@article {4450, title = {Towards clinical application of implantable brain-computer interfaces for people with late-stage ALS: medical and ethical considerations.}, journal = {J Neurol}, volume = {270}, year = {2023}, month = {03/2023}, pages = {1323-1336}, abstract = {

Individuals with amyotrophic lateral sclerosis (ALS) frequently develop speech and communication problems in the course of their disease. Currently available augmentative and alternative communication technologies do not present a solution for many people with advanced ALS, because these devices depend on residual and reliable motor activity. Brain-computer interfaces (BCIs) use neural signals for computer control and may allow people with late-stage ALS to communicate even when conventional technology falls short. Recent years have witnessed fast progression in the development and validation of implanted BCIs, which place neural signal recording electrodes in or on the cortex. Eventual widespread clinical application of implanted BCIs as an assistive communication technology for people with ALS will have significant consequences for their daily life, as well as for the clinical management of the disease,~among others because of the potential interaction between the BCI and other procedures people with ALS undergo, such as tracheostomy. This article aims to facilitate responsible real-world implementation of implanted BCIs. We review the state of the art of research on implanted BCIs for communication, as well as the medical and ethical implications of the clinical application of this technology. We conclude that the contribution of all BCI stakeholders, including clinicians of the various ALS-related disciplines, will be needed to develop procedures for, and shape the process of, the responsible clinical application of implanted BCIs.

}, keywords = {Amyotrophic Lateral Sclerosis, brain-computer interfaces, Electroencephalography, Humans, Self-Help Devices, Speech}, issn = {1432-1459}, doi = {10.1007/s00415-022-11464-6}, author = {Vansteensel, Mariska J and Klein, Eran and van Thiel, Ghislaine and Gaytant, Michael and Simmons, Zachary and Wolpaw, Jonathan R and Vaughan, Theresa M} } @article {4357, title = {A neural population selective for song in human auditory cortex}, journal = {Current Biology}, volume = {32}, year = {2022}, pages = {1470-1484.e12}, abstract = {Summary How is music represented in the brain? While neuroimaging has revealed some spatial segregation between responses to music versus other sounds, little is known about the neural code for music itself. To address this question, we developed a method to infer canonical response components of human auditory cortex using intracranial responses to natural sounds, and further used the superior coverage of fMRI to map their spatial distribution. The inferred components replicated many prior findings, including distinct neural selectivity for speech and music, but also revealed a novel component that responded nearly exclusively to music with singing. Song selectivity was not explainable by standard acoustic features, was located near speech- and music-selective responses, and was also evident in individual electrodes. These results suggest that representations of music are fractionated into subpopulations selective for different types of music, one of which is specialized for the analysis of song.}, keywords = {Auditory Cortex, component, ECoG, Electrocorticography, fMRI, music, natural sounds, song, Speech, voice}, issn = {0960-9822}, doi = {https://doi.org/10.1016/j.cub.2022.01.069}, url = {https://www.sciencedirect.com/science/article/pii/S0960982222001312}, author = {Sam V. Norman-Haignere and Jenelle Feather and Dana Boebinger and Peter Brunner and Anthony Ritaccio and Josh H. McDermott and Gerwin Schalk and Nancy Kanwisher} } @article {3407, title = {Real-time functional mapping: potential tool for improving language outcome in pediatric epilepsy surgery.}, journal = {J Neurosurg Pediatr}, volume = {14}, year = {2014}, month = {09/2014}, pages = {287-95}, abstract = {

Accurate language localization expands surgical treatment options for epilepsy patients and reduces the risk of postsurgery language deficits. Electrical cortical stimulation mapping (ESM) is considered to be the clinical gold standard for language localization. While ESM affords clinically valuable results, it can be poorly tolerated by children, requires active participation and compliance, carries a risk of inducing seizures, is highly time consuming, and is labor intensive. Given these limitations, alternative and/or complementary functional localization methods such as analysis of electrocorticographic (ECoG) activity in high gamma frequency band in real time are needed to precisely identify eloquent cortex in children. In this case report, the authors examined 1) the use of real-time functional mapping (RTFM) for language localization in a high gamma frequency band derived from ECoG to guide surgery in an epileptic pediatric patient and 2) the relationship of RTFM mapping results to postsurgical language outcomes. The authors found that RTFM demonstrated relatively high sensitivity (75\%) and high specificity (90\%) when compared with ESM in a "next-neighbor" analysis. While overlapping with ESM in the superior temporal region, RTFM showed a few other areas of activation related to expressive language function, areas that were eventually resected during the surgery. The authors speculate that this resection may be associated with observed postsurgical expressive language deficits. With additional validation in more subjects, this finding would suggest that surgical planning and associated assessment of the risk/benefit ratio would benefit from information provided by RTFM mapping.

}, keywords = {Adolescent, Anticonvulsants, Brain Mapping, Cerebral Cortex, Electric Stimulation, Electroencephalography, Epilepsies, Partial, Female, Humans, Language, Neuropsychological Tests, Sensitivity and Specificity, Speech}, issn = {1933-0715}, doi = {10.3171/2014.6.PEDS13477}, url = {http://www.ncbi.nlm.nih.gov/pubmed/24995815}, author = {Korostenskaja, Milena and Chen, Po-Ching and Salinas, Christine M and Westerveld, Michael and Peter Brunner and Gerwin Schalk and Cook, Jane C and Baumgartner, James and Lee, Ki H} } @article {2210, title = {Temporal evolution of gamma activity in human cortex during an overt and covert word repetition task.}, journal = {Front Hum Neurosci}, volume = {6}, year = {2012}, month = {05/2012}, pages = {99}, abstract = {

Several scientists have proposed different models for cortical processing of speech. Classically, the regions participating in language were thought to be modular with a linear sequence of activations. More recently, modern theoretical models have posited a more hierarchical and distributed interaction of anatomic areas for the various stages of speech processing. Traditional imaging techniques can only define the location or time of cortical activation, which impedes the further evaluation and refinement of these models. In this study, we take advantage of recordings from the surface of the brain [electrocorticography (ECoG)], which can accurately detect the location and timing of cortical activations, to study the time course of ECoG high gamma (HG) modulations during an overt and covert word repetition task for different cortical areas. For overt word production, our results show substantial perisylvian cortical activations early in the perceptual phase of the task that were maintained through word articulation. However, this broad activation is attenuated during the expressive phase of covert word repetition. Across the different repetition tasks, the utilization of the different cortical sites within the perisylvian region varied in the degree of activation dependent on which stimulus was provided (auditoryor visual cue) and whether the word was to be spoken or imagined. Taken together, the data support current models of speech that have been previously described with functional imaging. Moreover, this study demonstrates that the broad perisylvian speech network activates early and maintains suprathreshold activation throughout the word repetition task that appears to be modulated by the demands of different conditions.

}, keywords = {cortex, Electrocorticography, gamma rhythms, human, Speech}, issn = {1662-5161}, doi = {10.3389/fnhum.2012.00099}, url = {http://www.ncbi.nlm.nih.gov/pubmed/22563311}, author = {Leuthardt, E C and Pei, Xiao-Mei and Breshears, Jonathan and Charles M Gaona and Sharma, Mohit and Zachary V. Freudenberg and Barbour, Dennis L and Gerwin Schalk} } @article {2196, title = {Electrocorticographic frequency alteration mapping for extraoperative localization of speech cortex.}, journal = {Neurosurgery}, volume = {66}, year = {2010}, month = {02/2010}, pages = {E407-9}, abstract = {

OBJECTIVE:\ 

Electrocortical stimulation (ECS) has long been established for delineating eloquent cortex in extraoperative mapping. However, ECS is still coarse and inefficient in delineating regions of functional cortex and can be hampered by afterdischarges. Given these constraints, an adjunct approach to defining motor cortex is the use of electrocorticographic (ECoG) signal changes associated with active regions of cortex. The broad range of frequency oscillations are categorized into 2 main groups with respect to sensorimotor cortex: low-frequency bands (LFBs) and high-frequency bands (HFBs). The LFBs tend to show a power reduction, whereas the HFBs show power increases with cortical activation. These power changes associated with activated cortex could potentially provide a powerful tool in delineating areas of speech cortex. We explore ECoG signal alterations as they occur with activated region of speech cortex and its potential in clinical brain mapping applications.

METHODS:\ 

We evaluated 7 patients who underwent invasive monitoring for seizure localization. Each had extraoperative ECS mapping to identify speech cortex. Additionally, all subjects performed overt speech tasks with an auditory or a visual cue to identify associated frequency power changes in regard to location and degree of concordance with ECS results.

RESULTS:\ 

Electrocorticographic frequency alteration mapping (EFAM) had an 83.9\% sensitivity and a 40.4\% specificity in identifying any language site when considering both frequency bands and both stimulus cues. Electrocorticographic frequency alteration mapping was more sensitive in identifying the Wernicke area (100\%) than the Broca area (72.2\%). The HFB is uniquely suited to identifying the Wernicke area, whereas a combination of the HFB and LFB is important for Broca localization.

CONCLUSION:\ 

The concordance between stimulation and spectral power changes demonstrates the possible utility of EFAM as an adjunct method to improve the efficiency and resolution of identifying speech cortex.

}, keywords = {Acoustic Stimulation, Adolescent, Adult, Brain Mapping, Cerebral Cortex, Chi-Square Distribution, Electroencephalography, Epilepsy, Female, Humans, Male, Mass Spectrometry, Middle Aged, Photic Stimulation, Speech, Verbal Behavior, Young Adult}, issn = {1524-4040}, doi = {10.1227/01.NEU.0000345352.13696.6F}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20087111}, author = {Wu, Melinda and Wisneski, Kimberly and Gerwin Schalk and Sharma, Mohit and Roland, Jarod and Breshears, Jonathan and Charles M Gaona and Leuthardt, E C} }