03030nas a2200265 4500008004100000022001400041245016500055210006900220260001600289490000700305520208500312653002502397653002102422653001302443653001102456653002102467653002202488653002602510100002502536700001702561700002202578700002202600700002202622856012002644 2023 eng d a1741-255200aMethods for automated delineation and assessment of EMG responses evoked by peripheral nerve stimulation in diagnostic and closed-loop therapeutic applications.0 aMethods for automated delineation and assessment of EMG response c2023 Jul 210 v203 a

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' recruitment curves (92 curves across all participants) and on the conditioning protocol'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 ±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±1.4%of the retrospective estimate; for the 'threshold' current that produced an M-wave 10% of maximum, this value was±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.

10aElectric Stimulation10aElectromyography10aH-Reflex10aHumans10aMuscle, Skeletal10aPeripheral Nerves10aRetrospective Studies1 aMcKinnon, Michael, L1 aHill, Jeremy1 aCarp, Jonathan, S1 aDellenbach, Blair1 aThompson, Aiko, K uhttps://www.neurotechcenter.org/publications/2023/methods-automated-delineation-and-assessment-emg-responses-evoked03177nas a2200493 4500008004100000022001400041245012000055210006900175260001200244300001200256490000800268520172300276653001801999653002002017653001502037653001102052653002202063653001102085653001102096653001402107653001302121653000902134653001602143653003102159653001402190653002602204653001302230653001802243653001602261100001802277700002302295700002102318700002302339700002602362700002402388700001802412700001902430700001402449700002202463700002202485700002602507700003102533856011902564 2020 eng d a1573-737300aPotential differences between monolingual and bilingual patients in approach and outcome after awake brain surgery.0 aPotential differences between monolingual and bilingual patients c07/2020 a587-5980 v1483 a

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.

10aBrain Mapping10aBrain Neoplasms10aCraniotomy10aFemale10aFollow-Up Studies10aGlioma10aHumans10aIncidence10aLanguage10aMale10aMiddle Aged10aMonitoring, Intraoperative10aPrognosis10aRetrospective Studies10aSeizures10aUnited States10aWakefulness1 aReFaey, Karim1 aTripathi, Shashwat1 aBhargav, Adip, G1 aGrewal, Sanjeet, S1 aMiddlebrooks, Erik, H1 aSabsevitz, David, S1 aJentoft, Mark1 aBrunner, Peter1 aWu, Adela1 aTatum, William, O1 aRitaccio, Anthony1 aChaichana, Kaisorn, L1 aQuinones-Hinojosa, Alfredo uhttps://www.neurotechcenter.org/publications/2020/potential-differences-between-monolingual-and-bilingual-patients