Disruption of layer-specific visual processing in a model of focal neocortical epilepsy.

The epileptic brain is the result of a sequence of events transforming normal neuronal populations into hyperexcitable networks supporting recurrent seizure generation. These modifications are known to induce fundamental alterations of circuit function and, ultimately, of behavior. However, how hyperexcitability affects information processing in cortical sensory circuits is not yet fully understood. Here, we investigated interlaminar alterations in sensory processing of the visual cortex in a mouse model of focal epilepsy. We found three main circuit dynamics alterations in epileptic mice: (i) a spreading of visual contrast-driven gamma modulation across layers, (ii) an increase in firing rate that is layer-unspecific for excitatory units and localized in infragranular layers for inhibitory neurons, and (iii) a strong and contrast-dependent locking of firing units to network activity. Altogether, our data show that epileptic circuits display a functional disruption of layer-specific organization of visual sensory processing, which could account for visual dysfunction observed in epileptic subjects. Understanding these mechanisms paves the way to circuital therapeutic interventions for epilepsy.

Clinical and Cardiovascular Magnetic Resonance Imaging Features of Cardiac Amyloidosis.

Amyloidosis is a systemic disease characterized by the accumulation of insoluble aggregates in various organs, leading to parenchymal damage. When these amyloid fibrils are deposited in the extracellular matrix of the cardiac structures, the condition is referred to as cardiac amyloidosis (CA). The extent of organ involvement determines the degree of cardiac impairment, which can significantly impact prognosis. The two most implicated proteins in CA are transthyretin and misfolded monoclonal immunoglobulin light chains. These proteins give rise to two distinct clinical forms of CA: transthyretin amyloidosis (ATTR-CA) and light-chain amyloidosis (AL-CA). ATTR-CA is further classified into two subtypes: ATTRm-CA, which occurs at a younger age and is caused by hereditary misfolded mutated proteins, and ATTRwt-CA, which is an acquired wild-type form more commonly observed in older adults, referred to as senile amyloidosis. While AL-CA was considered the most prevalent form for many years, recent autopsy studies have revealed an increase in cases of ATTRwt-CA. This narrative review aims to describe the clinical and imaging features of CA, with a particular focus on cardiac complications and mortality associated with the AL form. Early identification and differentiation of CA from other disorders are crucial, given the higher risk and severity of cardiac involvement in AL-CA. Furthermore, emphasis is placed on the potential utility of cardiovascular magnetic resonance imaging in detecting early cases of CA.

Motor improvement estimation and task adaptation for personalized robot-aided therapy: a feasibility study.

BACKGROUND: In the past years, robotic systems have become increasingly popular in upper limb rehabilitation. Nevertheless, clinical studies have so far not been able to confirm superior efficacy of robotic therapy over conventional methods. The personalization of robot-aided therapy according to the patients' individual motor deficits has been suggested as a pivotal step to improve the clinical outcome of such approaches. METHODS: Here, we present a model-based approach to personalize robot-aided rehabilitation therapy within training sessions. The proposed method combines the information from different motor performance measures recorded from the robot to continuously estimate patients' motor improvement for a series of point-to-point reaching movements in different directions. Additionally, it comprises a personalization routine to automatically adapt the rehabilitation training. We engineered our approach using an upper-limb exoskeleton. The implementation was tested with 17 healthy subjects, who underwent a motor-adaptation paradigm, and two subacute stroke patients, exhibiting different degrees of motor impairment, who participated in a pilot test undergoing rehabilitative motor training. RESULTS: The results of the exploratory study with healthy subjects showed that the participants divided into fast and slow adapters. The model was able to correctly estimate distinct motor improvement progressions between the two groups of participants while proposing individual training protocols. For the two pilot patients, an analysis of the selected motor performance measures showed that both patients were able to retain the improvements gained during training when reaching movements were reintroduced at a later stage. These results suggest that the automated training adaptation was appropriately timed and specifically tailored to the abilities of each individual. CONCLUSIONS: The results of our exploratory study demonstrated the feasibility of the proposed model-based approach for the personalization of robot-aided rehabilitation therapy. The pilot test with two subacute stroke patients further supported our approach, while providing encouraging results for the applicability in clinical settings. Trial registration This study is registered in ClinicalTrials.gov (NCT02770300, registered 30 March 2016, https://clinicaltrials.gov/ct2/show/NCT02770300).

The effect of fibrin sealant tissue glue in reducing post-operative collections following parotidectomy.

PURPOSE: Seroma/sialocele and haematoma formations following parotidectomy are common complications. Fibrin-sealant tissue glue (FSTG) applied to the surgical bed prior to closure has been used widely to reduce such complications at other surgical sites. We sought to evaluate a potential role in parotidectomy, examining outcomes before and after the use of FSTG was introduced in our department. METHODS: Outcomes were studied retrospectively for 1 year prior to the introduction of FSTG (group A, n = 31), and prospectively for 1 year subsequently (group B, n = 29). Primary outcome measures were seroma/sialocele and haematoma rates. Secondary outcome measures of interest included the use of a surgical drain and the duration of hospital stay. Chi-squared statistics and Mann-Whitney U tests were used to compare the outcomes between groups as appropriate. RESULTS: Seroma/sialocele rates were significantly lower in group B than in group A (n = 2 [6.9%] versus n = 8 [25.8%], p = 0.01) (Fig. 1), with an absolute risk reduction of 18.9%, a relative risk reduction of 26.7%, and a number needed to treat of 5.3. Haematoma rates were similar between groups (n = 0 [0%] versus n = 1 [3.2%], p = 0.36) (Fig. 2). In group A, a surgical drain was used in 24 cases (77.4%), while no cases in group B were drained.Fig. 1Seroma ratesFig. 2Haematoma rates CONCLUSION: The use of FSTG appears to significantly reduce the risk of post-parotidectomy seroma/sialocele formation and facilitates safe, drain-free daycase surgery. We hope this report will prompt other departments to consider using this technique and that our findings will help foster further appraisal in larger, prospective studies going forward.

Detection of movement onset using EMG signals for upper-limb exoskeletons in reaching tasks.

BACKGROUND: To assist people with disabilities, exoskeletons must be provided with human-robot interfaces and smart algorithms capable to identify the user's movement intentions. Surface electromyographic (sEMG) signals could be suitable for this purpose, but their applicability in shared control schemes for real-time operation of assistive devices in daily-life activities is limited due to high inter-subject variability, which requires custom calibrations and training. Here, we developed a machine-learning-based algorithm for detecting the user's motion intention based on electromyographic signals, and discussed its applicability for controlling an upper-limb exoskeleton for people with severe arm disabilities. METHODS: Ten healthy participants, sitting in front of a screen while wearing the exoskeleton, were asked to perform several reaching movements toward three LEDs, presented in a random order. EMG signals from seven upper-limb muscles were recorded. Data were analyzed offline and used to develop an algorithm that identifies the onset of the movement across two different events: moving from a resting position toward the LED (Go-forward), and going back to resting position (Go-backward). A set of subject-independent time-domain EMG features was selected according to information theory and their probability distributions corresponding to rest and movement phases were modeled by means of a two-component Gaussian Mixture Model (GMM). The detection of movement onset by two types of detectors was tested: the first type based on features extracted from single muscles, whereas the second from multiple muscles. Their performances in terms of sensitivity, specificity and latency were assessed for the two events with a leave one-subject out test method. RESULTS: The onset of movement was detected with a maximum sensitivity of 89.3% for Go-forward and 60.9% for Go-backward events. Best performances in terms of specificity were 96.2 and 94.3% respectively. For both events the algorithm was able to detect the onset before the actual movement, while computational load was compatible with real-time applications. CONCLUSIONS: The detection performances and the low computational load make the proposed algorithm promising for the control of upper-limb exoskeletons in real-time applications. Fast initial calibration makes it also suitable for helping people with severe arm disabilities in performing assisted functional tasks.

Unidirectional brain to muscle connectivity reveals motor cortex control of leg muscles during stereotyped walking.

In lower mammals, locomotion seems to be mainly regulated by subcortical and spinal networks. On the contrary, recent evidence suggests that in humans the motor cortex is also significantly engaged during complex locomotion tasks. However, a detailed understanding of cortical contribution to locomotion is still lacking especially during stereotyped activities. Here, we show that cortical motor areas finely control leg muscle activation during treadmill stereotyped walking. Using a novel technique based on a combination of Reliable Independent Component Analysis, source localization and effective connectivity, and by combining electroencephalographic (EEG) and electromyographic (EMG) recordings in able-bodied adults we were able to examine for the first time cortical activation patterns and cortico-muscular connectivity including information flow direction. Results not only provided evidence of cortical activity associated with locomotion, but demonstrated significant causal unidirectional drive from contralateral motor cortex to muscles in the swing leg. These insights overturn the traditional view that human cortex has a limited role in the control of stereotyped locomotion, and suggest useful hypotheses concerning mechanisms underlying gait under other conditions. ONE SENTENCE SUMMARY: Motor cortex proactively drives contralateral swing leg muscles during treadmill walking, counter to the traditional view of stereotyped human locomotion.

Model-based variables for the kinematic assessment of upper-extremity impairments in post-stroke patients.

BACKGROUND: Common scales for clinical evaluation of post-stroke upper-limb motor recovery are often complemented with kinematic parameters extracted from movement trajectories. However, there is no a general consensus on which parameters to use. Moreover, the selected variables may be redundant and highly correlated or, conversely, may incompletely sample the kinematic information from the trajectories. Here we sought to identify a set of clinically useful variables for an exhaustive but yet economical kinematic characterization of upper limb movements performed by post-stroke hemiparetic subjects. METHODS: For this purpose, we pursued a top-down model-driven approach, seeking which kinematic parameters were pivotal for a computational model to generate trajectories of point-to-point planar movements similar to those made by post-stroke subjects at different levels of impairment. RESULTS: The set of kinematic variables used in the model allowed for the generation of trajectories significantly similar to those of either sub-acute or chronic post-stroke patients at different time points during the therapy. Simulated trajectories also correctly reproduced many kinematic features of real movements, as assessed by an extensive set of kinematic metrics computed on both real and simulated curves. When inspected for redundancy, we found that variations in the variables used in the model were explained by three different underlying and unobserved factors related to movement efficiency, speed, and accuracy, possibly revealing different working mechanisms of recovery. CONCLUSION: This study identified a set of measures capable of extensively characterizing the kinematics of upper limb movements performed by post-stroke subjects and of tracking changes of different motor improvement aspects throughout the rehabilitation process.

Serious complications during aural impression-taking for hearing aids: a case report and review of the literature.

OBJECTIVES: Complications during aural impression-taking for hearing aids are relatively rare. We present a case to highlight the need for vigilance when taking an aural impression and review the literature to identify other cases in order to assess the range of complications encountered and the sequelae of this potentially serious problem. METHODS: We present a case report and a review of the literature. RESULTS: The most common complication was the entry of mold material into the middle ear cavity. This frequently occurred in patients with a preexisting perforation of the tympanic membrane, although traumatic perforation occurred in 5 cases. Spread of the mold material within the middle ear cavity was frequently extensive, with 46% of cases involving the eustachian tube. There were 6 cases of ossicular chain involvement: encasement of the ossicles in 5 and extensive ossicular erosion in 1. The extent of the surgical procedures performed varied widely, ranging from simple removal of the foreign body in the mastoid cavity to tympanomastoidectomy with a facial recess approach and ossiculoplasty. In 50% of cases, the patient recovered without any complication. However, further hearing loss was observed in 36% of cases. CONCLUSIONS: When mold material is impacted in the ear canal and visualization of the middle ear is obscured, we advise against simple piecemeal removal. Such cases are best managed by an experienced otologist.

Human ability to discriminate direction of three-dimensional force stimuli applied to the finger pad.

Sensory information from tactile mechanoreceptors located in the glabrous skin of the hand is crucial for skillful object exploration and manipulation. These mechanoreceptors reliably encode the direction of fingertip forces, and the brain certainly relies on this information in both sensorimotor and cognitive tasks. In this study, we examined human ability to discriminate the direction of force stimuli applied to the volar surface of the index fingertip on the basis of tactile information only. We show that humans can discriminate three-dimensional (3D) force stimuli whose directions differ by an angle as small as 7.1 ° in the plane tangential to the skin surface. Moreover, we found that the discrimination ability was mainly affected by the time-varying phases of the stimulus, because adding a static plateau phase to the stimulus improved the discrimination threshold only to a limited extent.

Bioelectronic medicine for the autonomic nervous system: clinical applications and perspectives.

Bioelectronic medicine (BM) is an emerging new approach for developing novel neuromodulation therapies for pathologies that have been previously treated with pharmacological approaches. In this review, we will focus on the neuromodulation of autonomic nervous system (ANS) activity with implantable devices, a field of BM that has already demonstrated the ability to treat a variety of conditions, from inflammation to metabolic and cognitive disorders. Recent discoveries about immune responses to ANS stimulation are the laying foundation for a new field holding great potential for medical advancement and therapies and involving an increasing number of research groups around the world, with funding from international public agencies and private investors. Here, we summarize the current achievements and future perspectives for clinical applications of neural decoding and stimulation of the ANS. First, we present the main clinical results achieved so far by different BM approaches and discuss the challenges encountered in fully exploiting the potential of neuromodulatory strategies. Then, we present current preclinical studies aimed at overcoming the present limitations by looking for optimal anatomical targets, developing novel neural interface technology, and conceiving more efficient signal processing strategies. Finally, we explore the prospects for translating these advancements into clinical practice.

Connectivity Measures Differentiate Cortical and Subcortical Sub-Acute Ischemic Stroke Patients.

Brain lesions caused by cerebral ischemia lead to network disturbances in both hemispheres, causing a subsequent reorganization of functional connectivity both locally and remotely with respect to the injury. Quantitative electroencephalography (qEEG) methods have long been used for exploring brain electrical activity and functional connectivity modifications after stroke. However, results obtained so far are not univocal. Here, we used basic and advanced EEG methods to characterize how brain activity and functional connectivity change after stroke. Thirty-three unilateral post stroke patients in the sub-acute phase and ten neurologically intact age-matched right-handed subjects were enrolled. Patients were subdivided into two groups based on lesion location: cortico-subcortical (CS, n = 18) and subcortical (S, n = 15), respectively. Stroke patients were evaluated in the period ranging from 45 days since the acute event (T0) up to 3 months after stroke (T1) with both neurophysiological (resting state EEG) and clinical assessment (Barthel Index, BI) measures, while healthy subjects were evaluated once. Brain power at T0 was similar between the two groups of patients in all frequency bands considered (δ, θ, α, and ß). However, evolution of θ-band power over time was different, with a normalization only in the CS group. Instead, average connectivity and specific network measures (Integration, Segregation, and Small-worldness) in the ß-band at T0 were significantly different between the two groups. The connectivity and network measures at T0 also appear to have a predictive role in functional recovery (BI T1-T0), again group-dependent. The results obtained in this study showed that connectivity measures and correlations between EEG features and recovery depend on lesion location. These data, if confirmed in further studies, on the one hand could explain the heterogeneity of results so far observed in previous studies, on the other hand they could be used by researchers as biomarkers predicting spontaneous recovery, to select homogenous groups of patients for the inclusion in clinical trials.

Computational approaches to decode grasping force and velocity level in upper-limb amputee from intraneural peripheral signals.

Objective. Recent results have shown the potentials of neural interfaces to provide sensory feedback to subjects with limb amputation increasing prosthesis usability. However, their advantages for decoding motor control signals over current methods based on electromyography (EMG) are still debated. In this study we compared a standard EMG-based method with approaches that use peripheral intraneural data to infer distinct levels of grasping force and velocity in a trans-radial amputee.Approach. Surface EMG (three channels) and intraneural signals (collected with transverse intrafascicular multichannel electrodes, TIMEs, 56 channels) were simultaneously recorded during the amputee's intended grasping movements. We sorted single unit activity (SUA) from each neural signal and then we identified the most informative units. EMG envelopes were extracted from the recorded EMG signals. A reference support vector machine (SVM) classifier was used to map EMG envelopes into desired force and velocity levels. Two decoding approaches using SUA were then tested and compared to the EMG-based reference classifier: (a) SVM classification of firing rates into desired force and velocity levels; (b) reconstruction of covariates (the grasp cue level or EMG envelopes) from neural data and use of covariates for classification into desired force and velocity levels.Main results.Using EMG envelopes as reconstructed covariates from SUA yielded significantly better results than the other approaches tested, with performance similar to that of the EMG-based reference classifier, and stable over three different recording days. Of the two reconstruction algorithms used in this approach, a linear Kalman filter and a nonlinear point process adaptive filter, the nonlinear filter gave better results.Significance.This study presented a new effective approach for decoding grasping force and velocity from peripheral intraneural signals in a trans-radial amputee, which relies on using SUA to reconstruct EMG envelopes. Being dependent on EMG recordings only for the training phase, this approach can fully exploit the advantages of implanted neural interfaces and potentially overcome, in the medium to long term, current state-of-the-art methods. (Clinical trial's registration number: NCT02848846).

Importance of serum calcium in spontaneous neck haematoma.

We present an unusual case of spontaneous cervical haemorrhage secondary to extra-capsular bleeding from a parathyroid adenoma. Signs and symptoms on presentation included sore throat, dysphagia and anterior chest ecchymosis. While CT confirmed active cervical haemorrhage, elevated serum calcium and parathyroid hormone raised suspicion of possible parathyroid pathology. This case report and literature review highlight the diagnostic value of serum calcium in presentations of acute spontaneous neck haematoma. This should be considered especially in the acute phase, where imaging may not identify the source of haemorrhage. Initial observation and deferred surgery is the treatment of choice, with emergency operative management reserved for respiratory distress and worsening compressive symptoms.

Neural signal recording and processing in somatic neuroprosthetic applications. A review.

Neurointerfaces have acquired major relevance as both rehabilitative and therapeutic tools for patients with spinal cord injury, limb amputations and other neural disorders. Bidirectional neural interfaces are a key component for the functional control of neuroprosthetic devices. The two main neuroprosthetic applications of interfaces with the peripheral nervous system (PNS) are: the refined control of artificial prostheses with sensory neural feedback, and functional electrical stimulation (FES) systems attempting to generate motor or visceral responses in paralyzed organs. The results obtained in experimental and clinical studies with both, extraneural and intraneural electrodes are very promising in terms of the achieved functionality for the neural stimulation mode. However, the results of neural recordings with peripheral nerve interfaces are more limited. In this paper we review the different existing approaches for PNS signals recording, denoising, processing and classification, enabling their use for bidirectional interfaces. PNS recordings can provide three types of signals: i) population activity signals recorded by using extraneural electrodes placed on the outer surface of the nerve, which carry information about cumulative nerve activity; ii) spike activity signals recorded with intraneural electrodes placed inside the nerve, which carry information about the electrical activity of a set of individual nerve fibers; and iii) hybrid signals, which contain both spiking and cumulative signals. Finally, we also point out some of the main limitations, which are hampering clinical translation of neural decoding, and indicate possible solutions for improvement.

Decoding Neural Metabolic Markers From the Carotid Sinus Nerve in a Type 2 Diabetes Model.

Recent studies showed that the carotid sinus nerve (CSN) and the sympathetic nervous system (SNS) are overactivated in type 2 diabetes and that restoring the correct CSN neural activity can re-establish the proper metabolism. However, a robust characterization of the relationship between CSN and SNS neural activities and metabolism in type 2 diabetes is still missing. Here, we investigated the relationship between neural activity of CSN and SNS in control rats and in rats with diet-induced type 2 diabetes and the animal condition during metabolic challenges. We found that the diabetic condition can be discriminated on the basis of CSN and SNS neural activities due to a high-frequency shift in both spectra. This shift is suppressed in the SNS in case of CSN denervation, confirming the role of CSN in driving sympathetic overactivation in type 2 diabetes. Interestingly, the Inter-Burst-Intervals (IBIs) calculated from CSN bursts strongly correlate with perturbations in glycaemia levels. This finding, held for both control and diabetic rats, indicates the possibility of detecting metabolic information from neural recordings even in pathological conditions. Our results suggest that CSN activity could serve as a marker to monitor glycaemic alterations and, therefore, it could be used for closed-loop control of CSN neuromodulation. This paves the way to the development of novel and effective bioelectronic therapies for type 2 diabetes.

Combined Rehabilitation Promotes the Recovery of Structural and Functional Features of Healthy Neuronal Networks after Stroke.

Rehabilitation is considered the most effective treatment for promoting the recovery of motor deficits after stroke. One of the most challenging experimental goals is to unambiguously link brain rewiring to motor improvement prompted by rehabilitative therapy. Previous work showed that robotic training combined with transient inactivation of the contralesional cortex promotes a generalized recovery in a mouse model of stroke. Here, we use advanced optical imaging and manipulation tools to study cortical remodeling induced by this rehabilitation paradigm. We show that the stabilization of peri-infarct synaptic contacts accompanies increased vascular density induced by angiogenesis. Furthermore, temporal and spatial features of cortical activation recover toward pre-stroke conditions through the progressive formation of a new motor representation in the peri-infarct area. In the same animals, we observe reinforcement of inter-hemispheric connectivity. Our results provide evidence that combined rehabilitation promotes the restoration of structural and functional features distinctive of healthy neuronal networks.

A Robotic System for Adaptive Training and Function Assessment of Forelimb Retraction in Mice.

Rodent models are decisive for translational research in healthy and pathological conditions of motor function thanks to specific similarities with humans. Here, we present an upgraded version of the M-Platform, a robotic device previously designed to train mice during forelimb retraction tasks. This new version significantly extends its possibilities for murine experiments during motor tasks: 1) an actuation system for friction adjustment allows to automatically adapt pulling difficulty; 2) the device can be used both for training, with a retraction task, and for assessment, with an isometric task; and 3) the platform can be integrated with a neurophysiology systems to record simultaneous cortical neural activity. Results of the validation experiments with healthy mice confirmed that the M-Platform permits precise adjustments of friction during the task, thus allowing to change its difficulty and that these variations induce a different improvement in motor performance, after specific training sessions. Moreover, simultaneous and high quality (high signal-to-noise ratio) neural signals can be recorded from the rostral forelimb area (RFA) during task execution. With the novel features presented herein, the M-Platform may allow to investigate the outcome of a customized motor rehabilitation protocol after neural injury, to analyze task-related signals from brain regions interested by neuroplastic events and to perform optogenetic silencing or stimulation during experiments in transgenic mice.

Combining robotic training and inactivation of the healthy hemisphere restores pre-stroke motor patterns in mice.

Focal cortical stroke often leads to persistent motor deficits, prompting the need for more effective interventions. The efficacy of rehabilitation can be increased by 'plasticity-stimulating' treatments that enhance experience-dependent modifications in spared areas. Transcallosal pathways represent a promising therapeutic target, but their role in post-stroke recovery remains controversial. Here, we demonstrate that the contralesional cortex exerts an enhanced interhemispheric inhibition over the perilesional tissue after focal cortical stroke in mouse forelimb motor cortex. Accordingly, we designed a rehabilitation protocol combining intensive, repeatable exercises on a robotic platform with reversible inactivation of the contralesional cortex. This treatment promoted recovery in general motor tests and in manual dexterity with remarkable restoration of pre-lesion movement patterns, evaluated by kinematic analysis. Recovery was accompanied by a reduction of transcallosal inhibition and 'plasticity brakes' over the perilesional tissue. Our data support the use of combinatorial clinical therapies exploiting robotic devices and modulation of interhemispheric connectivity.

Delta Power Is Higher and More Symmetrical in Ischemic Stroke Patients with Cortical Involvement.

A brain injury resulting from unilateral stroke critically alters brain functionality and the complex balance within the cortical activity. Such modifications may critically depend on lesion location and cortical involvement. Indeed, recent findings pointed out the necessity of applying a stratification based on lesion location when investigating inter-hemispheric balance in stroke. Here, we tested whether cortical involvement could imply differences in band-specific activity and brain symmetry in post stroke patients with cortico-subcortical and subcortical strokes. We explored brain activity related to lesion location through EEG power analysis and quantitative Electroencephalography (qEEG) measures. Thirty stroke patients in the subacute phase and 10 neurologically intact age-matched right-handed subjects were enrolled. Stroke patients were equally subdivided in two groups based on lesion location: cortico-subcortical (CS, mean age ± SD: 72.21 ± 10.97 years; time since stroke ± SD: 31.14 ± 11.73 days) and subcortical (S, mean age ± SD: 68.92 ± 10.001 years; time since stroke ± SD: 26.93 ± 13.08 days) group. We assessed patients' neurological status by means of National Institutes of Health Stroke Scale (NIHSS). High density EEG at rest was recorded and power spectral analysis in Delta (1-4 Hz) and Alpha (8-14 Hz) bands was performed. qEEG metrics as pairwise derived Brain Symmetry Index (pdBSI) and Delta/Alpha Ratio (DAR) were computed and correlated with NIHSS score. S showed a lower Delta power in the Unaffected Hemisphere (UH) compared to Affected Hemisphere (AH; z = -1.98, p < 0.05) and a higher Alpha power compared to CS (z = -2.18, p < 0.05). pdBSI was negatively correlated with NIHSS (R = -0.59, p < 0.05). CS showed a higher value and symmetrical distribution of Delta band activity (z = -2.37, p < 0.05), confirmed also by a higher DAR value compared to S (z = -2.48, p < 0.05). Patients with cortico-subcortical and subcortical lesions show different brain symmetry in the subacute phase. Interestingly, in subcortical stroke patient brain activity is related with the clinical function. qEEG measures can be explicative of brain activity related to lesion location and they could allow precise definition of diagnostic-therapeutic algorithms in stroke patients.