Julie Tremblay

Acute and Chronic Changes in Diffusivity Measures after Sports Concussion

Despite negative neuroimaging findings in concussed athletes, studies indicate that the acceleration and deceleration of the brain after concussive impacts result in metabolic and electrophysiological alterations that may be attributable to changes in white matter resulting from biomechanical strain. In the present study we investigated the effects of sports concussion on white matter using three different diffusion tensor imaging (DTI) measures: fractional anisotropy (FA), mean diffusivity (MD), and axial diffusivity (AD). We compared a group of 10 non-concussed athletes with a group of 18 concussed athletes of the same age (mean age 22.5 years) and education (mean 16 years) using a voxel-based approach (VBA) in both the acute and chronic post-injury phases. All concussed athletes were scanned 1-6 days post-concussion and again 6 months later in a 3T Siemens Trio(™) MRI. Three 2×2 repeated-measures analyses of variance (ANOVAs) were conducted, one for each measure of DTI used in the current study. There was a main group effect of FA, which was increased in dorsal regions of both corticospinal tracts (CST) and in the corpus callosum in concussed athletes at both time points. There was a main group effect of AD in the right CST, where concussed athletes showed elevated values relative to controls at both time points. MD values were decreased in concussed athletes, in whom analyses revealed significant group differences in the CST and corpus callosum at both time points. Although the use of VBA does limit the analyses to large tracts, and it has clinical limitations with regard to individual analyses, our results nevertheless indicate that sports concussions do result in changes in diffusivity in the corpus callosum and CST that are not detected using conventional neuroimaging techniques.

Mother and Stranger: An Electrophysiological Study of Voice Processing in Newborns

In the mature adult brain, there are voice selective regions that are especially tuned to familiar voices. Yet, little is known about how the infants brain treats such information. Here, we investigated, using electrophysiology and source analyses, how newborns process their mothers voice compared with that of a stranger. Results suggest that, shortly after birth, newborns distinctly process their mothers voice at an early preattentional level and at a later presumably cognitive level. Activation sources revealed that exposure to the maternal voice elicited early language-relevant processing, whereas the strangers voice elicited more voice-specific responses. A central probably motor response was also observed at a later time, which may reflect an innate auditory-articulatory loop. The singularity of left-dominant brain activation pattern together with its ensuing sustained greater central activation in response to the mothers voice may provide the first neurophysiologic index of the preferential mothers role in language acquisition.

Neurometabolic and microstructural alterations following a sports-related concussion in female athletes

Abstract Background: Sports-related concussions are a major public health concern affecting millions of individuals annually. Neurometabolic and microstructural alterations have been reported in the chronic phase following a concussion in male athletes, while no study has investigated these alterations in female athletes. Methods: Neurometabolic and microstructural alterations following a concussion were investigated by comparing 10 female athletes with a concussion and 10 control female athletes, using magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI). Athletes with concussion were scanned at least 7 months post-concussion (mean = 18.9 months). Results: MRS revealed a significant lower level of myo-inositol in the hippocampus and the primary motor cortices (M1) bilaterally. DTI analysis using Tract-Based Spatial Statistics (TBSS) showed no difference in fractional anisotropy (FA) while higher level of mean diffusivity (MD) in athletes with concussion was detected in large white matter tracts including the forceps minors, inferior/superior longitudinal fasciculi, inferior fronto-occipital fasciculus, cingulum, uncinate fasciculus, anterior thalamic radiations and corticospinal tract. Moreover, a region of interest approach for the corpus callosum revealed a significant lower level of FA in the segment containing fibres projecting to M1. Conclusions: This study demonstrates persistent neurometabolic and microstructural alterations in female athletes suffering a sports-related concussion.

Non-invasive continuous EEG-fNIRS recording of temporal lobe seizures

PURPOSE Functional near-infrared spectroscopy (fNIRS) is a technique that allows continuous non-invasive monitoring of tissue oxygenation and haemodynamics in the brain. By using combined EEG-fNIRS recordings, we sought to better understand the pathophysiology of temporal lobe seizures. RESULTS Nine patients (5 males; mean age 35 years; range 11-56 years) with refractory mesial temporal lobe epilepsy underwent combined EEG-fNIRS recordings. Eight complex partial seizures from 3 patients were successfully recorded. All seizures were associated with significant local and remote haemodynamic changes which outlasted the duration of seizures. Over the epileptogenic temporal lobe, increased oxygenation [increase in cerebral blood volume (CBV) and oxyhaemoglobin (HbO), decrease in deoxyhaemoglobin (HbR)] was followed by a deoxygenated state [increase in HbR]. A similar haemodynamic profile was seen over the contralateral temporal lobe (even without evidence of epileptic propagation) though variations generally had lower amplitudes. Heterogeneous haemodynamic changes in remote frontal and/or parietal areas were also noted early on when epileptic activity was limited to the temporal lobe. CONCLUSION EEG-fNIRS reveals complex local and remote oxygenation changes during temporal lobe seizures.

Nonlinear hemodynamic responses in human epilepsy: a multimodal analysis with fNIRS-EEG and fMRI-EEG.

Functional magnetic resonance imaging (fMRI) combined with electroencephalography (fMRI-EEG) is a neuroimaging technique based on the blood oxygenation level dependent (BOLD) signal which has been shown to be useful in the study of epilepsy for the localization of the epileptogenic focus. Functional near-infrared spectroscopy (fNIRS) combined with EEG (fNIRS-EEG) is another imaging technique based on the measurement of oxygenated and deoxygenated hemoglobin with complementary clinical potential in epilepsy, for continuous patient monitoring, language lateralization, and focus localization. In this work fMRI-EEG and fNIRS-EEG are used to quantify nonlinear hemodynamic responses in three cases of human refractory focal epilepsy, by using the Volterra kernel expansion up to second order. Prior to analyzing real data, extensive simulations are carried out to show that nonlinearities are estimable. The Volterra methodology is then applied to multimodal data recorded from 3 epileptic patients selected for their frequent spiking activity. Care is taken to account for variability of hemodynamic responses due to other causes than Volterra nonlinearities. Statistically significant nonlinearities are observed for all patients and all modalities. Good concordance between fNIRS and fMRI is found for both the amplitude of the Volterra responses, and, with limitations, in the localization of the epileptic focus and regions of inverted responses (negative BOLD signals). In one patient, Volterra nonlinearities allowed epileptic focus identification with fMRI, while analyses without nonlinearities failed to see it. In simulations when nonlinearities were included, analysis without Volterra nonlinearities performed poorly. These two observations suggest routinely checking for nonlinearities in functional imaging of patients presenting with frequent spikes.

Detection of hemodynamic responses to epileptic activity using simultaneous Electro-EncephaloGraphy (EEG)/Near Infra Red Spectroscopy (NIRS) acquisitions

Simultaneous recordings of Electro-EncephaloGraphy (EEG) with Near InfraRed Spectroscopy (NIRS) allow measuring hemodynamic changes (changes in the concentration of oxy- and deoxyhemoglobin) at the time of epileptic discharges detected on scalp EEG. Two NIRS detection methods based on the General Linear Model (GLM) respectively in the time domain and in the time-frequency domain are investigated in this study using realistic simulations of spontaneous interictal epileptic activity. We evaluated the sensitivity at different Signal to Noise Ratios (SNR), the effect of either a large or a small number of discharges and the impact of model misspecification (e.g. omission or false detection of epileptic discharges). We also explored the effect on the estimation of key parameters, which set the model order. Simulations showed that both methods become inaccurate in lower SNR conditions, leading to many false positive detections. However, the time-frequency estimator showed better performance than the time-domain one. Key parameters for each algorithm were identified and results suggest to model confounds in the GLM differently for oxy- and deoxyhemoglobin. We also demonstrated that an inaccurate marking of epileptic events has a small impact on the detection statistics whereas an inaccurate specification of the hemodynamic response function delay decreases drastically the detection abilities. Finally, we illustrated the two methods on clinical EEG/NIRS data of one patient with focal epilepsy, showing an increase of regional Cerebral Blood Volume (rCBV) spatially concordant with the presumed epileptogenic focus.

Noninvasive continuous functional near-infrared spectroscopy combined with electroencephalography recording of frontal lobe seizures

Purpose:  To investigate spatial and metabolic changes associated with frontal lobe seizures.

Distinct hemispheric specializations for native and non-native languages in one-day-old newborns identified by fNIRS.

This study assessed whether the neonatal brain recruits different neural networks for native and non-native languages at birth. Twenty-seven one-day-old full-term infants underwent functional near-infrared spectroscopy (fNIRS) recording during linguistic and non-linguistic stimulation. Fourteen newborns listened to linguistic stimuli (native and non-native language stories) and 13 newborns were exposed to non-linguistic conditions (native and non-native stimuli played in reverse). Comparisons between left and right hemisphere oxyhemoglobin (HbO2) concentration changes over the temporal areas revealed clear left hemisphere dominance for native language, whereas non-native stimuli were associated with right hemisphere lateralization. In addition, bilateral cerebral activation was found for non-linguistic stimulus processing. Overall, our findings indicate that from the first day after birth, native language and prosodic features are processed in parallel by distinct neural networks.

fNIRS-EEG study of focal interictal epileptiform discharges

Functional near-infrared spectroscopy (fNIRS) acquired with electroencephalography (EEG) is a relatively new non-invasive neuroimaging technique with potential for long term monitoring of the epileptic brain. Simultaneous EEG-fNIRS recording allows the spatio-temporal reconstruction of the hemodynamic response in terms of the concentration changes in oxy-hemoglobin (HbO) and deoxy-hemoglobin (HbR) associated with recorded epileptic events such as interictal epileptic discharges (IEDs) or seizures. While most previous studies investigating fNIRS in epilepsy had limitations due to restricted spatial coverage and small sample sizes, this work includes a sufficiently large number of channels to provide an extensive bilateral coverage of the surface of the brain for a sample size of 40 patients with focal epilepsies. Topographic maps of significant activations due to each IED type were generated in four different views (dorsal, frontal, left and right) and were compared with the epileptic focus previously identified by an epileptologist. After excluding 5 patients due to the absence of IEDs and 6 more with mesial temporal foci too deep for fNIRS, we report that significant HbR (respectively HbO) concentration changes corresponding to IEDs were observed in 62% (resp. 38%) of patients with neocortical epilepsies. This HbR/HbO response was most significant in the epileptic focus region among all the activations in 28%/21% of patients.

Developmental patterns of expressive language hemispheric lateralization in children, adolescents and adults using functional near-infrared spectroscopy

The development of language hemispheric specialization is not well understood in young children, especially regarding expressive language functions. In this study, we investigated age-related changes in expressive language lateralization patterns in a population of children (3-6 and 7-10 years old), adolescents (11-16 years old), and young adults (19-30 years old). During functional near-infrared spectroscopy recordings, all participants performed a verbal fluency task, which consisted in naming as many words as possible belonging to a given semantic category. Hemoglobin concentration changes were measured in bilateral frontal and temporal cortical areas. During the language task, results showed a strong left hemisphere response along with weaker right hemisphere activation in all groups. Age-related increases in hemodynamic responses were found bilaterally, with younger children showing smaller hemodynamic responses than adolescents and adults in both hemispheres. Overall, these findings confirm that a left hemisphere specialization is already established in young children and persists through adulthood. Early left hemisphere specialization for expressive language suggests that language development hinges on structural and functional properties of the human brain with little reorganization occurring with development.