Dynamics of Epileptiform Discharges Induced by Transcranial Magnetic Stimulation in Genetic Generalized Epilepsy

2017 ◽  
Vol 27 (07) ◽  
pp. 1750037 ◽  
Author(s):  
Dimitris Kugiumtzis ◽  
Christos Koutlis ◽  
Alkiviadis Tsimpiris ◽  
Vasilios K. Kimiskidis
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Brain Connectivity ◽  
Effective Connectivity ◽  
Brain Network ◽  
Brain State ◽  
Epileptiform Discharges ◽  
Eeg Recordings ◽  
Generalized Epilepsy ◽  
The Brain

Objective: In patients with Genetic Generalized Epilepsy (GGE), transcranial magnetic stimulation (TMS) can induce epileptiform discharges (EDs) of varying duration. We hypothesized that (a) the ED duration is determined by the dynamic states of critical network nodes (brain areas) at the early post-TMS period, and (b) brain connectivity changes before, during and after the ED, as well as within the ED. Methods: EEG recordings from two GGE patients were analyzed. For hypothesis (a), the characteristics of the brain dynamics at the early ED stage are measured with univariate and multivariate EEG measures and the dependence of the ED duration on these measures is evaluated. For hypothesis (b), effective connectivity measures are combined with network indices so as to quantify the brain network characteristics and identify changes in brain connectivity. Results: A number of measures combined with specific channels computed on the first EEG segment post-TMS correlate with the ED duration. In addition, brain connectivity is altered from pre-ED to ED and post-ED and statistically significant changes were also detected across stages within the ED. Conclusion: ED duration is not purely stochastic, but depends on the dynamics of the post-TMS brain state. The brain network dynamics is significantly altered in the course of EDs.

Direct Causal Networks for the Study of Transcranial Magnetic Stimulation Effects on Focal Epileptiform Discharges

2015 ◽  
Vol 25 (05) ◽  
pp. 1550006 ◽  
Author(s):  
Dimitris Kugiumtzis ◽  
Vasilios K. Kimiskidis
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Network Structure ◽  
Magnetic Stimulation ◽  
Brain Connectivity ◽  
Effective Connectivity ◽  
Epileptic Focus ◽  
Sham Stimulation ◽  
Focal Seizures ◽  
Epileptiform Discharges ◽  
The Brain

Background: Transcranial magnetic stimulation (TMS) can have inhibitory effects on epileptiform discharges (EDs) of patients with focal seizures. However, the brain connectivity before, during and after EDs, with or without the administration of TMS, has not been extensively explored. Objective: To investigate the brain network of effective connectivity during ED with and without TMS in patients with focal seizures. Methods: For the effective connectivity a direct causality measure is applied termed partial mutual information from mixed embedding (PMIME). TMS-EEG data from two patients with focal seizures were analyzed. Each EEG record contained a number of EDs in the majority of which TMS was administered over the epileptic focus. As a control condition, sham stimulation over the epileptogenic zone or real TMS at a distance from the epileptic focus was also performed. The change in brain connectivity structure was investigated from the causal networks formed at each sliding window. Conclusion: The PMIME could detect distinct changes in the network structure before, within, and after ED. The administration of real TMS over the epileptic focus, in contrast to sham stimulation, terminated the ED prematurely in a node-specific manner and regained the network structure as if it would have terminated spontaneously.

scholarly journals Segregated brain state during hypnosis

2019 ◽  
Author(s):  
Jarno Tuominen ◽  
Sakari Kallio ◽  
Valtteri Kaasinen ◽  
Henry Railo
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Brain Activation ◽  
Brain State ◽  
Neural Connectivity ◽  
Single Word ◽  
Electrophysiological Response ◽  
Hypnotic Induction ◽  
Brain States ◽  
The Brain

Can the brain be shifted into a different state using a simple social cue, as tests on highly hypnotisable subjects would suggest? Demonstrating an altered brain state is difficult. Brain activation varies greatly during wakefulness and can be voluntarily influenced. We measured the complexity of electrophysiological response to transcranial magnetic stimulation (TMS) in one “hypnotic virtuoso”. Such a measure produces a response outside the subject’s voluntary control and has been proven adequate for discriminating conscious from unconscious brain states. We show that a single-word hypnotic induction robustly shifted global neural connectivity into a state where activity remained sustained but failed to ignite strong, coherent activity in frontoparietal cortices. Changes in perturbational complexity indicate a similar move toward a more segregated state. We interpret these findings to suggest a shift in the underlying state of the brain, likely moderating subsequent hypnotic responding. [preprint updated 20/02/2020]

scholarly journals Transcranial magnetic stimulation: studying the brain--behaviour relationship by induction of ‘virtual lesions’

1999 ◽  
Vol 354 (1387) ◽  
pp. 1229-1238 ◽  
Author(s):  
Alvaro Pascual-Leone
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Brain Connectivity ◽  
Brain Activity ◽  
Causal Link ◽  
Non Invasive ◽  
Invasive Method ◽  
Normal Humans ◽  
The Brain ◽  
Neuroimaging Techniques

Transcranial magnetic stimulation (TMS) provides a non-invasive method of induction of a focal current in the brain and transient modulation of the function of the targeted cortex. Despite limited understanding about focality and mechanisms of action, TMS provides a unique opportunity of studying brain-behaviour relations in normal humans. TMS can enhance the results of other neuroimaging techniques by establishing the causal link between brain activity and task performance, and by exploring functional brain connectivity.

scholarly journals Segregated brain state during hypnosis

2021 ◽  
Vol 2021 (1) ◽  
Author(s):  
Jarno Tuominen ◽  
Sakari Kallio ◽  
Valtteri Kaasinen ◽  
Henry Railo
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Brain State ◽  
Neural Connectivity ◽  
Single Word ◽  
Electrophysiological Response ◽  
Hypnotic Induction ◽  
Brain States ◽  
Global Brain ◽  
The Brain

Abstract Can the brain be shifted into a different state using a simple social cue, as tests on highly hypnotizable subjects would suggest? Demonstrating an altered global brain state is difficult. Brain activation varies greatly during wakefulness and can be voluntarily influenced. We measured the complexity of electrophysiological response to transcranial magnetic stimulation in one ‘hypnotic virtuoso’. Such a measure produces a response arguably outside the subject’s voluntary control and has been proven adequate for discriminating conscious from unconscious brain states. We show that a single-word hypnotic induction robustly shifted global neural connectivity into a state where activity remained sustained but failed to ignite strong, coherent activity in frontoparietal cortices. Changes in perturbational complexity indicate a similar move towards a more segregated state. We interpret these findings to suggest a shift in the underlying state of the brain, likely moderating subsequent hypnotic responding.

Utilizing the brain network activation (BNA) technology for transcranial magnetic stimulation treatment management in depression

2018 ◽  
Vol 11 (6) ◽  
pp. e16
Author(s):  
Peremen Ziv ◽  
Shani-Hershkovich Revital ◽  
Issachar Gil ◽  
Geva Amir ◽  
Levkovitz Yechiel
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Brain Network ◽  
Treatment Management ◽  
Network Activation ◽  
The Brain

Connectivity Guided Theta Burst Transcranial Magnetic Stimulation Versus Repetitive Transcranial Magnetic Stimulation for Treatment Resistant Moderate to Severe Depression: Magnetic Resonance Imaging Protocol and SARS COVID-19 induced changes for a Randomised Double-blind Controlled Trial (BRIGhTMIND) (Preprint)

2021 ◽  
Author(s):  
Stefan Pszczolkowski ◽  
William J. Cottam ◽  
Paul M. Briley ◽  
Sarina J. Iwabuchi ◽  
Catherine Kaylor-Hughes ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Resonance ◽  
Magnetic Stimulation ◽  
Brain Connectivity ◽  
Controlled Trial ◽  
Treatment Resistant ◽  
Double Blind ◽  
Mri Guidance ◽  
Dorsolateral Prefrontal ◽  
The Brain

BACKGROUND Depression is a significant health and economic burden. In approximately one third of patients, depression is resistant to first line treatments and therefore it is essential that alternative treatments are found. Transcranial magnetic stimulation (TMS) is a neuromodulatory treatment involving the application of magnetic pulses to the brain that is approved in the UK and the US in treatment resistant depression. This trial aims to compare the clinical effectiveness, cost-effectiveness and mechanism of action between standard treatment repetitive TMS (rTMS) targeted at the F3 EEG site, with a newer treatment – a type of TMS called theta-burst stimulation (TBS) targeted based on measures of functional brain connectivity. This protocol outlines the brain imaging acquisition and analysis for the BRIGhTMIND trial that is used to create personalised TMS targets and answer the proposed mechanistic hypotheses. OBJECTIVE The objectives of the imaging arm of the BRIGhTMIND study are to identify functional and neurochemical brain signatures indexing the treatment mechanisms of rTMS and cgiTBS and to identify imaging-based markers predicting response to treatment. METHODS The study is a randomised double-blind controlled trial with 1:1 allocation to either 20 sessions of a) TBS or b) standard rTMS. Multimodal magnetic resonance imaging (MRI) is acquired per participant at baseline (prior to TMS treatment) with T1-weighted and task-free functional MRI during rest (rsfMRI) utilised to estimate TMS targets. For participants enrolled in the mechanistic substudy additional diffusion-weighted, sequences are acquired at baseline and at post-treatment follow-up 16 weeks after treatment randomisation. Core datasets of T1-weighted and task-free functional MRI during rest (rsfMRI) are acquired for all participants and utilised to estimate TMS targets. Additional sequences of arterial spin labelling, magnetic resonance spectroscopy and diffusion-weighted images are acquired dependent on recruitment site for mechanistic evaluation. Standard rTMS treatment is targeted at the F3 electrode site over the left dorsolateral prefrontal cortex whilst TBS treatment is guided using the coordinate of peak effective connectivity from the right anterior insula to the left dorsolateral prefrontal cortex. Both treatment targets benefit from a level of MRI-guidance but only TBS is provided with precision targeting based on functional brain connectivity. RESULTS Recruitment began January 2019 and is ongoing. Data collection is expected to continue until January 2023. CONCLUSIONS This trial will determine the impact of precision MRI guidance on rTMS treatment, and furthermore, assess the neural mechanisms underlying this treatment in treatment resistant depressed patients. CLINICALTRIAL International Standard Randomized Controlled Trial Number (ISRCTN) 19674644; https://www.isrctn.com/ISRCTN19674644. Registered 2nd October 2018.

Stereotactic Brain Biopsy in Eloquent Areas Assisted by Navigated Transcranial Magnetic Stimulation: a Technical Case Report

2018 ◽  
Vol 17 (3) ◽  
pp. E124-E129 ◽  
Author(s):  
Jiri Bartek ◽  
Gerald Cooray ◽  
Mominul Islam ◽  
Margret Jensdottir
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Stereotactic Biopsy ◽  
Brain Biopsy ◽  
Awake Surgery ◽  
Histopathological Diagnosis ◽  
Navigated Transcranial Magnetic Stimulation ◽  
Stereotactic Brain Biopsy ◽  
Eloquent Areas ◽  
The Brain

Abstract BACKGROUND AND IMPORTANCE Stereotactic brain biopsy (SB) is an important part of the neurosurgical armamentarium, with the possibility of achieving histopathological diagnosis in otherwise inaccessible lesions of the brain. Nevertheless, the procedure is not without the risk of morbidity, which is especially true for lesions in eloquent parts of the brain, where even a minor adverse event can result in significant deficits. Navigated transcranial magnetic stimulation (nTMS) is widely used to chart lesions in eloquent areas, successfully guiding maximal safe resection, while its potential role in aiding with the planning of a stereotactic biopsy is so far unexplored. CLINICAL PRESENTATION Magnetic resonance imaging of a 67-yr-old woman presenting with dysphasia revealed a noncontrast enhancing left-sided lesion in the frontal and parietal pars opercularis. Due to the location of the lesion, nTMS was used to chart both primary motor and language cortex, utilizing this information to plan a safe SB trajectory and sampling area according to the initial work-up recommendations from the multidisciplinary neuro-oncology board. The SB was uneventful, with histology revealing a ganglioglioma, WHO I. The patient was discharged the following day, having declined to proceed with tumor resection (awake surgery) due to the non-negligible risk of morbidity. Upon 1- and 3-mo follow-up, she showed no signs of any procedure-related deficits. CONCLUSION nTMS can be implemented to aid with the planning of a stereotactic biopsy procedure in eloquent areas of the brain, and should be considered part of the neurosurgical armamentarium.

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