Name: combined invasive subcortical and non-invasive surface neurophysiological recordings for the assessment of cognitive and emotional functions in humans
Uploaded: 2016-05-19T13:00:00
Description: Watch this Scientific Journal Video about Combined Invasive Subcortical and Non-invasive Surface Neurophysiological Recordings for the Assessment of Cognitive and Emotional Functions in Humans at JoVE

This work was supported by ERA-NET NEURON/BMBF Germany (TYMON). Publication fees are covered by a grant from the University Hospital D&#252;sseldorf.&#160;The Flanker task used here was modified from the initially programmed version by Prof. C. Beste and his group47.

The DBS procedure and invasive recordings were approved by the Ethics Commission of the University Clinic D&#252;sseldorf, Germany.
1. Experimental Paradigm Design and Patient&#39;s Consent
NOTE: Design an experimental paradigm or select an existing experimental paradigm to target a cognitive/emotional aspect of interest.
<ol>
	<li>Select patients that will undergo DBS-treatment. Ask if the DBS-Patient meets the study&#39;s inclusion criteria.&#160;If yes, obtain ...

In contrast to non-invasive brain recording techniques like scalp-EEG and MEG, the proposed combined invasive and non-invasive neurophysiological recording framework provides a remarkable opportunity to extract information from cortical and subcortical areas in relation to cognitive-emotional tasks. Such information is reflected by brain oscillatory activity at multiple frequency bands and different levels of organization in relation to brain functioning44. Brain oscillatory patterns that are relevant in our r...

Invasive neurophysiological recordings in humans date back to seminal studies targeting electrocorticographic recordings from cortical areas and the cerebellum during epilepsy surgery and tumor research1. A critical milestone into further development of such recording procedure has been the introduction of the stereotactic technique that provides safe and efficient access to deep structures of the human brain2. Apart from clinical treatment, brain invasive approaches in humans provide a rather unique opportunity to study brain function in relation to recorded activity patterns modulated by external stimuli, notably the case of intra- and post-operative invasive recordings in patients undergoing deep brain stimulation (DBS) procedures. The applicability and usefulness of DBS has been addressed in various neurological and neuropsychiatric diseases from Parkinson&#39;s disease (PD) to obsessive compulsive disorder (OCD) or conditions like chronic disorders of consciousness (DOC).
In particular, DBS has been applied in the treatment of Parkinson&#39;s disease3,4,5, essential tremor6, primary/generalized segmental dystonia7,8,9, Huntington&#39;s disease10,11, treatment-resistant-depression12,13, nicotine and alcohol addiction14, Alzheimer&#39;s disease15,16, Tourette&#39;s syndrome17 and chronic disorder of consciousness (DOC)18,19,20.
Within the scope of neuropsychiatry, DBS is an approved/CE-marked treatment for obsessive compulsive disorder (OCD) targeting the anterior limb of the internal capsule (ALIC) and is in use targeting the ventral capsule/ventral striatum/ventral caudate (VC/VS),nucleus accumbens (Nac) and the subthalamic nucleus (STN)21. Regarding DBS in OCD22, recent studies emphasize the role of STN into the mechanism of compulsive checking by utilizing memory based-paradigms23,24,25.
Noteworthy, modulation of brain activity under the influence of paradigms with cognitive and emotional connotation has been emphasized in DOC26,27,28,29. Thus, DBS is highlighted not only as a prospective treatment for chronic DOC, but also as a clinical procedure that opens up the possibility of studying the modulation of subcortical activity by recording local field potentials (LFP) from central thalamic regions intra- and post- operatively.
In DBS, neurosurgical implantation of electrodes is based on the stereotactic technique that safely accounts for brain anatomical constraints, while patient&#39;s stimulation is customized through intra-operative impulse-stimulation tests. Post-operative LFP recording is possible after initial implantation of DBS electrodes and before internalization of the impulse generator. In particular, the present protocol is centered on post-operative recordings.
In combination with LFPs, simultaneous recording of cortical brain activity can be achieved for instance by non-invasive electroencephalography (EEG) or magnetoencephalography (MEG)30,31. These two non-invasive methods are supported due to its excellent time resolution. While MEG is less affected than EEG by skull effects32, EEG appears advantageous because it is less affected by artifacts caused by metallic implants and head movements and it can be used at the patient&#39;s bed-side33. By simultaneous recording of cortical-subcortical brain activity (LFP and EEG/MEG) in response to applied emotional-cognitive paradigms, different relationships between brain oscillations and behavior could be established on the basis of time-frequency coupling analyses34. In turn, such patterns could lead to prospective biomarkers of a patient&#39;s individualized cognitive and emotional states and optimization of treatment parameters considering individualized settings.
The following protocol targets invasive and non-invasive neurophysiological recording in humans for the assessment of cognitive and emotional function, specifically at the cortical and subcortical level (EEG and LFPs).
First, the neurophysiological recording steps illustrated in the video, that accompanies the present protocol, correspond to a recording with an example patient with movement disorder that performs the so called Flanker task (Example 1).
Second, steps in the protocol are discussed by focusing on the methodology of analysis and sample results taken from a published DBS example in chronic DOC26 (Example 2).
These two examples highlight the applicability of the proposed protocol to DBS-treated patients with different disorders and various experimental paradigms.

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	<tbody>
		<tr >
			<td >BrainAmp Amplifier</td>
			<td >Brain Products GmbH, Gilching Germany</td>
			<td ></td>
			<td >Quantity: 2</td>
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		<tr >
			<td >BrainVision Recorder Software</td>
			<td >Brain Products GmbH, Gilching Germany</td>
			<td ></td>
			<td >1 License&#160;</td>
		</tr>
		<tr >
			<td >BrainVision Analyzer Software&#160;</td>
			<td >Brain Products GmbH, Gilching Germany</td>
			<td></td>
			<td >1 License&#160;</td>
		</tr>
		<tr >
			<td >Fiber Optic cables and USB connectors</td>
			<td >Brain Products GmbH, Gilching Germany</td>
			<td ></td>
			<td >These come with the above listed equipment</td>
		</tr>
		<tr >
			<td >Electrode Input box (64 channels)</td>
			<td >Brain Products GmbH, Gilching Germany</td>
			<td></td>
			<td >Quantity: 1</td>
		</tr>
		<tr >
			<td >EEG gel&#160;</td>
			<td >Natus Inc</td>
			<td></td>
			<td >Quantity: 1</td>
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			<td >Isopropyl alcohol</td>
			<td>Sch&#252;lke &#38; Mayr GmbH, Germany</td>
			<td></td>
			<td >Quantity: 1</td>
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			<td >Skin preparation gel</td>
			<td >Weaver and Co, USA</td>
			<td></td>
			<td >Quantity: 1</td>
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			<td >MATLAB&#160;&#160;</td>
			<td>Math-Works, Natick, Massachusetts, USA</td>
			<td></td>
			<td >1 License</td>
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		<tr >
			<td >FieldTrip toolbox</td>
			<td>http://www.fieldtriptoolbox.org/</td>
			<td></td>
			<td>Open Source</td>
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			<td >INOMED MER system&#160;</td>
			<td>INOMED Corp., Emmendingen, Germany</td>
			<td></td>
			<td>Quantity: 1</td>
		</tr>
		<tr >
			<td >Macroelectrodes (model 3387 quadripolar DBS lead)</td>
			<td>Medtronic Inc., Minneapolis, MN, USA</td>
			<td></td>
			<td>Quantity: 2</td>
		</tr>
		<tr >
			<td >Sterile percutaneous extension wires (model 3550-05)&#160;</td>
			<td>Medtronic Inc., Minneapolis, MN, USA</td>
			<td></td>
			<td>Quantity: 2</td>
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			<td >Twist lock cable (model 3550-03)&#160;</td>
			<td>Medtronic Inc., Minneapolis, MN, USA</td>
			<td></td>
			<td>Quantity: 2</td>
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			<td >custom made connectors to DIN 428092 touch proof connectors</td>
			<td></td>
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			<td>Quantity: 2</td>
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		<tr >
			<td >Vercise Lead kit DB -2201&#160;</td>
			<td>Boston Scientific</td>
			<td></td>
			<td>Quantity: 2</td>
		</tr>
		<tr >
			<td >Contact extenion kit NM-3138&#160;</td>
			<td>Boston Scientific</td>
			<td></td>
			<td>Quantity: 2</td>
		</tr>
		<tr >
			<td >O.R. cabel &#38; extension SC-4100 A&#160;</td>
			<td>Boston Scientific</td>
			<td></td>
			<td>Quantity: 2</td>
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			<td >connector &#160; to touch proof&#160;</td>
			<td>Twente Medical Systems International B.V.</td>
			<td></td>
			<td>Quantity: 2</td>
		</tr>
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			<td >CT scanner Modell PQ2000 (Postoperative CT scans)</td>
			<td>Philips Healthcare GmbH Hamburg</td>
			<td></td>
			<td>Quantity: 1</td>
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			<td >Presentation Software (Flanker Task)</td>
			<td>Neurobehavioral systems Inc.</td>
			<td></td>
			<td>1 License&#160;</td>
		</tr>
		<tr >
			<td >MEG System</td>
			<td>Elekta Neuromag Inc</td>
			<td></td>
			<td>Alternatively</td>
		</tr>
		<tr >
			<td >High-density EEG sensor net (128 or 256 channels)</td>
			<td>Electrical Geodesics Inc (EGI), USA</td>
			<td></td>
			<td>Alternatively</td>
		</tr>
	</tbody>
</table>

combined invasive subcortical and non-invasive surface neurophysiological recordings for the assessment of cognitive and emotional functions in humans

In spite of the success in applying non-invasive electroencephalography (EEG), magneto-encephalography (MEG) and functional magnetic resonance imaging (fMRI) for extracting crucial information about the mechanism of the human brain, such methods remain insufficient to provide information about physiological processes reflecting cognitive and emotional functions at the subcortical level. In this respect, modern invasive clinical approaches in humans, such as deep brain stimulation (DBS), offer a tremendous possibility to record subcortical brain activity, namely local field potentials (LFPs) representing coherent activity of neural assemblies from localized basal ganglia or thalamic regions. Notwithstanding the fact that invasive approaches in humans are applied only after medical indication and thus recorded data correspond to altered brain circuits, valuable insight can be gained regarding the presence of intact brain functions in relation to brain oscillatory activity and the pathophysiology of disorders in response to experimental cognitive paradigms. In this direction, a growing number of DBS studies in patients with Parkinson&#39;s disease (PD) target not only motor functions but also higher level processes such as emotions, decision-making, attention, memory and sensory perception. Recent clinical trials also emphasize the role of DBS as an alternative treatment in neuropsychiatric disorders ranging from obsessive compulsive disorder (OCD) to chronic disorders of consciousness (DOC). Consequently, we focus on the use of combined invasive (LFP) and non-invasive (EEG) human brain recordings in assessing the role of cortical-subcortical structures in cognitive and emotional processing trough experimental paradigms (e.g. speech stimuli with emotional connotation or paradigms of cognitive control such as the Flanker task), for patients undergoing DBS treatment.

For the DBS-DOC case (Example 2), we now provide data on target localization for DBS implantation, schematic diagrams of LFP electrode and EEG set up, exemplary recordings of EEG and LFP activity (raw data) and representative analysis results:
Figure 2A shows planned trajectory (black line) projected on an anatomic atlas36, section 30, coronary, 10.7 mm behind the anterior commissure (AC) (red line: A...

Watch this Scientific Journal Video about Combined Invasive Subcortical and Non-invasive Surface Neurophysiological Recordings for the Assessment of Cognitive and Emotional Functions in Humans at JoVE

Combined Invasive Subcortical and Non-invasive Surface Neurophysiological Recordings for the Assessment of Cognitive and Emotional Functions in Humans

The present protocol aims at assessing cognitive-emotional functions in the basal ganglia by simultaneous neurophysiological recording of local field potentials and non-invasive brain cortical activity (EEG). The procedure is exemplified by the use of paradigms involving speech stimuli with emotional connotation or the Flanker task involving cognitive control.

In spite of the success in applying non-invasive electroencephalography (EEG), magneto-encephalography (MEG) and functional magnetic resonance imaging ...

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