scholarly journals The Insula: A Stimulating Island of the Brain

2021 ◽  
Vol 11 (11) ◽  
pp. 1533
Author(s):  
Inès Rachidi ◽  
Lorella Minotti ◽  
Guillaume Martin ◽  
Dominique Hoffmann ◽  
Julien Bastin ◽  
...  
Keyword(s):  
Anterior Insula ◽  
Homologous Region ◽  
Seizure Onset ◽  
Functional Brain Mapping ◽  
Axonal Conduction ◽  
Seizure Onset Zone ◽  
Clinical Responses ◽  
History Of ◽  
Posterior Insula ◽  
The Brain

Direct cortical stimulation (DCS) in epilepsy surgery patients has a long history of functional brain mapping and seizure triggering. Here, we review its findings when applied to the insula in order to map the insular functions, evaluate its local and distant connections, and trigger seizures. Clinical responses to insular DCS are frequent and diverse, showing a partial segregation with spatial overlap, including a posterior somatosensory, auditory, and vestibular part, a central olfactory-gustatory region, and an anterior visceral and cognitive-emotional portion. The study of cortico-cortical evoked potentials (CCEPs) has shown that the anterior (resp. posterior) insula has a higher connectivity rate with itself than with the posterior (resp. anterior) insula, and that both the anterior and posterior insula are closely connected, notably between the homologous insular subdivisions. All insular gyri show extensive and complex ipsilateral and contralateral extra-insular connections, more anteriorly for the anterior insula and more posteriorly for the posterior insula. As a rule, CCEPs propagate first and with a higher probability around the insular DCS site, then to the homologous region, and later to more distal regions with fast cortico-cortical axonal conduction delays. Seizures elicited by insular DCS have rarely been specifically studied, but their rate does not seem to differ from those of other DCS studies. They are mainly provoked from the insular seizure onset zone but can also be triggered by stimulating intra- and extra-insular early propagation zones. Overall, in line with the neuroimaging studies, insular DCS studies converge on the view that the insula is a multimodal functional hub with a fast propagation of information, whose organization helps understand where insular seizures start and how they propagate.

scholarly journals Unsupervised seizure localisation with attention-based graph neural networks

2020 ◽  
Author(s):  
Daniele Grattarola ◽  
Lorenzo Livi ◽  
Cesare Alippi ◽  
Richard Wennberg ◽  
Taufik Valiante
Keyword(s):  
Neural Networks ◽  
Brain Activity ◽  
Functional Networks ◽  
Seizure Onset ◽  
The Past ◽  
Seizure Onset Zone ◽  
Brain States ◽  
Graph Neural Networks ◽  
Intracranial Electroencephalography ◽  
The Brain

Abstract Graph neural networks (GNNs) and the attention mechanism are two of the most significant advances in artificial intelligence methods over the past few years. The former are neural networks able to process graph-structured data, while the latter learns to selectively focus on those parts of the input that are more relevant for the task at hand. In this paper, we propose a methodology for seizure localisation which combines the two approaches. Our method is composed of several blocks. First, we represent brain states in a compact way by computing functional networks from intracranial electroencephalography recordings, using metrics to quantify the coupling between the activity of different brain areas. Then, we train a GNN to correctly distinguish between functional networks associated with interictal and ictal phases. The GNN is equipped with an attention-based layer which automatically learns to identify those regions of the brain (associated with individual electrodes) that are most important for a correct classification. The localisation of these regions is fully unsupervised, meaning that it does not use any prior information regarding the seizure onset zone. We report results both for human patients and for simulators of brain activity. We show that the regions of interest identified by the GNN strongly correlate with the localisation of the seizure onset zone reported by electroencephalographers. We also show that our GNN exhibits uncertainty on those patients for which the clinical localisation was also unsuccessful, highlighting the robustness of the proposed approach.

Prolonged postictal hemianopsia after a focal extraoccipital onset seizure

2021 ◽  
Vol 14 (1) ◽  
pp. e239021
Author(s):  
Vibhangini S Wasade ◽  
Jennifer L Logan
Keyword(s):  
Epileptiform Activity ◽  
Diagnostic Evaluation ◽  
Onset Seizure ◽  
Seizure Onset ◽  
Seizure Termination ◽  
Seizure Onset Zone ◽  
History Of ◽  
Epilepsy Monitoring

We report a case of a prolonged postictal hemianopsia occurring after a focal extraoccipital seizure. A 55-year-old man with a history of neurosyphilis, treated with penicillin, presented to our epilepsy monitoring unit (EMU) for diagnostic evaluation of his spells occurring for 2 years. The spell semiology was stereotypical, described as oral and manual automatisms, speech difficulty and unresponsiveness. During the EMU stay, after his typical seizure was recorded, he experienced right hemianopsia lasting for 2 hours. Electrographically, the ictal pattern was prominent over the left temporal derivation and propagated to the left occipital derivation as the seizure progressed. Interictal epileptiform activity was over the left temporal derivations. We support the view that postictal phenomenon may represent merely a seizure termination zone and not be necessarily localising to the seizure onset zone. Furthermore, prolonged isolated postictal symptom of hemianopsia could also be noted in rare situations.

scholarly journals Neural Substrates Underlying Learning-Related Changes of the Unconditioned Fear Response

2013 ◽  
Vol 7 (1) ◽  
pp. 41-52 ◽  
Author(s):  
Kimberly H. Wood ◽  
Dystany Kuykendall ◽  
Lawrence W. Ver Hoef ◽  
David C. Knight
Keyword(s):  
Associative Learning ◽  
Pavlovian Conditioning ◽  
Emotional Response ◽  
Negative Relationship ◽  
Neural Substrates ◽  
Brain Regions ◽  
Anterior Insula ◽  
Fmri Signal ◽  
Posterior Insula ◽  
The Brain

The ability to predict an impending threat during Pavlovian conditioning diminishes the emotional response that is produced once the threat is encountered. Diminution of the threat response appears to be mediated by somewhat independent associative learning and expectancy-related processes. Therefore, the present study was designed to better understand the neural mechanisms that support associative learning processes, independent of expectancy, that influence the emotional response to a threat. Healthy volunteers took part in a Pavlovian conditioning procedure during which trait anxiety, expectation of the unconditioned stimulus (UCS), skin conductance response (SCR), and functional magnetic resonance imaging (fMRI) signal were assessed. The results showed no evidence for associative learning that was independent of expectation. Threat-related SCR expression was diminished on predictable trials vs. unpredictable trials of the UCS (i.e. conditioned UCR diminution). Similar to SCR, conditioned UCR diminution was observed within the left dorsolateral PFC, dorsomedial PFC, ventromedial PFC, and left anterior insula. In contrast, potentiation of the threat-related fMRI signal response was observed within left dorsolateral PFC, inferior parietal lobule (IPL), and posterior insula. A negative relationship was observed between UCS expectancy and UCR expression within the dorsomedial PFC, ventromedial PFC, and anterior insula. Finally, the anticipatory fMRI signal responses within the PFC, posterior cingulate, and amygdala showed an inverse relationship with threat-related activation within the brain regions that showed UCR diminution. The current findings suggest that the PFC and amygdala support learning-related processes that impact the magnitude of the emotional response to a threat.

scholarly journals Damage to the right insula disrupts the perception of affective touch

eLife ◽  
2020 ◽  
Vol 9 ◽  
Author(s):  
Louise P Kirsch ◽  
Sahba Besharati ◽  
Christina Papadaki ◽  
Laura Crucianelli ◽  
Sara Bertagnoli ◽  
...  
Keyword(s):  
Right Hemisphere ◽  
Anterior Insula ◽  
Affective Touch ◽  
Cortical Organization ◽  
Touch Perception ◽  
Posterior Insula ◽  
The Right ◽  
Tactile System ◽  
The Brain

Specific, peripheral C-tactile afferents contribute to the perception of tactile pleasure, but the brain areas involved in their processing remain debated. We report the first human lesion study on the perception of C-tactile touch in right hemisphere stroke patients (N = 59), revealing that right posterior and anterior insula lesions reduce tactile, contralateral and ipsilateral pleasantness sensitivity, respectively. These findings corroborate previous imaging studies regarding the role of the posterior insula in the perception of affective touch. However, our findings about the crucial role of the anterior insula for ipsilateral affective touch perception open new avenues of enquiry regarding the cortical organization of this tactile system.

scholarly journals Changes in metabolites in the brain of patients with fibromyalgia after treatment with an NMDA receptor antagonist

2019 ◽  
Vol 32 (6) ◽  
pp. 408-419 ◽  
Author(s):  
Nicolas Fayed ◽  
Barbara Oliván ◽  
Yolanda Lopez del Hoyo ◽  
Eva Andrés ◽  
Mari Cruz Perez-Yus ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Magnetic Resonance ◽  
Magnetic Resonance Spectroscopy ◽  
Clinical Global Impression ◽  
Anterior Insula ◽  
Resonance Spectroscopy ◽  
Posterior Cingulate ◽  
Posterior Insula ◽  
The Right ◽  
The Brain

The aims of this work were to evaluate whether the treatment of patients with fibromyalgia with memantine is associated with significant changes in metabolite concentrations in the brain, and to explore any changes in clinical outcome measures. Magnetic resonance spectroscopy was performed of the right anterior and posterior insula, both hippocampi and the posterior cingulate cortex. Questionnaires on pain, anxiety, depression, global function, quality of life and cognitive impairment were used. Ten patients were studied at baseline and after three months of treatment with memantine. Significant increases were observed in the following areas: N-acetylaspartate (4.47 at baseline vs. 4.71 at three months, p = 0.02) and N-acetylaspartate+N-acetylaspartate glutamate in the left hippocampus (5.89 vs. 5.98; p = 0.007); N-acetylaspartate+N-acetylaspartate glutamate in the right hippocampus (5.31 vs 5.79; p = 0.01) and the anterior insula (7.56 vs. 7.70; p = 0.033); glutamate+glutamine/creatine ratio in the anterior insula (2.03 vs. 2.17; p = 0.022) and the posterior insula (1.77 vs. 2.00; p = 0.004); choline/creatine ratio in the posterior cingulate (0.18 vs. 0.19; p = 0.023); and creatine in the right hippocampus (3.60 vs. 3.85; p = 0.007). At the three-month follow-up, memantine improved cognitive function assessed by the Cognition Mini-Exam (31.50, SD = 2.95 vs. 34.40, SD = 0.6; p = 0.005), depression measured by the Hamilton Depression Scale (7.70, SD = 0.81 vs. 7.56, SD = 0.68; p = 0.042) and severity of illness measured by the Clinical Global Impression severity scale (5.79, SD = 0.96 vs. 5.31, SD = 1.12; p = 0.007). Depression, clinical global impression and cognitive function showed improvement with memantine. Magnetic resonance spectroscopy could be useful in monitoring response to the pharmacological treatment of fibromyalgia.

scholarly journals Laughter is in the air: involvement of key nodes of the emotional motor system in the anticipation of tickling

2019 ◽  
Vol 14 (8) ◽  
pp. 837-847 ◽  
Author(s):  
Elise Wattendorf ◽  
Birgit Westermann ◽  
Klaus Fiedler ◽  
Simone Ritz ◽  
Annetta Redmann ◽  
...  
Keyword(s):  
Sensory Processing ◽  
Anterior Insula ◽  
Anterior Cingulate ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Periaqueductal Gray Matter ◽  
Internal Globus Pallidus ◽  
Posterior Insula ◽  
Anticipatory Activity ◽  
The Brain

Abstract In analogy to the appreciation of humor, that of tickling is based upon the re-interpretation of an anticipated emotional situation. Hence, the anticipation of tickling contributes to the final outburst of ticklish laughter. To localize the neuronal substrates of this process, functional magnetic resonance imaging (fMRI) was conducted on 31 healthy volunteers. The state of anticipation was simulated by generating an uncertainty respecting the onset of manual foot tickling. Anticipation was characterized by an augmented fMRI signal in the anterior insula, the hypothalamus, the nucleus accumbens and the ventral tegmental area, as well as by an attenuated one in the internal globus pallidus. Furthermore, anticipatory activity in the anterior insula correlated positively with the degree of laughter that was produced during tickling. These findings are consistent with an encoding of the expected emotional consequences of tickling and suggest that early regulatory mechanisms influence, automatically, the laughter circuitry at the level of affective and sensory processing. Tickling activated not only those regions of the brain that were involved during anticipation, but also the posterior insula, the anterior cingulate cortex and the periaqueductal gray matter. Sequential or combined anticipatory and tickling-related neuronal activities may adjust emotional and sensorimotor pathways in preparation for the impending laughter response.

scholarly journals Network dynamics of the brain and influence of the epileptic seizure onset zone

2014 ◽  
Vol 111 (49) ◽  
pp. E5321-E5330 ◽  
Author(s):  
Samuel P. Burns ◽  
Sabato Santaniello ◽  
Robert B. Yaffe ◽  
Christophe C. Jouny ◽  
Nathan E. Crone ◽  
...  
Keyword(s):  
Epileptic Seizure ◽  
Network Dynamics ◽  
Seizure Onset ◽  
Seizure Onset Zone ◽  
The Brain

scholarly journals L2HGDH Missense Variant in a Cat with L-2-Hydroxyglutaric Aciduria

Genes ◽  
2021 ◽  
Vol 12 (5) ◽  
pp. 682
Author(s):  
Matthias Christen ◽  
Nils Janzen ◽  
Anne Fraser ◽  
Adrian C. Sewell ◽  
Vidhya Jagannathan ◽  
...  
Keyword(s):  
Current Knowledge ◽  
Genetic Defect ◽  
Clinical Signs ◽  
Missense Variant ◽  
Microcytic Anemia ◽  
Abnormal Behavior ◽  
Functional Candidate Gene ◽  
History Of ◽  
The Brain ◽  
Hydroxyglutaric Acid

A 7-month-old, spayed female, domestic longhair cat with L-2-hydroxyglutaric aciduria (L-2-HGA) was investigated. The aim of this study was to investigate the clinical signs, metabolic changes and underlying genetic defect. The owner of the cat reported a 4-month history of multiple paroxysmal seizure-like episodes, characterized by running around the house, often in circles, with abnormal behavior, bumping into obstacles, salivating and often urinating. The episodes were followed by a period of disorientation and inappetence. Neurological examination revealed an absent bilateral menace response. Routine blood work revealed mild microcytic anemia but biochemistry, ammonia, lactate and pre- and post-prandial bile acids were unremarkable. MRI of the brain identified multifocal, bilaterally symmetrical and T2-weighted hyperintensities within the prosencephalon, mesencephalon and metencephalon, primarily affecting the grey matter. Urinary organic acids identified highly increased levels of L-2-hydroxyglutaric acid. The cat was treated with the anticonvulsants levetiracetam and phenobarbitone and has been seizure-free for 16 months. We sequenced the genome of the affected cat and compared the data to 48 control genomes. L2HGDH, coding for L-2-hydroxyglutarate dehydrogenase, was investigated as the top functional candidate gene. This search revealed a single private protein-changing variant in the affected cat. The identified homozygous variant, XM_023255678.1:c.1301A>G, is predicted to result in an amino acid change in the L2HGDH protein, XP_023111446.1:p.His434Arg. The available clinical and biochemical data together with current knowledge about L2HGDH variants and their functional impact in humans and dogs allow us to classify the p.His434Arg variant as a causative variant for the observed neurological signs in this cat.

Neural fragility as an EEG marker of the seizure onset zone

2021 ◽  
Author(s):  
Adam Li ◽  
Chester Huynh ◽  
Zachary Fitzgerald ◽  
Iahn Cajigas ◽  
Damian Brusko ◽  
...  
Keyword(s):  
Seizure Onset ◽  
Seizure Onset Zone
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