Biomedical subjects

O Blanke

Publications and source records attributed to O Blanke.

30 records · Page 2Linked to original sources

PubMed2000

Location of the human frontal eye field as defined by electrical cortical stimulation: anatomical, functional and electrophysiological characteristics.

Electrical cortical stimulation of the human frontal gyri and the precentral gyrus has been shown to induce eye movements and it has classically been assumed that these stimulation-induced eye movements result from electrical interference with the human homologue of the monkey frontal eye field (FEF). However, amplitude of electrical current and induced type of eye movement, which are essential for the determination of eye fields in the monkey, have not been investigated systematically in man. We applied electrical cortical stimulation in the lateral frontal cortex in six epileptic patients. Sites whose stimulation resulted in eye movements were determined with respect to gyral and sulcal patterns, Talairach coordinates and neighboring functions as found by electrical cortical stimulation. Based on this approach, a restricted location of the electrically defined FEF is proposed within a larger oculomotor region on the posterior part of the middle frontal gyrus.

Adolescent↗

PubMed2000

EEG-triggered functional MRI in patients with pharmacoresistant epilepsy.

Functional magnetic resonance imaging (fMRI) triggered by scalp electroencephalography (EEG) recordings has become a promising new tool for noninvasive epileptic focus localization. Studies to date have shown that it can be used safely and that highly localized information can be obtained. So far, no reports using comprehensive clinical information and/or long-term follow-up after epilepsy surgery in a larger patient group have been given that would allow a valuable judgment of the utility of this technique. Here, the results of 11 patients with EEG-triggered fMRI exams who also underwent presurgical evaluation of their epilepsy are given. In most patients we were able to record good quality EEG inside the magnet, allowing us to trigger fMRI acquisition by interictal discharges. The fMRI consisted of echoplanar multislice acquisition permitting a large anatomical coverage of the patient's brain. In 8 of the 11 patients the exam confirmed clinical diagnosis, either by the presence (n = 7) or absence (n = 1) of focal signal enhancement. In six patients, intracranial recordings were carried out, and in five of them, the epileptogenic zone as determined by fMRI was confirmed. Limitations were encountered a) when the focus was too close to air cavities; b) if an active epileptogenic focus was absent; and c) if only reduced cooperation with respect to body movements was provided by the patient. We conclude that EEG-triggered fMRI is a safe and powerful noninvasive tool that improves the diagnostic value of MRI by localizing the epileptic focus precisely.

Adolescent↗

PubMed2000

Electrical cortical stimulation of the human prefrontal cortex evokes complex visual hallucinations.

Complex visual hallucinations are a well-known feature of electrical stimulation or epileptic discharge in the temporal lobe. It has been proposed that these visual hallucinations result from an electrical interference with the ventral visual processing stream in the lateral temporal lobe and the memory system in medial temporal structures, which explains their frequent visual and mnestic features. Even though recent studies have demonstrated visual and memory functions in the prefrontal cortex, up to now epileptic discharge or electrical stimulation of prefrontal structures has only rarely been reported to induce visual phenomena. We report on two patients undergoing invasive presurgical epilepsy evaluation in which electrical cortical stimulation of the left prefrontal cortex repeatedly induced complex visual hallucinations. Interestingly, the induced visual responses differed with respect to their spatial organization: whereas those evoked on the inferior frontal gyrus were perceived in the whole visual field, complex visual responses on the middle frontal gyrus were restricted to the contralateral hemispace. Based on the spatial organization of the visual experiences in our patients, animal work, and neuroimaging data it might be suggested that specific subregions of the human prefrontal cortex might contain separate visual and mnemonic processing mechanisms.

Journal Article↗

PubMed2000

Internally driven vs. externally cued movement selection: a study on the timing of brain activity.

Brain imaging studies in man and single cell recordings in monkey have suggested that medial supplementary motor areas (SMA) and lateral pre-motor areas (PMA) are functionally dissociated concerning their involvement in internally driven and externally cued movements. This dichotomy, however, seems to be relative rather than absolute. Here, we searched for further evidence of relative differences and aimed to determine by what aspect of brain activity (duration, strength, or both) these might be accounted for. Event-related potentials (ERPs) were recorded while healthy, right-handed subjects selected one of three possible right hand digit movements based either on 'internal' choice or 'external' cues. The results obtained from ERP mapping suggest that movement selection evokes the same electrical brain activity patterns in terms of surface potential configurations in the same order and at the same strength independent of the selection mode. These identical configurations, however, differed in their duration. Combined with the results of a distributed source localization procedure, our data are suggestive of longer lasting activity in SMA during the 'internal' and longer lasting activity in PMA during the 'external' condition. Our results confirm previous findings in showing that SMA and PMA are distinctively involved in the two tasks and that this functional dichotomy is relative rather than absolute but indicate that such a dissociation can result from differences in duration rather than pure strength of activation.

Adult↗

PubMed2000

Temporal and spatial determination of EEG-seizure onset in the frequency domain.

OBJECTIVE: A quantitative analysis of scalp electric fields in patients suffering from pharmacoresistant temporal lobe epilepsy was performed in order to study the development of rhythmic ictal activities over time. METHODS: A method that calculates phase-corrected voltage maps in the frequency domain (FFT-approximation) was applied to ictal multichannel recordings in 10 epileptic patients. The onset of the ictally dominant frequency was determined and its temporal evolution over a time period of 46 s around the ictal EEG onset was studied. The analysis was completed by a linear inverse solution that estimated the sources of the dominant frequency. RESULTS: This method permitted the identification of an ictally dominant frequency which started on the average prior to the onset of initial EEG signs as determined by visual inspection. The frequency incremented during the evolution of the seizure in all patients. The linear inverse solution algorithm localized the source of this frequency to the brain region which was clinically determined as the site of seizure onset and whose resection rendered all patients seizure-free. CONCLUSIONS: Our data suggest that the constant increase of the ictally dominant frequency is related to the amount of temporal lobe tissue generating the ictal discharges. Frequential analysis of ictal electric fields can be reliably used to detect focal pathological activity early during seizure onset arising in deep structures such as the mesial temporal lobe.

Adult↗

PubMed2000

Distinct behavioral and EEG topographic correlates of loss of consciousness in absences.

PURPOSE: To describe the behavioral and EEG topographic correlates of absences with 3-Hz generalized spike-waves and partitioned impairment of consciousness. METHODS: Two adult women had so-called "phantom" absences, characterized by brief and mild impairments of consciousness that were previously inconspicuous to both patient and physician. Neuropsychological examination was performed under video-EEG monitoring during absence status. EEG topographic mapping of spike-wave discharges was obtained in the two cases. RESULTS: Only mild attentional and executive disturbances were observed during absence status despite prolonged discharges. Spike-wave bursts were associated with selective impairment in the initiation of response and self-generated action, whereas short-term storage of external information during discharges was fully preserved. This is consistent with a predominant involvement of frontomesial cortex demonstrated by topographic mapping of spike-wave discharges in the two cases. By contrast, in two other patients with typical absences and a complete lack of retention for information given during the discharges, topographic mapping found a more lateral frontal involvement by spike-wave activity. CONCLUSIONS: Different types of absence seizures may impair distinct components of conscious behavior. A predominant involvement of frontomesial thalamocortical circuitry may underlie an "inconspicuous" disorder of consciousness as seen in phantom absences with selective loss of initiation and goal-oriented behavior, whereas involvement of more lateral frontal areas in typical absences may additionally disrupt working memory processes.

Adult↗

PubMed2000

Simple and complex vestibular responses induced by electrical cortical stimulation of the parietal cortex in humans.

The present study reports on a patient undergoing invasive monitoring for intractable epilepsy who experienced different vestibular sensations after electrical cortical stimulation of the inferior parietal lobule at the anterior part of the intraparietal sulcus. Types of vestibular response ranged from simple to complex sensations and depended on stimulation site and applied current. The findings suggest vestibular topography and hierarchical processing within the parietal vestibular cortex of humans.

Adult↗

PubMed2000

Measuring the complexity of time series: an application to neurophysiological signals.

Measures of signal complexity can be used to distinguish neurophysiological activation from noise in those neuroimaging techniques where we record variations of brain activity with time, e.g., fMRI, EEG, ERP. In this paper we explore a recently developed approach to calculate a quantitative measure of deterministic signal complexity and information content: The Renyi number. The Renyi number is by definition an entropy, i.e., a classically used measure of disorder in physical systems, and is calculated in this paper over the basis of the time frequency representation (TFRs) of the measured signals. When calculated in this form, the Renyi entropy (RE) indirectly characterizes the complexity of a signal by providing an approximate counting of the number of separated elementary atoms that compose the time series in the time frequency plane. In this sense, this measure conforms closely to our visual notion of complexity since low complexity values are obtained for signals formed by a small number of "components". The most remarkable properties of this measure are twofold: 1) It does not rely on assumptions about the time series such as stationarity or gaussianity and 2) No model of the neural process under study is required, e.g., no hemodynamic response model for fMRI. The method is illustrated in this paper using fMRI, intracranial ERPs and intracranial potentials estimated from scalp recorded ERPs through an inverse solution (ELECTRA). The main theoretical and practical drawbacks of this measure, especially its dependence of the selected TFR, are discussed. Also the capability of this approach to produce, with less restrictive hypothesis, results comparable to those obtained with more standard methods but is emphasized.

Algorithms↗

PubMed1999

Visual activity in the human frontal eye field.

Although visual information processing in the monkey frontal eye field (FEF) has been well demonstrated, the contribution of its human homologue to vision is still unknown. Here we report a study of intracranial visual evoked potentials (VEPs) recorded from the human FEF which was identified by electrical cortical stimulation. Electrical stimulations and EEG recordings were carried out via subdural grid electrodes placed over the frontal cortex in three epileptic patients. Evoked eye movements were mainly horizontal and always directed to the hemispace contralateral to the stimulation site. Intracranial VEPs showed responses predominately to stimuli in the contralateral visual field. Our findings demonstrate a close relationship between the direction of the electrically elicited eye movements and the visual stimulus location which predominantly leads to neural responses in the FEF. These findings provide evidence for the functional role of the human FEF in the analysis of visual stimuli from the contralateral visual field as well as in the generation of eye movements towards these conspicuous targets.

Adolescent↗

PubMed1999

Frequency domain EEG source localization of ictal epileptiform activity in patients with partial complex epilepsy of temporal lobe origin.

The aim of this study was to investigate whether EEG source localization in the frequency domain, using the FFT dipole approximation (Lehmann, D. and Michel, C.M. Electroenceph. clin. Neurophysiol., 1990, 76: 271-276), would be useful for quantifying the frequency content of epileptic seizure activity. Between one and 7 extracranially recorded seizures were analyzed in each of 7 patients with mesolimbic epilepsy, who were seizure-free after temporal lobe resection. The full scalp frequency spectrum for the first 4 s after seizure onset, as well as for subsequent periods, was determined. Power peaks in the spectra were identified, and an instant dipole fit was performed for the frequencies corresponding to these peaks. Ictal frequencies, ranging between 3.5 and 8.5 Hz, showed a variable degree of stability over time in the different patients. For a particular frequency, dipole results were similar during the different phases of seizure development. In patients with more than one prominent frequency, dipole results for the different frequencies were similar. Dipole results were also similar between patients. We conclude that dipole localization of dominant frequencies, as obtained from full scalp FFT analysis, gives quite reproducible results for seizures originating in the mesial temporal area. The method may become a useful tool for the pre-surgical identification of patients with mesolimbic epilepsy.

Adult↗

PubMed1999

Spatiotemporal EEG analysis and distributed source estimation in presurgical epilepsy evaluation.

In the attempts to localize electric sources in the brain on the basis of multichannel EEG and/or MEG measurements, distributed source estimation procedures have become of increasing interest. Several commercial software packages offer such localization programs and results using these methods are seen more and more frequently in the literature. It is crucial that the users understand the similarities and differences of these methods and that they become aware of the advantages and limitations that are inherent to each approach. This review provides this information from a theoretical as well as from a practical point of view. The theoretical part gives the algorithmic basis of the electromagnetic inverse problem and shows how the different a priori assumptions are formally integrated in these equations. The authors restrict this formalism to the linear inverse solutions i.e., those solutions in which the inversion procedure can be represented as a matrix applied to the data. It will be shown that their properties can be best characterized by their resolution kernels and that methods with optimal resolution matrices can be designed. The authors also discuss the important problem of regularization strategies that are used to minimize the influence of noise. Finally, a new kind of inverse solution, termed ELECTRA (for ELECTRical Analysis), is presented that is based on constraining the source model on the basis of the currents that can actually be measured by the scalp recorded EEG. The practical part of the review illustrates the localization procedures with different clinical data sets. Three aspects become important when working with real data: 1) Clinical data is usually far from ideal (limited number of electrodes, noise, etc.). The behavior of inverse procedures in such unfortunate situations has to be evaluated. 2) The selection of the time points or time periods of interest is crucial, especially in the analysis of spontaneous EEG. 3) Additional information coming from other modalities is usually available and can be incorporated. The authors are illustrating these important points in the case of interictal and ictal epileptiform activity. Spike averaging, frequency domain source localization, and temporal segmentation based on electric field topographies will be discussed. Finally, the technique of EEG-triggered functional magnetic resonance imaging (fMRI) will be illustrated, where EEG is recorded in the magnet and is used to synchronize fMRI acquisition with interictal events. The analysis of both functional data, i.e. the EEG in terms of three-dimensional source localization and the EEG-triggered fMRI, combines the advantages of the two techniques: the temporal resolution of the EEG and the spatial resolution of the fMRI.

Adult↗

PubMed1998

Non-invasive epileptic focus localization using EEG-triggered functional MRI and electromagnetic tomography.

We present a new approach for non-invasive localization of focal epileptogenic discharges in patients considered for surgical treatment. EEG-triggered functional MR imaging (fMRI) and 3D EEG source localization were combined to map the primary electrical source with high spatial resolution. The method is illustrated by the case of a patient with medically intractable frontal lobe epilepsy. EEG obtained in the MRI system allowed triggering of the fMRI acquisition by the patient's habitual epileptogenic discharges. fMRI revealed multiple areas of signal enhancement. Three-dimensional EEG source localization identified the same active areas and provided evidence of onset in the left frontal lobe. Subsequent electrocorticography from subdural electrodes confirmed spike and seizure onset over this region. This approach, i.e. the combination of EEG-triggered fMRI and 3D EEG source analysis, represents a promising additional tool for presurgical epilepsy evaluation allowing precise non-invasive identification of the epileptic foci.

Adolescent↗