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1.
Nature ; 626(7999): 593-602, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38093008

RESUMO

Understanding the neural basis of speech perception requires that we study the human brain both at the scale of the fundamental computational unit of neurons and in their organization across the depth of cortex. Here we used high-density Neuropixels arrays1-3 to record from 685 neurons across cortical layers at nine sites in a high-level auditory region that is critical for speech, the superior temporal gyrus4,5, while participants listened to spoken sentences. Single neurons encoded a wide range of speech sound cues, including features of consonants and vowels, relative vocal pitch, onsets, amplitude envelope and sequence statistics. Neurons at each cross-laminar recording exhibited dominant tuning to a primary speech feature while also containing a substantial proportion of neurons that encoded other features contributing to heterogeneous selectivity. Spatially, neurons at similar cortical depths tended to encode similar speech features. Activity across all cortical layers was predictive of high-frequency field potentials (electrocorticography), providing a neuronal origin for macroelectrode recordings from the cortical surface. Together, these results establish single-neuron tuning across the cortical laminae as an important dimension of speech encoding in human superior temporal gyrus.


Assuntos
Córtex Auditivo , Neurônios , Percepção da Fala , Lobo Temporal , Humanos , Estimulação Acústica , Córtex Auditivo/citologia , Córtex Auditivo/fisiologia , Neurônios/fisiologia , Fonética , Fala , Percepção da Fala/fisiologia , Lobo Temporal/citologia , Lobo Temporal/fisiologia , Sinais (Psicologia) , Eletrodos
2.
J Neuropsychiatry Clin Neurosci ; 32(2): 185-190, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31394989

RESUMO

OBJECTIVES: Adult patients with epilepsy have an increased prevalence of major depressive disorder (MDD). Intracranial EEG (iEEG) captured during extended inpatient monitoring of patients with treatment-resistant epilepsy offers a particularly promising method to study MDD networks in epilepsy. METHODS: The authors used 24 hours of resting-state iEEG to examine the neural activity patterns within corticolimbic structures that reflected the presence of depressive symptoms in 13 adults with medication-refractory epilepsy. Principal component analysis was performed on the z-scored mean relative power in five standard frequency bands averaged across electrodes within a region. RESULTS: Principal component 3 was a statistically significant predictor of the presence of depressive symptoms (R2=0.35, p=0.014). A balanced logistic classifier model using principal component 3 alone correctly classified 78% of patients as belonging to the group with a high burden of depressive symptoms or a control group with minimal depressive symptoms (sensitivity, 75%; specificity, 80%; area under the curve=0.8, leave-one-out cross validation). Classification was dependent on beta power throughout the corticolimbic network and low-frequency cingulate power. CONCLUSIONS: These finding suggest, for the first time, that neural features across circuits involved in epilepsy may distinguish patients who have depressive symptoms from those who do not. Larger studies are required to validate these findings and to assess their diagnostic utility in MDD.


Assuntos
Córtex Cerebral/fisiopatologia , Depressão/fisiopatologia , Epilepsia Resistente a Medicamentos/fisiopatologia , Eletrocorticografia , Sistema Límbico/fisiopatologia , Rede Nervosa/fisiopatologia , Adulto , Biomarcadores , Feminino , Humanos , Masculino , Projetos Piloto , Análise de Componente Principal
3.
PLoS Comput Biol ; 13(6): e1005511, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28570661

RESUMO

The disruption of coupling between brain areas has been suggested as the mechanism underlying loss of consciousness in anesthesia. This hypothesis has been tested previously by measuring the information transfer between brain areas, and by taking reduced information transfer as a proxy for decoupling. Yet, information transfer is a function of the amount of information available in the information source-such that transfer decreases even for unchanged coupling when less source information is available. Therefore, we reconsidered past interpretations of reduced information transfer as a sign of decoupling, and asked whether impaired local information processing leads to a loss of information transfer. An important prediction of this alternative hypothesis is that changes in locally available information (signal entropy) should be at least as pronounced as changes in information transfer. We tested this prediction by recording local field potentials in two ferrets after administration of isoflurane in concentrations of 0.0%, 0.5%, and 1.0%. We found strong decreases in the source entropy under isoflurane in area V1 and the prefrontal cortex (PFC)-as predicted by our alternative hypothesis. The decrease in source entropy was stronger in PFC compared to V1. Information transfer between V1 and PFC was reduced bidirectionally, but with a stronger decrease from PFC to V1. This links the stronger decrease in information transfer to the stronger decrease in source entropy-suggesting reduced source entropy reduces information transfer. This conclusion fits the observation that the synaptic targets of isoflurane are located in local cortical circuits rather than on the synapses formed by interareal axonal projections. Thus, changes in information transfer under isoflurane seem to be a consequence of changes in local processing more than of decoupling between brain areas. We suggest that source entropy changes must be considered whenever interpreting changes in information transfer as decoupling.


Assuntos
Anestésicos Inalatórios/farmacologia , Estado de Consciência , Isoflurano/farmacologia , Processos Mentais/efeitos dos fármacos , Inconsciência , Anestesia , Animais , Estado de Consciência/efeitos dos fármacos , Estado de Consciência/fisiologia , Feminino , Furões , Córtex Pré-Frontal/efeitos dos fármacos , Inconsciência/induzido quimicamente , Inconsciência/fisiopatologia
4.
Neuroimage ; 143: 70-81, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27596024

RESUMO

Resting state functional magnetic resonance imaging (rsfMRI) has emerged as a versatile tool for non-invasive measurement of functional connectivity patterns in the brain. RsfMRI brain dynamics in rodents, non-human primates, and humans share similar properties; however, little is known about the resting state functional connectivity patterns in the ferret, an animal model with high potential for developmental and cognitive translational study. To address this knowledge-gap, we performed rsfMRI on anesthetized ferrets using a 9.4T MRI scanner, and subsequently performed group-level independent component analysis (gICA) to identify functionally connected brain networks. Group-level ICA analysis revealed distributed sensory, motor, and higher-order networks in the ferret brain. Subsequent connectivity analysis showed interconnected higher-order networks that constituted a putative default mode network (DMN), a network that exhibits altered connectivity in neuropsychiatric disorders. Finally, we assessed ferret brain topological efficiency using graph theory analysis and found that the ferret brain exhibits small-world properties. Overall, these results provide additional evidence for pan-species resting-state networks, further supporting ferret-based studies of sensory and cognitive function.


Assuntos
Mapeamento Encefálico/métodos , Encéfalo/fisiologia , Furões/fisiologia , Imageamento por Ressonância Magnética/métodos , Animais , Encéfalo/diagnóstico por imagem , Feminino
5.
Eur J Neurosci ; 43(2): 230-44, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26505737

RESUMO

The role of higher-order thalamic structures in sensory processing remains poorly understood. Here, we used the ferret (Mustela putorius furo) as a novel model species for the study of the lateral posterior (LP)-pulvinar complex and its structural and functional connectivity with area 17 [primary visual cortex (V1)]. We found reciprocal anatomical connections between the lateral part of the LP nucleus of the LP-pulvinar complex (LPl) and V1. In order to investigate the role of this feedback loop between LPl and V1 in shaping network activity, we determined the functional interactions between LPl and the supragranular, granular and infragranular layers of V1 by recording multiunit activity and local field potentials. Coherence was strongest between LPl and the supragranular V1, with the most distinct peaks in the delta and alpha frequency bands. Inter-area interaction measured by spike-phase coupling identified the delta frequency band being dominated by the infragranular V1 and multiple frequency bands that were most pronounced in the supragranular V1. This inter-area coupling was differentially modulated by full-field synthetic and naturalistic visual stimulation. We also found that visual responses in LPl were distinct from those in V1 in terms of their reliability. Together, our data support a model of multiple communication channels between LPl and the layers of V1 that are enabled by oscillations in different frequency bands. This demonstration of anatomical and functional connectivity between LPl and V1 in ferrets provides a roadmap for studying the interaction dynamics during behaviour, and a template for identifying the activity dynamics of other thalamo-cortical feedback loops.


Assuntos
Neurônios/fisiologia , Pulvinar/citologia , Pulvinar/fisiologia , Córtex Visual/citologia , Córtex Visual/fisiologia , Potenciais de Ação , Animais , Ondas Encefálicas , Feminino , Furões , Vias Neurais/citologia , Vias Neurais/fisiologia , Estimulação Luminosa
6.
J Neurophysiol ; 113(10): 3798-815, 2015 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-25833839

RESUMO

During general anesthesia, global brain activity and behavioral state are profoundly altered. Yet it remains mostly unknown how anesthetics alter sensory processing across cortical layers and modulate functional cortico-cortical connectivity. To address this gap in knowledge of the micro- and mesoscale effects of anesthetics on sensory processing in the cortical microcircuit, we recorded multiunit activity and local field potential in awake and anesthetized ferrets (Mustela putoris furo) during sensory stimulation. To understand how anesthetics alter sensory processing in a primary sensory area and the representation of sensory input in higher-order association areas, we studied the local sensory responses and long-range functional connectivity of primary visual cortex (V1) and prefrontal cortex (PFC). Isoflurane combined with xylazine provided general anesthesia for all anesthetized recordings. We found that anesthetics altered the duration of sensory-evoked responses, disrupted the response dynamics across cortical layers, suppressed both multimodal interactions in V1 and sensory responses in PFC, and reduced functional cortico-cortical connectivity between V1 and PFC. Together, the present findings demonstrate altered sensory responses and impaired functional network connectivity during anesthesia at the level of multiunit activity and local field potential across cortical layers.


Assuntos
Vias Aferentes/fisiologia , Anestesia , Potenciais Evocados/fisiologia , Córtex Pré-Frontal/fisiologia , Córtex Visual/fisiologia , Vigília/fisiologia , Estimulação Acústica , Vias Aferentes/efeitos dos fármacos , Animais , Feminino , Furões , Estimulação Luminosa , Análise Espectral , Córtex Visual/efeitos dos fármacos
7.
J Neurosci ; 33(27): 11262-75, 2013 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-23825429

RESUMO

Transcranial direct current stimulation (tDCS) has emerged as a potentially safe and effective brain stimulation modality that alters cortical excitability by passing a small, constant electric current through the scalp. tDCS creates an electric field that weakly modulates the membrane voltage of a large number of cortical neurons. Recent human studies have suggested that sine-wave stimulation waveforms [transcranial alternating current stimulation (tACS)] represent a more targeted stimulation paradigm for the enhancement of cortical oscillations. Yet, the underlying mechanisms of how periodic, weak global perturbations alter the spatiotemporal dynamics of large-scale cortical network dynamics remain a matter of debate. Here, we simulated large-scale networks of spiking neuron models to address this question in endogenously rhythmic networks. We identified distinct roles of the depolarizing and hyperpolarizing phases of tACS in entrainment, which entailed moving network activity toward and away from a strong nonlinearity provided by the local excitatory coupling of pyramidal cells. Together, these mechanisms gave rise to resonance dynamics characterized by an Arnold tongue centered on the resonance frequency of the network. We then performed multichannel extracellular recordings of multiunit firing activity during tACS in anesthetized ferrets (Mustela putoris furo), a model species with a gyrencephalic brain, to verify that weak global perturbations can selectively enhance oscillations at the applied stimulation frequency. Together, these results provide a detailed mechanistic understanding of tACS at the level of large-scale network dynamics and support the future design of activity-dependent feedback tACS paradigms that dynamically tailor stimulation frequency to the spectral peak of ongoing brain activity.


Assuntos
Córtex Cerebral/fisiologia , Redes Neurais de Computação , Estimulação Magnética Transcraniana/métodos , Animais , Furões , Humanos
8.
Neuropsychopharmacology ; 49(1): 163-178, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37369777

RESUMO

Despite increasing prevalence and huge personal and societal burden, psychiatric diseases still lack treatments which can control symptoms for a large fraction of patients. Increasing insight into the neurobiology underlying these diseases has demonstrated wide-ranging aberrant activity and functioning in multiple brain circuits and networks. Together with varied presentation and symptoms, this makes one-size-fits-all treatment a challenge. There has been a resurgence of interest in the use of neurostimulation as a treatment for psychiatric diseases. Initial studies using continuous open-loop stimulation, in which clinicians adjusted stimulation parameters during patient visits, showed promise but also mixed results. Given the periodic nature and fluctuations of symptoms often observed in psychiatric illnesses, the use of device-driven closed-loop stimulation may provide more effective therapy. The use of a biomarker, which is correlated with specific symptoms, to deliver stimulation only during symptomatic periods allows for the personalized therapy needed for such heterogeneous disorders. Here, we provide the reader with background motivating the use of closed-loop neurostimulation for the treatment of psychiatric disorders. We review foundational studies of open- and closed-loop neurostimulation for neuropsychiatric indications, focusing on deep brain stimulation, and discuss key considerations when designing and implementing closed-loop neurostimulation.


Assuntos
Estimulação Encefálica Profunda , Transtornos Mentais , Humanos , Estimulação Encefálica Profunda/métodos , Transtornos Mentais/terapia
9.
J Neurophysiol ; 110(12): 2739-51, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24047911

RESUMO

Anesthesia is widely used in medicine and research to achieve altered states of consciousness and cognition. Whereas changes to macroscopic cortical activity patterns by anesthesia measured at the spatial resolution of electroencephalography have been widely studied, modulation of mesoscopic and microscopic network dynamics by anesthesia remain poorly understood. To address this gap in knowledge, we recorded spontaneous mesoscopic (local field potential) and microscopic (multiunit activity) network dynamics in primary visual cortex (V1) and prefrontal cortex (PFC) of awake and isoflurane anesthetized ferrets (Mustela putoris furo). This approach allowed for examination of activity as a function of cortical area, cortical layer, and anesthetic depth with much higher spatial and temporal resolution than in previous studies. We hypothesized that a primary sensory area and an association cortical area would exhibit different patterns of network modulation by anesthesia due to their different functional roles. Indeed, we found effects specific to cortical area and cortical layer. V1 exhibited minimal changes in rhythmic structure with anesthesia but differential modulation of input layer IV. In contrast, anesthesia profoundly altered spectral power in PFC, with more uniform modulation across cortical layers. Our results demonstrate that anesthesia modulates spontaneous cortical activity in an area- and layer-specific manner. These finding provide the basis for 1) refining anesthesia monitoring algorithms, 2) reevaluating the large number of systems neuroscience studies performed in anesthetized animals, and 3) increasing our understanding of differential dynamics across cortical layers and areas.


Assuntos
Anestésicos Inalatórios/farmacologia , Ondas Encefálicas/efeitos dos fármacos , Isoflurano/farmacologia , Rede Nervosa/efeitos dos fármacos , Córtex Pré-Frontal/efeitos dos fármacos , Córtex Visual/efeitos dos fármacos , Animais , Feminino , Furões , Rede Nervosa/fisiologia , Especificidade de Órgãos , Córtex Pré-Frontal/fisiologia , Córtex Visual/fisiologia
10.
J Vis Exp ; (197)2023 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-37486114

RESUMO

Deep brain stimulation involves the administration of electrical stimulation to targeted brain regions for therapeutic benefit. In the context of major depressive disorder (MDD), most studies to date have administered continuous or open-loop stimulation with promising but mixed results. One factor contributing to these mixed results may stem from when the stimulation is applied. Stimulation administration specific to high-symptom states in a personalized and responsive manner may be more effective at reducing symptoms compared to continuous stimulation and may avoid diminished therapeutic effects related to habituation. Additionally, a lower total duration of stimulation per day is advantageous for reducing device energy consumption. This protocol describes an experimental workflow using a chronically implanted neurostimulation device to achieve closed-loop stimulation for individuals with treatment-refractory MDD. This paradigm hinges on determining a patient-specific neural biomarker that is related to states of high symptoms and programming the device detectors, such that stimulation is triggered by this read-out of symptom state. The described procedures include how to obtain neural recordings concurrent with patient symptom reports, how to use these data in a state-space model approach to differentiate low- and high-symptom states and corresponding neural features, and how to subsequently program and tune the device to deliver closed-loop stimulation therapy.


Assuntos
Estimulação Encefálica Profunda , Transtorno Depressivo Maior , Humanos , Estimulação Encefálica Profunda/métodos , Transtorno Depressivo Maior/terapia , Medicina de Precisão , Encéfalo , Biomarcadores
11.
Brain Stimul ; 16(4): 1072-1082, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37385540

RESUMO

BACKGROUND: Humans routinely shift their sleepiness and wakefulness levels in response to emotional factors. The diversity of emotional factors that modulates sleep-wake levels suggests that the ascending arousal network may be intimately linked with networks that mediate mood. Indeed, while animal studies have identified select limbic structures that play a role in sleep-wake regulation, the breadth of corticolimbic structures that directly modulates arousal in humans remains unknown. OBJECTIVE: We investigated whether select regional activation of the corticolimbic network through direct electrical stimulation can modulate sleep-wake levels in humans, as measured by subjective experience and behavior. METHODS: We performed intensive inpatient stimulation mapping in two human participants with treatment resistant depression, who underwent intracranial implantation with multi-site, bilateral depth electrodes. Stimulation responses of sleep-wake levels were measured by subjective surveys (i.e. Stanford Sleepiness Scale and visual-analog scale of energy) and a behavioral arousal score. Biomarker analyses of sleep-wake levels were performed by assessing spectral power features of resting-state electrophysiology. RESULTS: Our findings demonstrated three regions whereby direct stimulation modulated arousal, including the orbitofrontal cortex (OFC), subgenual cingulate (SGC), and, most robustly, ventral capsule (VC). Modulation of sleep-wake levels was frequency-specific: 100Hz OFC, SGC, and VC stimulation promoted wakefulness, whereas 1Hz OFC stimulation increased sleepiness. Sleep-wake levels were correlated with gamma activity across broad brain regions. CONCLUSIONS: Our findings provide evidence for the overlapping circuitry between arousal and mood regulation in humans. Furthermore, our findings open the door to new treatment targets and the consideration of therapeutic neurostimulation for sleep-wake disorders.


Assuntos
Nível de Alerta , Sonolência , Animais , Humanos , Nível de Alerta/fisiologia , Sono/fisiologia , Vigília/fisiologia , Estimulação Elétrica
12.
bioRxiv ; 2023 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-37961359

RESUMO

High-density microelectrode arrays (MEAs) have opened new possibilities for systems neuroscience in human and non-human animals, but brain tissue motion relative to the array poses a challenge for downstream analyses, particularly in human recordings. We introduce DREDge (Decentralized Registration of Electrophysiology Data), a robust algorithm which is well suited for the registration of noisy, nonstationary extracellular electrophysiology recordings. In addition to estimating motion from spikes in the action potential (AP) frequency band, DREDge enables automated tracking of motion at high temporal resolution in the local field potential (LFP) frequency band. In human intraoperative recordings, which often feature fast (period <1s) motion, DREDge correction in the LFP band enabled reliable recovery of evoked potentials, and significantly reduced single-unit spike shape variability and spike sorting error. Applying DREDge to recordings made during deep probe insertions in nonhuman primates demonstrated the possibility of tracking probe motion of centimeters across several brain regions while simultaneously mapping single unit electrophysiological features. DREDge reliably delivered improved motion correction in acute mouse recordings, especially in those made with an recent ultra-high density probe. We also implemented a procedure for applying DREDge to recordings made across tens of days in chronic implantations in mice, reliably yielding stable motion tracking despite changes in neural activity across experimental sessions. Together, these advances enable automated, scalable registration of electrophysiological data across multiple species, probe types, and drift cases, providing a stable foundation for downstream scientific analyses of these rich datasets.

13.
Neuron ; 110(15): 2409-2421.e3, 2022 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-35679860

RESUMO

The action potential is a fundamental unit of neural computation. Even though significant advances have been made in recording large numbers of individual neurons in animal models, translation of these methodologies to humans has been limited because of clinical constraints and electrode reliability. Here, we present a reliable method for intraoperative recording of dozens of neurons in humans using the Neuropixels probe, yielding up to ∼100 simultaneously recorded single units. Most single units were active within 1 min of reaching target depth. The motion of the electrode array had a strong inverse correlation with yield, identifying a major challenge and opportunity to further increase the probe utility. Cell pairs active close in time were spatially closer in most recordings, demonstrating the power to resolve complex cortical dynamics. Altogether, this approach provides access to population single-unit activity across the depth of human neocortex at scales previously only accessible in animal models.


Assuntos
Neocórtex , Neurônios , Potenciais de Ação/fisiologia , Eletrodos , Eletrodos Implantados , Humanos , Neurônios/fisiologia , Reprodutibilidade dos Testes
14.
J Neural Eng ; 18(4)2021 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-34330113

RESUMO

Objective.Intracranial neural recordings and electrical stimulation are tools used in an increasing range of applications, including intraoperative clinical mapping and monitoring, therapeutic neuromodulation, and brain computer interface control and feedback. However, many of these applications suffer from a lack of spatial specificity and localization, both in terms of sensed neural signal and applied stimulation. This stems from limited manufacturing processes of commercial-off-the-shelf (COTS) arrays unable to accommodate increased channel density, higher channel count, and smaller contact size.Approach.Here, we describe a manufacturing and assembly approach using thin-film microfabrication for 32-channel high density subdural micro-electrocorticography (µECoG) surface arrays (contacts 1.2 mm diameter, 2 mm pitch) and intracranial electroencephalography (iEEG) depth arrays (contacts 0.5 mm × 1.5 mm, pitch 0.8 mm × 2.5 mm). Crucially, we tackle the translational hurdle and test these arrays during intraoperative studies conducted in four humans under regulatory approval.Main results.We demonstrate that the higher-density contacts provide additional unique information across the recording span compared to the density of COTS arrays which typically have electrode pitch of 8 mm or greater; 4 mm in case of specially ordered arrays. Our intracranial stimulation study results reveal that refined spatial targeting of stimulation elicits evoked potentials with differing spatial spread.Significance.Thin-film,µECoG and iEEG depth arrays offer a promising substrate for advancing a number of clinical and research applications reliant on high-resolution neural sensing and intracranial stimulation.


Assuntos
Interfaces Cérebro-Computador , Eletrocorticografia , Eletrodos Implantados , Humanos , Microtecnologia , Espaço Subdural
15.
Nat Commun ; 12(1): 2764, 2021 05 12.
Artigo em Inglês | MEDLINE | ID: mdl-33980852

RESUMO

The hippocampus is diversely interconnected with other brain systems along its axis. Cycles of theta-frequency activity are believed to propagate from the septal to temporal pole, yet it is unclear how this one-way route supports the flexible cognitive capacities of this structure. We leveraged novel thin-film microgrid arrays conformed to the human hippocampal surface to track neural activity two-dimensionally in vivo. All oscillation frequencies identified between 1-15 Hz propagated across the tissue. Moreover, they dynamically shifted between two roughly opposite directions oblique to the long axis. This predominant propagation axis was mirrored across participants, hemispheres, and consciousness states. Directionality was modulated in a participant who performed a behavioral task, and it could be predicted by wave amplitude topography over the hippocampal surface. Our results show that propagation directions may thus represent distinct meso-scale network computations, operating along versatile spatiotemporal processing routes across the hippocampal body.


Assuntos
Hipocampo/fisiologia , Ritmo Teta/fisiologia , Comportamento/fisiologia , Eletrocorticografia , Humanos , Modelos Neurológicos , Septo do Cérebro/fisiologia , Lobo Temporal/fisiologia
16.
Front Neurosci ; 15: 762097, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34975374

RESUMO

Deep brain stimulation (DBS) is a plausible therapy for various neuropsychiatric disorders, though continuous tonic stimulation without regard to underlying physiology (open-loop) has had variable success. Recently available DBS devices can sense neural signals which, in turn, can be used to control stimulation in a closed-loop mode. Closed-loop DBS strategies may mitigate many drawbacks of open-loop stimulation and provide more personalized therapy. These devices contain many adjustable parameters that control how the closed-loop system operates, which need to be optimized using a combination of empirically and clinically informed decision making. We offer a practical guide for the implementation of a closed-loop DBS system, using examples from patients with chronic pain. Focusing on two research devices from Medtronic, the Activa PC+S and Summit RC+S, we provide pragmatic details on implementing closed- loop programming from a clinician's perspective. Specifically, by combining our understanding of chronic pain with data-driven heuristics, we describe how to tune key parameters to handle feature selection, state thresholding, and stimulation artifacts. Finally, we discuss logistical and practical considerations that clinicians must be aware of when programming closed-loop devices.

17.
Front Hum Neurosci ; 15: 714256, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34322004

RESUMO

Closed-loop neurostimulation is a promising therapy being tested and clinically implemented in a growing number of neurological and psychiatric indications. This therapy is enabled by chronically implanted, bidirectional devices including the Medtronic Summit RC+S system. In order to successfully optimize therapy for patients implanted with these devices, analyses must be conducted offline on the recorded neural data, in order to inform optimal sense and stimulation parameters. The file format, volume, and complexity of raw data from these devices necessitate conversion, parsing, and time reconstruction ahead of time-frequency analyses and modeling common to standard neuroscientific analyses. Here, we provide an open-source toolbox written in Matlab which takes raw files from the Summit RC+S and transforms these data into a standardized format amenable to conventional analyses. Furthermore, we provide a plotting tool which can aid in the visualization of multiple data streams and sense, stimulation, and therapy settings. Finally, we describe an analysis module which replicates RC+S on-board power computations, a functionality which can accelerate biomarker discovery. This toolbox aims to accelerate the research and clinical advances made possible by longitudinal neural recordings and adaptive neurostimulation in people with neurological and psychiatric illnesses.

18.
Nat Med ; 27(10): 1696-1700, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34608328

RESUMO

Deep brain stimulation is a promising treatment for neuropsychiatric conditions such as major depression. It could be optimized by identifying neural biomarkers that trigger therapy selectively when symptom severity is elevated. We developed an approach that first used multi-day intracranial electrophysiology and focal electrical stimulation to identify a personalized symptom-specific biomarker and a treatment location where stimulation improved symptoms. We then implanted a chronic deep brain sensing and stimulation device and implemented a biomarker-driven closed-loop therapy in an individual with depression. Closed-loop therapy resulted in a rapid and sustained improvement in depression. Future work is required to determine if the results and approach of this n-of-1 study generalize to a broader population.


Assuntos
Encéfalo/efeitos da radiação , Estimulação Encefálica Profunda/métodos , Transtorno Depressivo Maior/terapia , Estimulação Elétrica/métodos , Adulto , Biomarcadores/análise , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/diagnóstico por imagem , Transtorno Depressivo Maior/patologia , Feminino , Humanos , Índice de Gravidade de Doença , Resultado do Tratamento
19.
J Clin Med ; 9(10)2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-33003443

RESUMO

Early studies of deep brain stimulation (DBS) for various neurological disorders involved a temporary trial period where implanted electrodes were externalized, in which the electrical contacts exiting the patient's brain are connected to external stimulation equipment, so that stimulation efficacy could be determined before permanent implant. As the optimal brain target sites for various diseases (i.e., Parkinson's disease, essential tremor) became better established, such trial periods have fallen out of favor. However, deep brain stimulation trial periods are experiencing a modern resurgence for at least two reasons: (1) studies of newer indications such as depression or chronic pain aim to identify new targets and (2) a growing interest in adaptive DBS tools necessitates neurophysiological recordings, which are often done in the peri-surgical period. In this review, we consider the possible approaches, benefits, and risks of such inpatient trial periods with a specific focus on developing new DBS therapies for chronic pain.

20.
eNeuro ; 5(1)2018.
Artigo em Inglês | MEDLINE | ID: mdl-29619407

RESUMO

Higher-order visual thalamus plays a fundamental but poorly understood role in attention-demanding tasks. To investigate how neuronal dynamics in higher-order visual thalamus are modulated by sustained attention, we performed multichannel electrophysiological recordings in the lateral posterior-pulvinar complex (LP/pulvinar) in the ferret (Mustela putorius furo). We recorded single unit activity and local field potential (LFP) during the performance of the five-choice serial reaction time task (5-CSRTT), which is used in both humans and animals as an assay of sustained attention. We found that half of the units exhibited an increasing firing rate during the delay period before stimulus onset (attention-modulated units). In contrast, the non-attention-modulated units responded to the stimulus, but not during the delay period. Spike-field coherence (SFC) of only the attention-modulated neurons significantly increased from the start of the delay period until screen touch, predominantly in the θ frequency band. In addition, θ power and θ/γ phase amplitude coupling (PAC) were elevated throughout the delay period. Our findings suggest that the θ oscillation plays a central role in orchestrating thalamic signaling during sustained attention.


Assuntos
Potenciais de Ação/fisiologia , Atenção/fisiologia , Neurônios/fisiologia , Tálamo/fisiologia , Ritmo Teta/fisiologia , Percepção Visual/fisiologia , Animais , Eletrodos Implantados , Feminino , Furões , Ritmo Gama/fisiologia , Atividade Motora/fisiologia , Vias Visuais/fisiologia
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