A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy

Resting-state functional connectivity MRI (rs-fcMRI) is a technique that identifies connectivity between different brain regions based on correlations over time in the blood-oxygenation level dependent signal. rs-fcMRI has been applied extensively to identify abnormalities in brain connectivity in d...

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Main Authors: Shafi, Mouhsin M., Whitfield-Gabrieli, Susan, Chu, Catherine J., Pascual-Leone, Alvaro, Chang, Bernard S.
Other Authors: McGovern Institute for Brain Research at MIT
Format: Article
Language:en_US
Published: MyJoVE Corporation 2017
Online Access:http://hdl.handle.net/1721.1/109862
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author Shafi, Mouhsin M.
Whitfield-Gabrieli, Susan
Chu, Catherine J.
Pascual-Leone, Alvaro
Chang, Bernard S.
author2 McGovern Institute for Brain Research at MIT
author_facet McGovern Institute for Brain Research at MIT
Shafi, Mouhsin M.
Whitfield-Gabrieli, Susan
Chu, Catherine J.
Pascual-Leone, Alvaro
Chang, Bernard S.
author_sort Shafi, Mouhsin M.
collection MIT
description Resting-state functional connectivity MRI (rs-fcMRI) is a technique that identifies connectivity between different brain regions based on correlations over time in the blood-oxygenation level dependent signal. rs-fcMRI has been applied extensively to identify abnormalities in brain connectivity in different neurologic and psychiatric diseases. However, the relationship among rs-fcMRI connectivity abnormalities, brain electrophysiology and disease state is unknown, in part because the causal significance of alterations in functional connectivity in disease pathophysiology has not been established. Transcranial Magnetic Stimulation (TMS) is a technique that uses electromagnetic induction to noninvasively produce focal changes in cortical activity. When combined with electroencephalography (EEG), TMS can be used to assess the brain's response to external perturbations. Here we provide a protocol for combining rs-fcMRI, TMS and EEG to assess the physiologic significance of alterations in functional connectivity in patients with neuropsychiatric disease. We provide representative results from a previously published study in which rs-fcMRI was used to identify regions with abnormal connectivity in patients with epilepsy due to a malformation of cortical development, periventricular nodular heterotopia (PNH). Stimulation in patients with epilepsy resulted in abnormal TMS-evoked EEG activity relative to stimulation of the same sites in matched healthy control patients, with an abnormal increase in the late component of the TMS-evoked potential, consistent with cortical hyperexcitability. This abnormality was specific to regions with abnormal resting-state functional connectivity. Electrical source analysis in a subject with previously recorded seizures demonstrated that the origin of the abnormal TMS-evoked activity co-localized with the seizure-onset zone, suggesting the presence of an epileptogenic circuit. These results demonstrate how rs-fcMRI, TMS and EEG can be utilized together to identify and understand the physiological significance of abnormal brain connectivity in human diseases.
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spelling mit-1721.1/1098622022-09-29T17:30:07Z A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy Shafi, Mouhsin M. Whitfield-Gabrieli, Susan Chu, Catherine J. Pascual-Leone, Alvaro Chang, Bernard S. McGovern Institute for Brain Research at MIT Whitfield-Gabrieli, Susan Resting-state functional connectivity MRI (rs-fcMRI) is a technique that identifies connectivity between different brain regions based on correlations over time in the blood-oxygenation level dependent signal. rs-fcMRI has been applied extensively to identify abnormalities in brain connectivity in different neurologic and psychiatric diseases. However, the relationship among rs-fcMRI connectivity abnormalities, brain electrophysiology and disease state is unknown, in part because the causal significance of alterations in functional connectivity in disease pathophysiology has not been established. Transcranial Magnetic Stimulation (TMS) is a technique that uses electromagnetic induction to noninvasively produce focal changes in cortical activity. When combined with electroencephalography (EEG), TMS can be used to assess the brain's response to external perturbations. Here we provide a protocol for combining rs-fcMRI, TMS and EEG to assess the physiologic significance of alterations in functional connectivity in patients with neuropsychiatric disease. We provide representative results from a previously published study in which rs-fcMRI was used to identify regions with abnormal connectivity in patients with epilepsy due to a malformation of cortical development, periventricular nodular heterotopia (PNH). Stimulation in patients with epilepsy resulted in abnormal TMS-evoked EEG activity relative to stimulation of the same sites in matched healthy control patients, with an abnormal increase in the late component of the TMS-evoked potential, consistent with cortical hyperexcitability. This abnormality was specific to regions with abnormal resting-state functional connectivity. Electrical source analysis in a subject with previously recorded seizures demonstrated that the origin of the abnormal TMS-evoked activity co-localized with the seizure-onset zone, suggesting the presence of an epileptogenic circuit. These results demonstrate how rs-fcMRI, TMS and EEG can be utilized together to identify and understand the physiological significance of abnormal brain connectivity in human diseases. 2017-06-14T18:01:14Z 2017-06-14T18:01:14Z 2016-12 Article http://purl.org/eprint/type/JournalArticle 1940-087X http://hdl.handle.net/1721.1/109862 Shafi, Mouhsin M. et al. “A Multimodal Imaging- and Stimulation-Based Method of Evaluating Connectivity-Related Brain Excitability in Patients with Epilepsy.” Journal of Visualized Experiments 117 (2016): n. pag. © 2016 Journal of Visualized Experiments en_US http://dx.doi.org/10.3791/53727 Journal of Visualized Experiments Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use. application/pdf MyJoVE Corporation Journal of Visualized Experiments (JoVE)
spellingShingle Shafi, Mouhsin M.
Whitfield-Gabrieli, Susan
Chu, Catherine J.
Pascual-Leone, Alvaro
Chang, Bernard S.
A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy
title A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy
title_full A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy
title_fullStr A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy
title_full_unstemmed A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy
title_short A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy
title_sort multimodal imaging and stimulation based method of evaluating connectivity related brain excitability in patients with epilepsy
url http://hdl.handle.net/1721.1/109862
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