Xavier De Tiege

Brain function in the vegetative state.

Positron emission tomography (PET) techniques represent a useful tool to better understand the residual brain function in vegetative state patients. It has been shown that overall cerebral metabolic rates for glucose are massively reduced in this condition. However, the recovery of consciousness from vegetative state is not always associated with substantial changes in global metabolism. This finding led us to hypothesize that some vegetative patients are unconscious not just because of a global loss of neuronal function, but rather due to an altered activity in some critical brain regions and to the abolished functional connections between them. We used voxel-based Statistical Parametric Mapping (SPM) approaches to characterize the functional neuroanatomy of the vegetative state. The most dysfunctional brain regions were bilateral frontal and parieto-temporal associative cortices. Despite the metabolic impairment, external stimulation still induced a significant neuronal activation (i.e., change in blood flow) in vegetative patients as shown by both auditory click stimuli and noxious somatosensory stimuli. However, this activation was limited to primary cortices and dissociated from higher-order associative cortices, thought to be necessary for conscious perception. Finally, we demonstrated that vegetative patients have impaired functional connections between distant cortical areas and between the thalami and the cortex and, more importantly, that recovery of consciousness is paralleled by a restoration of this cortico-thalamo-cortical interaction.

Limits of Early Diagnosis of Herpes Simplex Encephalitis in Children: A Retrospective Study of 38 Cases

The prognosis of herpes simplex encephalitis (HSE) depends on the early and appropriate administration of specific antiviral therapy. We retrospectively reviewed 38 cases of children with proven HSE, to evaluate the reliability of polymerase chain reaction results, according to the time of cerebrospinal fluid (CSF) sampling. Initial negative results were observed in 8 of 33 CSF samples drawn before day 3 of the disease and were significantly associated with a low level of protein and <10 leukocytes/mm3 in the CSF.

Functional motor-cortex mapping using corticokinematic coherence.

We present a novel method, corticokinematic coherence (CKC), for functional mapping of the motor cortex by computing coherence between cortical magnetoencephalographic (MEG) signals and the kinematics of voluntary movements. Ten subjects performed self-paced flexion-extensions of the right-hand fingers at about 3 Hz, with a three-axis accelerometer attached to the index finger. Cross-correlogram and coherence spectra were computed between 306 MEG channels and the accelerometer signals. In all subjects, accelerometer and coherence spectra showed peaks around 3-5 Hz and 6-10 Hz, corresponding to the movement frequencies. The coherence was statistically significant (P<0.05) in all subjects, with sources at the hand area of the primary motor cortex contralateral to the movement. CKC appears to be a promising and robust method for reliable and convenient functional mapping of the human motor cortex.

The pace of prosodic phrasing couples the listener's cortex to the reader's voice.

We studied online coupling between a readers voice and a listeners cortical activity using a novel, ecologically valid continuous listening paradigm. Whole‐scalp magnetoencephalographic (MEG) signals were recorded from 10 right‐handed, native French‐speaking listeners in four conditions: a female (Exp1f) and a male (Exp1m) reading the same text in French; a male reading a text in Finnish (Exp 2), a language incomprehensible for the subjects, and a male humming Exp1 text (Exp 3). The fundamental frequency (f0) of the readers voice was recorded with an accelerometer attached to the throat, and coherence was computed between f0 time‐course and listeners MEG. Similar levels of right‐hemisphere‐predominant coherence were found at ˜0.5 Hz in Exps 1–3. Dynamic imaging of coherent sources revealed that the most coherent brain regions were located in the right posterior superior temporal sulcus (pSTS) and posterior superior temporal gyrus (pSTG) in Exps 1–2 and in the right supratemporal auditory cortex in Exp 3. Comparison between speech rhythm and phrasing suggested a connection of the observed coherence to pauses at the sentence level both in the spoken and hummed text. These results demonstrate significant coupling at ∼0.5 Hz between readers voice and listeners cortical signals during listening to natural continuous voice. The observed coupling suggests that voice envelope fluctuations, due to prosodic rhythmicity at the phrasal and sentence levels, are reflected in the listeners cortex as rhythmicity of about 2‐s cycles. The predominance of the coherence in the right pSTS and pSTG suggests hemispherical asymmetry in processing of speech sounds at subsentence time scales. Hum Brain Mapp, 2013.

EEG-fMRI in children with pharmacoresistant focal epilepsy

Summary:  Purpose: To evaluate the usefulness of EEG‐combined functional magnetic resonance imaging (EEG‐fMRI) to localize epileptogenic sources.

External globus pallidus stimulation modulates brain connectivity in Huntington's disease.

Positron emission tomography with O-15-labeled water was used to study at rest the neurophysiological effects of bilateral external globus pallidus (GPe) deep brain stimulation in patients with Huntingtons disease (HD). Five patients were compared with a control group in the on and off states of the stimulator. External globus pallidus stimulation decreased neuronal activity and modulated cerebral connectivity within the basal ganglia-thalamocortical circuitry, the sensorimotor, and the default-mode networks. These data indicate that GPe stimulation modulates functional integration in HD patients in accordance with the basal ganglia-thalamocortical circuit model.

Increased cortical activity in binge drinkers during working memory task: a preliminary assessment through a functional magnetic resonance imaging study.

Background Cerebral dysfunction is a common feature of both chronic alcohol abusers and binge drinkers. Here, we aimed to study whether, at equated behavioral performance levels, binge drinkers exhibited increased neural activity while performing simple cognitive tasks. Methods Thirty-two participants (16 binge drinkers and 16 matched controls) were scanned using functional magnetic resonance imaging (fMRI) while performing an n-back working memory task. In the control zero-back (N0) condition, subjects were required to press a button with the right hand when the number “2″ was displayed. In the two-back (N2) condition, subjects had to press a button when the displayed number was identical to the number shown two trials before. Results fMRI analyses revealed higher bilateral activity in the pre-supplementary motor area in binge drinkers than matched controls, even though behavioral performances were similar. Moreover, binge drinkers showed specific positive correlations between the number of alcohol doses consumed per occasion and higher activity in the dorsomedial prefrontal cortex, as well as between the number of drinking occasions per week and higher activity in cerebellum, thalamus and insula while performing the N2 memory task. Conclusions Binge alcohol consumption leads to possible compensatory cerebral changes in binge drinkers that facilitate normal behavioral performance. These changes in cerebral responses may be considered as vulnerability factors for developing adult substance use disorders.

Insights into the pathophysiology of psychomotor regression in CSWS syndromes from FDG-PET and EEG-fMRI.

Epilepsy syndromes with continuous spikes‐and‐waves during slow sleep (CSWS) are age‐related epileptic encephalopathies characterized by the development of various types of psychomotor regression in close temporal concordance with the appearance of the electroencephalography (EEG) pattern of CSWS. Functional cerebral imaging studies performed in children with CSWS have shown evidence for the existence of increase in metabolism or perfusion at the site of the epileptic focus, associated with decrease in metabolism or perfusion in distant and connected brain areas. Longitudinal [18F]‐fluorodeoxyglucose–positron emission tomography (FDG‐PET) studies and effective connectivity analyses have suggested the existence of a pathophysiologic link between increases and decreases in metabolism/perfusion that could be explained by the theory of remote inhibition. These findings highlight that the psychomotor regression observed in CSWS syndromes is not only related to the neurophysiologic impairment at the site of the epileptic foci but also to epilepsy‐induced neurophysiologic changes in distant connected brain areas.

Recording epileptic activity with MEG in a light-weight magnetic shield

Ten patients with focal epilepsy were studied with magnetoencephalography (MEG) to determine if a new light-weight magnetically shielded room (lMSR) provides sufficient attenuation of magnetic interference to detect and localize the magnetic correlates of epileptic activity. Interictal MEG epileptic events co-localizing with the presumed location of the epileptogenic zone were found in all patients. MEG measurements performed in the lMSR provide an adequate signal-to-noise ratio for non-invasive localization of epileptic foci.

Neuronal network coherent with hand kinematics during fast repetitive hand movements

We quantified the coupling between magnetoencephalographic (MEG) cortical signals and the kinematics of fast repetitive voluntary hand movements monitored by a 3-axis accelerometer. Ten healthy right-handed adults performed self-paced flexion-extension movements of right-hand fingers at ~3Hz with either touching the thumb during flexions (TOUCH) or not (noTOUCH). At the sensor level, we found in all subjects and conditions significant coherence at the movement frequency (F0) and its first harmonic (F1). Coherence values were significantly higher in TOUCH compared to noTOUCH. At the group level, dynamic imaging of coherent sources localized the main source of coherent activity at the left primary motor (M1) hand area, except at F0 TOUCH were the main source was localized at the left primary sensory (S1) hand area. Other coherent brain areas were also identified at right S1-M1 cortices (F0), left dorsolateral prefrontal cortex (F1), left posterior parietal cortex (F0 TOUCH and F1 noTOUCH) and left medial S1-M1 areas (TOUCH). This study highlights the prominent role of rhythmic neuronal activity phase-locked to movements for the encoding and the integration of key sensori-motor features of limb kinematics. This study also suggests that somatosensory afferences play a key role to sustain a high synchronization level between the neuronal activity in coherent brain areas and hand acceleration. Some coherent brain regions differed between F0 and F1 in both conditions, suggesting that distinct cortical areas are involved in different features of hand kinematics.