- Email: [email protected]
Secondary chronic cluster headache treated by DBS: first reported case
Abstracts / Brain Stimulation 8 (2015) 343e359
Results: The individualized Theta Burst Stimulation showed significantly higher correlation with the background frequencies. Discussion: The system proved capable of consistently matching the individualized stimulus frequency to the ongoing background activity in a simulated patient with TMS stimuli. The correlation was greater than for set TBS parameters, as was designed. Future studies will be conducted to determine whether this technical adjustment may lead to clinical differences.
123 High-definition Transcranial Direct Current Stimulation effect and its time-course on 2-back task: An event-related potential (ERP) study D.G.H. Tan , K.H. Ting , C.C.H Chan Applied Cognitive Neuroscience Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University *E-mail: [email protected]. Background: The newly-developed high-definition direct current stimulation (HD-tDCS) provides more focal stimulation over the scalp than the conventional tDCS. This study aimed to provide further evidence in understanding its short-term effect and its modulation effects on working memory. Methods: Twenty healthy young adults (Mean age ¼ 19.5 1.4 years old; 13 female) performed a working memory task (two-back task) before, after and 1 week after receiving 10 minutes of 1mA anodal HD-tDCS stimulation at left inferior lateral prefrontal cortex (F3). Each task consisted 100 trials with 30 targets. Scalp ERP were recorded during the task. Repeated measure ANOVAs were used to analyze the mean amplitude of N200 and P300 indexing key processes in two-back task at midline sites (Fz, Cz and Pz), as well as behavioural accuracy rate and response time, to examine stimulation effect across the three occasions. Results: Inverse efficiency (IE ¼ hit rate/hit RT) observed significant stimulation effect with better performance at 1-week after stimulation than at pre-stimulation (F(2,38) ¼ 5.07, p ¼ .01). N200 was more negative-going than pre-stimulation at Fz (F(1,19) ¼ 14.197, p ¼ .001) and Cz (F(1,19) ¼ 11.138, p ¼ .003) after 1 week. A centrally distributed negativity peaked at 180 ms was observed to be enhanced than pre-stimulation and post-stimulation after one week (p < .017), and correlated higher IE. Conclusion: One session of 10-minute anodal HD-tDCS was found to enhance the conscious attention to or ignoring of an irrelevant stimulus (N200) and N180 which was elicited by template mismatch in performing a cognitive task related to working memory. These effects were sustained till 1 week after stimulation. This finding added evidence to the effect of the newly developed HD-tDCS and its potential sustenance after 1 week.
125 Frequency-frequency coupling of brain oscillations in studying ictal EEG activity Chien-Hung Yeh a, Yue-Loong Hsin b a The Research Center for Adaptive Data Analysis/Center for Dynamical Biomarker and Translational Medicine, National Central University, Chungli, Taiwan b Department of Neurology, Chung Shan Medical University Hospital, Taichung, Taiwan High-frequency oscillations (HFOs) have proven important and useful. Recent studies suggest that cross-frequency coupling play a functional role in neuronal computation, communication and learning. High-frequency brain activity is found to be nested by low-frequency brain rhythms. Here we proposed a new analytical tool to compute the coupling
345
between the amplitudes of different oscillatory components at different frequencies. We analyzed intracranial EEG signals of seizure activity to investigate the dynamics. We first utilize empirical mode decomposition (EMD) to extract nonlinear oscillations at different frequencies. All EMD components of a signal, called intrinsic mode functions (IMFs) are unique to the signal, and derived in the time domain without assumptions of their frequency, amplitude, or functional form, allowing for frequency and amplitude changes at timescales close to the sampling rate of the data. Then we use Hilbert transform to obtain instantaneous amplitude of each IMF d amplitude envelop. We used EMD to extract oscillatory components of the amplitude envelopes in the given frequency region to quantify amplitude-amplitude coupling (AAC) over a specific range of frequencies. After evaluating the standard deviation of each IMFs extracted from the given amplitude envelops, by taking the amplitude envelop from one of the 1st extracted IMFs and the phase from the 2nd extracted IMFs, we can therefore quantify their AAC. There were common features of seizure dynamics. During a seizure, the dynamic of phase-amplitude coupling showed a drifting on the on the amplitude-given frequency (b or Y wave) to its lower frequency approximately in the middle of the dynamic process, while the dynamic of AAC further shows that the coupling behavior become more center to a certain point gradually. HFOs within individual channel were consistantly nested by lower frequency waves. Our findings further support that cross-frequency coupling serve as a mechanism of large-scale brain networks operating at seizure.
126 Secondary chronic cluster headache treated by DBS: first reported case M. Rizzi , G. Messina , R. Cordella , M. Leone , A. Franzini Dept of Neurosurgery, IRCCS Foundation Neurological Institute “Carlo Besta”, Milan Italy Deep brain stimulation (DBS) of the posterior hypothalamus (pHyp) has been reported as an effective treatment for primary and drug-resistant, chronic cluster headache (CCH). We here describe the use of such a procedure for the treatment of secondary CCH due to a neoplasm affecting the soft tissues of the right hemiface. A 34 years-old male affected by infiltrating angiomyolipoma of the right hemiface, who subsequently developed drug-refractory homolateral CCH, underwent DBS of the right pHyp region at the Fondazione IRCCS Istituto Nazionale Neurologico Carlo Besta, in 2009. After surgery, the patient presented a significant reduction in frequency of pain bouts (from up to 15 attacks/day observed to 3 attacks/years). However, because of a subsequent infection, the entire system was removed, with pain relapse. After re-implantation of the system, successful outcome was observed. In 2014, after head injury, he started again to suffer from CCH attacks. Extension cable damage was detected. After cable replacement, a relevant clinical improvement was observed. This brief report shows the feasibility of pHyp DBS in secondary drug-refractory CCH syndromes.
127 Gray matter atrophy influences cognitive after-effects of repetitive transcranial magnetic stimulation in patients with Alzheimer’s disease L. Anderkova a,b,*, R. Marecek a,b, I. Eliasova a,b, E. Janousova c, I. Rektorova a,b a First Department of Neurology, St. Anne’s University Hospital and School of Medicine, Masaryk University, Czech Republic
Results: The individualized Theta Burst Stimulation showed significantly higher correlation with the background frequencies. Discussion: The system proved capable of consistently matching the individualized stimulus frequency to the ongoing background activity in a simulated patient with TMS stimuli. The correlation was greater than for set TBS parameters, as was designed. Future studies will be conducted to determine whether this technical adjustment may lead to clinical differences.
123 High-definition Transcranial Direct Current Stimulation effect and its time-course on 2-back task: An event-related potential (ERP) study D.G.H. Tan , K.H. Ting , C.C.H Chan Applied Cognitive Neuroscience Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University *E-mail: [email protected]. Background: The newly-developed high-definition direct current stimulation (HD-tDCS) provides more focal stimulation over the scalp than the conventional tDCS. This study aimed to provide further evidence in understanding its short-term effect and its modulation effects on working memory. Methods: Twenty healthy young adults (Mean age ¼ 19.5 1.4 years old; 13 female) performed a working memory task (two-back task) before, after and 1 week after receiving 10 minutes of 1mA anodal HD-tDCS stimulation at left inferior lateral prefrontal cortex (F3). Each task consisted 100 trials with 30 targets. Scalp ERP were recorded during the task. Repeated measure ANOVAs were used to analyze the mean amplitude of N200 and P300 indexing key processes in two-back task at midline sites (Fz, Cz and Pz), as well as behavioural accuracy rate and response time, to examine stimulation effect across the three occasions. Results: Inverse efficiency (IE ¼ hit rate/hit RT) observed significant stimulation effect with better performance at 1-week after stimulation than at pre-stimulation (F(2,38) ¼ 5.07, p ¼ .01). N200 was more negative-going than pre-stimulation at Fz (F(1,19) ¼ 14.197, p ¼ .001) and Cz (F(1,19) ¼ 11.138, p ¼ .003) after 1 week. A centrally distributed negativity peaked at 180 ms was observed to be enhanced than pre-stimulation and post-stimulation after one week (p < .017), and correlated higher IE. Conclusion: One session of 10-minute anodal HD-tDCS was found to enhance the conscious attention to or ignoring of an irrelevant stimulus (N200) and N180 which was elicited by template mismatch in performing a cognitive task related to working memory. These effects were sustained till 1 week after stimulation. This finding added evidence to the effect of the newly developed HD-tDCS and its potential sustenance after 1 week.
125 Frequency-frequency coupling of brain oscillations in studying ictal EEG activity Chien-Hung Yeh a, Yue-Loong Hsin b a The Research Center for Adaptive Data Analysis/Center for Dynamical Biomarker and Translational Medicine, National Central University, Chungli, Taiwan b Department of Neurology, Chung Shan Medical University Hospital, Taichung, Taiwan High-frequency oscillations (HFOs) have proven important and useful. Recent studies suggest that cross-frequency coupling play a functional role in neuronal computation, communication and learning. High-frequency brain activity is found to be nested by low-frequency brain rhythms. Here we proposed a new analytical tool to compute the coupling
345
between the amplitudes of different oscillatory components at different frequencies. We analyzed intracranial EEG signals of seizure activity to investigate the dynamics. We first utilize empirical mode decomposition (EMD) to extract nonlinear oscillations at different frequencies. All EMD components of a signal, called intrinsic mode functions (IMFs) are unique to the signal, and derived in the time domain without assumptions of their frequency, amplitude, or functional form, allowing for frequency and amplitude changes at timescales close to the sampling rate of the data. Then we use Hilbert transform to obtain instantaneous amplitude of each IMF d amplitude envelop. We used EMD to extract oscillatory components of the amplitude envelopes in the given frequency region to quantify amplitude-amplitude coupling (AAC) over a specific range of frequencies. After evaluating the standard deviation of each IMFs extracted from the given amplitude envelops, by taking the amplitude envelop from one of the 1st extracted IMFs and the phase from the 2nd extracted IMFs, we can therefore quantify their AAC. There were common features of seizure dynamics. During a seizure, the dynamic of phase-amplitude coupling showed a drifting on the on the amplitude-given frequency (b or Y wave) to its lower frequency approximately in the middle of the dynamic process, while the dynamic of AAC further shows that the coupling behavior become more center to a certain point gradually. HFOs within individual channel were consistantly nested by lower frequency waves. Our findings further support that cross-frequency coupling serve as a mechanism of large-scale brain networks operating at seizure.
126 Secondary chronic cluster headache treated by DBS: first reported case M. Rizzi , G. Messina , R. Cordella , M. Leone , A. Franzini Dept of Neurosurgery, IRCCS Foundation Neurological Institute “Carlo Besta”, Milan Italy Deep brain stimulation (DBS) of the posterior hypothalamus (pHyp) has been reported as an effective treatment for primary and drug-resistant, chronic cluster headache (CCH). We here describe the use of such a procedure for the treatment of secondary CCH due to a neoplasm affecting the soft tissues of the right hemiface. A 34 years-old male affected by infiltrating angiomyolipoma of the right hemiface, who subsequently developed drug-refractory homolateral CCH, underwent DBS of the right pHyp region at the Fondazione IRCCS Istituto Nazionale Neurologico Carlo Besta, in 2009. After surgery, the patient presented a significant reduction in frequency of pain bouts (from up to 15 attacks/day observed to 3 attacks/years). However, because of a subsequent infection, the entire system was removed, with pain relapse. After re-implantation of the system, successful outcome was observed. In 2014, after head injury, he started again to suffer from CCH attacks. Extension cable damage was detected. After cable replacement, a relevant clinical improvement was observed. This brief report shows the feasibility of pHyp DBS in secondary drug-refractory CCH syndromes.
127 Gray matter atrophy influences cognitive after-effects of repetitive transcranial magnetic stimulation in patients with Alzheimer’s disease L. Anderkova a,b,*, R. Marecek a,b, I. Eliasova a,b, E. Janousova c, I. Rektorova a,b a First Department of Neurology, St. Anne’s University Hospital and School of Medicine, Masaryk University, Czech Republic