02579nas a2200289 4500008004100000022001400041245014200055210006900197260001200266300001400278490000800292520157400300653003401874653003001908653002701938653001101965653002201976653001101998100002802009700001602037700002502053700002102078700002102099700002402120700002402144856012102168 2023 eng d a1432-145900aTowards clinical application of implantable brain-computer interfaces for people with late-stage ALS: medical and ethical considerations.0 aTowards clinical application of implantable braincomputer interf c03/2023 a1323-13360 v2703 a

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.

10aAmyotrophic Lateral Sclerosis10abrain-computer interfaces10aElectroencephalography10aHumans10aSelf-Help Devices10aSpeech1 aVansteensel, Mariska, J1 aKlein, Eran1 avan Thiel, Ghislaine1 aGaytant, Michael1 aSimmons, Zachary1 aWolpaw, Jonathan, R1 aVaughan, Theresa, M uhttps://www.neurotechcenter.org/publications/2023/towards-clinical-application-implantable-brain-computer-interfaces01952nas a2200337 4500008004100000022001400041245006800055210006600123300001800189490000700207520101700214653002001231653001401251653000901265653002501274653000901299653001001308653001901318653000901337653001101346653001001357100002901367700002101396700002001417700001901437700002201456700002401478700001901502700002101521856007201542 2022 eng d a0960-982200aA neural population selective for song in human auditory cortex0 aneural population selective for song in human auditory cortex a1470-1484.e120 v323 aSummary 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.10aAuditory Cortex10acomponent10aECoG10aElectrocorticography10afMRI10amusic10anatural sounds10asong10aSpeech10avoice1 aNorman-Haignere, Sam, V.1 aFeather, Jenelle1 aBoebinger, Dana1 aBrunner, Peter1 aRitaccio, Anthony1 aMcDermott, Josh, H.1 aSchalk, Gerwin1 aKanwisher, Nancy uhttps://www.sciencedirect.com/science/article/pii/S096098222200131202881nas a2200397 4500008004100000022001400041245011100055210006900166260001200235300001100247490000700258520172500265653001501990653002002005653001802025653002002043653002502063653002702088653002402115653001102139653001102150653001302161653002902174653003202203653001102235100002602246700001902272700002602291700002402317700001902341700001902360700001802379700002302397700001502420856004802435 2014 eng d a1933-071500aReal-time functional mapping: potential tool for improving language outcome in pediatric epilepsy surgery.0 aRealtime functional mapping potential tool for improving languag c09/2014 a287-950 v143 a

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.

10aAdolescent10aAnticonvulsants10aBrain Mapping10aCerebral Cortex10aElectric Stimulation10aElectroencephalography10aEpilepsies, Partial10aFemale10aHumans10aLanguage10aNeuropsychological Tests10aSensitivity and Specificity10aSpeech1 aKorostenskaja, Milena1 aChen, Po-Ching1 aSalinas, Christine, M1 aWesterveld, Michael1 aBrunner, Peter1 aSchalk, Gerwin1 aCook, Jane, C1 aBaumgartner, James1 aLee, Ki, H uhttp://www.ncbi.nlm.nih.gov/pubmed/2499581502945nas a2200289 4500008004100000022001400041245010600055210006900161260001200230300000700242490000600249520210500255653001102360653002502371653001802396653001002414653001102424100001902435700001802454700002402472700002202496700001802518700002902536700002302565700001902588856004802607 2012 eng d a1662-516100aTemporal evolution of gamma activity in human cortex during an overt and covert word repetition task.0 aTemporal evolution of gamma activity in human cortex during an o c05/2012 a990 v63 a

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.

10acortex10aElectrocorticography10agamma rhythms10ahuman10aSpeech1 aLeuthardt, E C1 aPei, Xiao-Mei1 aBreshears, Jonathan1 aGaona, Charles, M1 aSharma, Mohit1 aFreudenberg, Zachary, V.1 aBarbour, Dennis, L1 aSchalk, Gerwin uhttp://www.ncbi.nlm.nih.gov/pubmed/2256331104454nas a2200433 4500008004100000022001400041245010500055210006900160260001200229300001100241490000700252520325900259653002503518653001503543653001003558653001803568653002003586653002803606653002703634653001303661653001103674653001103685653000903696653002203705653001603727653002303743653001103766653002003777653001603797100001603813700002303829700001903852700001803871700001803889700002403907700002203931700001903953856004803972 2010 eng d a1524-404000aElectrocorticographic frequency alteration mapping for extraoperative localization of speech cortex.0 aElectrocorticographic frequency alteration mapping for extraoper c02/2010 aE407-90 v663 a

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.

10aAcoustic Stimulation10aAdolescent10aAdult10aBrain Mapping10aCerebral Cortex10aChi-Square Distribution10aElectroencephalography10aEpilepsy10aFemale10aHumans10aMale10aMass Spectrometry10aMiddle Aged10aPhotic Stimulation10aSpeech10aVerbal Behavior10aYoung Adult1 aWu, Melinda1 aWisneski, Kimberly1 aSchalk, Gerwin1 aSharma, Mohit1 aRoland, Jarod1 aBreshears, Jonathan1 aGaona, Charles, M1 aLeuthardt, E C uhttp://www.ncbi.nlm.nih.gov/pubmed/20087111