attention tasks. Behavioral performance could be consistently predicted by two distinct resting-state coupling patterns: (1) amplitude envelope correlation of beta activity between homologous areas of both hemispheres, (2) lagged phase synchronization in EEG alpha activity between a brain area and the entire cortex. A disruption of these coupling patterns was also associated with neurological deficits in patients with stroke lesions. This suggests the existence of two distinct network systems responsible for resting-state integration. Lagged phase synchronization in the alpha band is associated with global interaction across networks while amplitude envelope correlation seems to be behaviorally relevant for interactions within networks and between hemispheres. These two coupling types may therefore provide complementary insights on brain physiology and pathology.

Network mechanisms of responsiveness to continuous theta-burst stimulation.

Continuous theta-burst stimulation (cTBS) can modify behavior, but effects are inconsistent and their mechanisms insufficiently understood. As coherence in resting-state networks influences human behavior, we hypothesized that cTBS may act via modulation of neural oscillation coherence. This study used electroencephalography (EEG) to investigate whether behavioral effects of cTBS on visuospatial attention are associated with coherence changes in the attention network. In healthy human subjects, cTBS of the right posterior parietal cortex (PPC) and the right frontal eye field was compared with sham stimulation. Effects on visuospatial attention were quantified with a visual exploration task, and network effects were assessed from surface EEG with inverse solutions and source coherence analyses. Before stimulation, left visual exploration was linearly correlated with alpha-band coherence between the right temporo-parietal cortex and the rest of the brain. Posterior parietal cortex stimulation induced neglect-like visual exploration behavior in the majority, but not all, subjects. It reduced alpha-band coherence between the stimulation site and the rest of the brain but also enhanced it between the contralateral left parietal cortex and the rest of the brain. The contralateral increase correlated with the induced reduction in left visual attention. The behavioral response of individual participants to cTBS could be predicted by coherence in the right temporo-parietal junction before stimulation. Behavioral effects of cTBS therefore depend on network states before stimulation and are linearly associated with changes in network interactions. In particular, cTBS modulates an interhemispheric competition in alpha-band coherence. EEG network imaging might help to optimize therapeutic cTBS in the future.