EEG Fractal Analysis Reflects Brain Impairment after Stroke

Rubega, Maria; Formaggio, Emanuela; Molteni, Franco; Guanziroli, Eleonora; Marco, Roberto Di; Baracchini, Claudio; Ermani, Mario; Ward, Nick; Masiero, Stefano; Felice, Alessandra Del

doi:10.3390/e23050592

Cited by 12 publications

(7 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…EEG recordings (exploratory) of study participants reflected a pattern of brain activity indicative of recovery exclusively in the ENTF group (49). More specifically, the EEG results are consistent with improvement in movement inhibition or motor learning (58) as well as increased signal complexity, a characteristic of healthy brain activity (59). In effect, the EEG data provide evidence for a biomarker of recovery putatively linked to plasticity (59) in the ENTF group but not in the sham group.…”

Section: Discussionsupporting

confidence: 62%

Frequency-tuned electromagnetic field therapy improves post-stroke motor function: A pilot randomized controlled trial

et al. 2022

View full text Add to dashboard Cite

Background and purposeImpaired upper extremity (UE) motor function is a common disability after ischemic stroke. Exposure to extremely low frequency and low intensity electromagnetic fields (ELF-EMF) in a frequency-specific manner (Electromagnetic Network Targeting Field therapy; ENTF therapy) is a non-invasive method available to a wide range of patients that may enhance neuroplasticity, potentially facilitating motor recovery. This study seeks to quantify the benefit of the ENTF therapy on UE motor function in a subacute ischemic stroke population.MethodsIn a randomized, sham-controlled, double-blind trial, ischemic stroke patients in the subacute phase with moderately to severely impaired UE function were randomly allocated to active or sham treatment with a novel, non-invasive, brain computer interface-based, extremely low frequency and low intensity ENTF therapy (1–100 Hz, < 1 G). Participants received 40 min of active ENTF or sham treatment 5 days/week for 8 weeks; ~three out of the five treatments were accompanied by 10 min of concurrent physical/occupational therapy. Primary efficacy outcome was improvement on the Fugl-Meyer Assessment – Upper Extremity (FMA-UE) from baseline to end of treatment (8 weeks).ResultsIn the per protocol set (13 ENTF and 8 sham participants), mean age was 54.7 years (±15.0), 19% were female, baseline FMA-UE score was 23.7 (±11.0), and median time from stroke onset to first stimulation was 11 days (interquartile range (IQR) 8–15). Greater improvement on the FMA-UE from baseline to week 4 was seen with ENTF compared to sham stimulation, 23.2 ± 14.1 vs. 9.6 ± 9.0, p = 0.007; baseline to week 8 improvement was 31.5 ± 10.7 vs. 23.1 ± 14.1. Similar favorable effects at week 8 were observed for other UE and global disability assessments, including the Action Research Arm Test (Pinch, 13.4 ± 5.6 vs. 5.3 ± 6.5, p = 0.008), Box and Blocks Test (affected hand, 22.5 ± 12.4 vs. 8.5 ± 8.6, p < 0.0001), and modified Rankin Scale (−2.5 ± 0.7 vs. −1.3 ± 0.7, p = 0.0005). No treatment-related adverse events were reported.ConclusionsENTF stimulation in subacute ischemic stroke patients was associated with improved UE motor function and reduced overall disability, and results support its safe use in the indicated population. These results should be confirmed in larger multicenter studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/NCT04039178, identifier: NCT04039178.

show abstract

Section: Discussionsupporting

confidence: 62%

Frequency-tuned electromagnetic field therapy improves post-stroke motor function: A pilot randomized controlled trial

et al. 2022

View full text Add to dashboard Cite

show abstract

“…A number of earlier studies investigated the relation between fractal-derived brain measures and pathological conditions [27,28,30,32,[60][61][62][63][64]. However, the studies targeting pDoC patients focused on either discriminating healthy individuals from UWS/MCS patients or on performing a differential diagnosis of UWS/MCS [28,32,33].…”

Section: Discussionmentioning

confidence: 99%

EEG fractal dimensions predict high-level behavioral responses in minimally conscious patients

et al. 2023

View full text Add to dashboard Cite

Background: Brain-injured patients may enter a state of minimal or inconsistent awareness termed Minimally Conscious State (MCS). Such patient may (MCS+) or may not (MCS-) exhibit high-level behavioral responses, and the two groups retain two inherently different rehabilitative paths and expected outcomes. We hypothesized that brain complexity may be treated as a proxy of high-level cognition and thus could be used as a neural correlate of consciousness. Methods: In this prospective observational study, 68 MCS patients (MCS-: 30; women: 31) were included (median [IQR] age 69 [20]; time post-onset 83 [28]). At admission to intensive rehabilitation, 30 minutes resting-state closed-eyes recordings were performed together with consciousness diagnosis following international guidelines. The width of the Multifractal Singularity Spectrum (MSS) was computed for each channel time series and entered nested cross-validated interpretable Machine Learning (ML) models targeting the differential diagnosis of MCS+/-. Results: Frontal MSS widths (p < 0.05), as well as the ones deriving from the left centro-temporal network (C3: p = 0.018, T3: p = 0.017; T5: p = 0.003) were found to be significantly higher in the MCS+ cohort. The best performing solution was found to be the K-Nearest Neighbor model with an aggregated test accuracy of 75.5% (median [IQR] AuROC for 100 executions 0.88 [0.02]). Coherently, the electrodes with highest Shapley values were found to be Fz and Cz, with four out the first five ranked features belonging to the fronto-central network. Conclusion: MCS+ is a frequent condition associated with a notably better prognosis than the MCS-. High fractality in the left centro-temporal network results coherent with neurological networks involved in the language function, proper of MCS+ patients. Using EEG-based interpretable algorithm to complement differential diagnosis of consciousness may improve rehabilitation pathways and communications with caregivers.

show abstract

“…We will investigate both linear (i.e., power spectral density [ 37 ], time-varying connectivity [ 38 ]) and nonlinear EEG features (i.e., entropy and fractal properties [ 39 , 40 ] in the scalp and inverse domains (Electrical Source Imaging [ 41 ]) from the data recorded at rest and during the execution of target reaching. The laterality index, which describes the contrast in amount of activation (i.e., relative power in the alpha band) between the right and left hemispheres, will be calculated during the target reaching.…”

Section: Methodsmentioning

confidence: 99%

Experimental protocol to investigate cortical, muscular and body representation alterations in adolescents with idiopathic scoliosis

Paramento,

Rubega,

Di Marco

et al. 2023

PLoS ONE

Self Cite

View full text Add to dashboard Cite

Background Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis. AIS is a three-dimensional morphological spinal deformity that affects approximately 1-3% of adolescents. Not all factors related to the etiology of AIS have yet been identified. Objective The primary aim of this experimental protocol is to quantitatively investigate alterations in body representation in AIS, and to quantitatively and objectively track the changes in body sensorimotor representation due to treatment. Methods Adolescent girls with a confirmed diagnosis of mild (Cobb angle: 10°-20°) or moderate (21°-35°) scoliosis as well as age and sex-matched controls will be recruited. Participants will be asked to perform a 6-min upright standing and two tasks—named target reaching and forearm bisection task. Eventually, subjects will fill in a self-report questionnaire and a computer-based test to assess body image. This evaluation will be repeated after 6 and 12 months of treatment (i.e., partial or full-time brace and physiotherapy corrective postural exercises). Results We expect that theta brain rhythm in the central brain areas, alpha brain rhythm lateralization and body representation will change over time depending on treatment and scoliosis progression as a compensatory strategy to overcome a sensorimotor dysfunction. We also expect asymmetric activation of the trunk muscle during reaching tasks and decreased postural stability in AIS. Conclusions Quantitatively assess the body representation at different time points during AIS treatment may provide new insights on the pathophysiology and etiology of scoliosis.

show abstract

EEG Fractal Analysis Reflects Brain Impairment after Stroke

Cited by 12 publications

References 33 publications

Frequency-tuned electromagnetic field therapy improves post-stroke motor function: A pilot randomized controlled trial

Frequency-tuned electromagnetic field therapy improves post-stroke motor function: A pilot randomized controlled trial

EEG fractal dimensions predict high-level behavioral responses in minimally conscious patients

Experimental protocol to investigate cortical, muscular and body representation alterations in adolescents with idiopathic scoliosis

Contact Info

Product

Resources

About