@article {4492, title = {Methods for automated delineation and assessment of EMG responses evoked by peripheral nerve stimulation in diagnostic and closed-loop therapeutic applications.}, journal = {J Neural Eng}, volume = {20}, year = {2023}, month = {2023 Jul 21}, abstract = {

Surface electromyography measurements of the Hoffmann (H-) reflex are essential in a wide range of neuroscientific and clinical applications. One promising emerging therapeutic application is H-reflex operant conditioning, whereby a person is trained to modulate the H-reflex, with generalized beneficial effects on sensorimotor function in chronic neuromuscular disorders. Both traditional diagnostic and novel realtime therapeutic applications rely on accurate definitions of the H-reflex and M-wave temporal bounds, which currently depend on expert case-by-case judgment. The current study automates such judgments.Our novel wavelet-based algorithm automatically determines temporal extent and amplitude of the human soleus H-reflex and M-wave. In each of 20 participants, the algorithm was trained on data from a preliminary 3 or 4 min recruitment-curve measurement. Output was evaluated on parametric fits to subsequent sessions{\textquoteright} recruitment curves (92 curves across all participants) and on the conditioning protocol{\textquoteright}s subsequent baseline trials (\~{}1200 per participant) performed near. Results were compared against the original temporal bounds estimated at the time, and against retrospective estimates made by an expert 6 years later.Automatic bounds agreed well with manual estimates: 95\% lay within {\textpm}2.5 ms. The resulting H-reflex magnitude estimates showed excellent agreement (97.5\% average across participants) between automatic and retrospective bounds regarding which trials would be considered successful for operant conditioning. Recruitment-curve parameters also agreed well between automatic and manual methods: 95\% of the automatic estimates of the current required to elicitfell within{\textpm}1.4\%of the retrospective estimate; for the {\textquoteright}threshold{\textquoteright} current that produced an M-wave 10\% of maximum, this value was{\textpm}3.5\%.Such dependable automation of M-wave and H-reflex definition should make both established and emerging H-reflex protocols considerably less vulnerable to inter-personnel variability and human error, increasing translational potential.

}, keywords = {Electric Stimulation, Electromyography, H-Reflex, Humans, Muscle, Skeletal, Peripheral Nerves, Retrospective Studies}, issn = {1741-2552}, doi = {10.1088/1741-2552/ace6fb}, author = {McKinnon, Michael L and Hill, N Jeremy and Carp, Jonathan S and Dellenbach, Blair and Thompson, Aiko K} } @article {4343, title = {Potential differences between monolingual and bilingual patients in approach and outcome after awake brain surgery.}, journal = {J Neurooncol}, volume = {148}, year = {2020}, month = {07/2020}, pages = {587-598}, abstract = {

INTRODUCTION: 20.8\% of the United States population and 67\% of the European population speak two or more languages. Intraoperative different languages, mapping, and localization are crucial. This investigation aims to address three questions between BL and ML patients: (1) Are there differences in complications (i.e. seizures) and DECS techniques during intra-operative brain mapping? (2) Is EOR different? and (3) Are there differences in the recovery pattern post-surgery?

METHODS: Data from 56 patients that underwent left-sided awake craniotomy for tumors infiltrating possible dominant hemisphere language areas from September 2016 to June 2019 were identified and analyzed in this study; 14 BL and 42 ML control patients. Patient demographics, education level, and the age of language acquisition were documented and evaluated. fMRI was performed on all participants.

RESULTS: 0 (0\%) BL and 3 (7\%) ML experienced intraoperative seizures (P = 0.73). BL patients received a higher direct DECS current in comparison to the ML patients (average = 4.7, 3.8, respectively, P = 0.03). The extent of resection was higher in ML patients in comparison to the BL patients (80.9 vs. 64.8, respectively, P = 0.04). The post-operative KPS scores were higher in BL patients in comparison to ML patients (84.3, 77.4, respectively, P = 0.03). BL showed lower drop in post-operative KPS in comparison to ML patients (- 4.3, - 8.7, respectively, P = 0.03).

CONCLUSION: We show that BL patients have a lower incidence of intra-operative seizures, lower EOR, higher post-operative KPS and tolerate higher DECS current, in comparison to ML patients.

}, keywords = {Brain Mapping, Brain Neoplasms, Craniotomy, Female, Follow-Up Studies, Glioma, Humans, Incidence, Language, Male, Middle Aged, Monitoring, Intraoperative, Prognosis, Retrospective Studies, Seizures, United States, Wakefulness}, issn = {1573-7373}, doi = {10.1007/s11060-020-03554-0}, author = {ReFaey, Karim and Tripathi, Shashwat and Bhargav, Adip G and Grewal, Sanjeet S and Middlebrooks, Erik H and Sabsevitz, David S and Jentoft, Mark and Peter Brunner and Wu, Adela and Tatum, William O and Ritaccio, Anthony and Chaichana, Kaisorn L and Quinones-Hinojosa, Alfredo} }