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Assessment of consciousness following severe brain-injury is challenging. Our hypothesis is that electroencephalography (EEG) can provide information on awareness, in terms of oscillatory activity and network task–related modifications, in people with disorders of consciousness. Similar results were obtained with neuroimaging techniques; we aim at demonstrating the use of EEG, which is low cost and routinely implemented, to the same goal. Nineteen-channel EEG was recorded in 7 persons with unresponsive wakefulness syndrome (UWS) and in 10 healthy subjects during the execution of active (attempted movement) and passive motor tasks as well as 2 mental imagery tasks. Event-related synchronization/desynchronization (ERS/ERD), coherence and network parameters were calculated in delta (1-4 Hz), theta (4-8 Hz), alpha1 (8-10 Hz), alpha2 (10-12 Hz), and beta (13-30 Hz) ranges. In UWS subjects, passive movement induced a weak alpha2 ERD over contralateral sensorimotor area. During motor imagery, ERD was detected over the frontal and motor contralateral brain areas; during spatial imagery, ERS in lower alpha band over the right temporo-parietal regions was missing. In UWS, functional connectivity provided evidence of network disruption and isolation of the motor areas, which cannot dialog with adjacent network nodes, likely suggesting a diffuse structural alteration. Our findings suggest that people with a clinical diagnosis of UWS were able to modulate their brain activity when prompted to perform movement tasks and thus suggest EEG as a potential tool to support diagnosis of disorders of consciousness.

In this study, we investigated the effects of oxygen toxicity on brain activity and functional connectivity (FC) in divers using a closed-circuit oxygen breathing apparatus. We acquired and analyzed electroencephalographic (EEG) signals from a group of normal professional divers (PD) and a group that developed oxygen intolerance, i.e., oxygen-intolerant professional divers (OPD), to evaluate the potential risk of a dive and understand the physiological mechanisms involved. The results highlighted a significant difference in the baseline levels of αrhythm between PD and OPD, with PD exhibiting a lower level to counteract the effects of increased O2inhalation, while OPD showed a higher level that resulted in a pathological state. Connectivity analysis revealed a strong correlation between cognitive and motor regions, and high levels of αsynchronization at rest in OPDs. Our findings suggest that a pathological condition may underlie the higher αlevels observed in these individuals when facing the stress of high O2inhalation. These findings support the hypothesis that oxygen modulates brain networks, and have important implications for understanding the neural mechanisms involved in oxygen toxicity. The study also provides a unique opportunity to investigate the impact of neurophysiological activity in simulated critical scenarios, and opens up new perspectives in the screening and monitoring of divers.

Functional connectivity estimates the temporal synchrony among functionally homogeneous brain regions based on the assessment of the dynamics of topologically localized neurophysiological responses. The aim of this study was to investigate task-related changes in brain activity and functional connectivity by applying different methods namely event-related desynchronization (ERD), coherence, and graph-theoretical analysis to electroencephalographic (EEG) recordings, for comparing their respective descriptive power and complementarity. As it is well known, ERD provides an estimate of differences in power spectral densities between active (or task) and rest conditions, functional connectivity allows assessing the level of synchronization between the signals recorded at different scalp locations and graph analysis enables the estimation of the functional network features and topology. EEG activity was recorded on 10 subjects during left/right arm movements. The theta, alpha, and beta bands were considered. Conventional analysis showed a significant ERD in both alpha and beta bands over the sensorimotor cortex during the left arm movement and in beta band during the right arm movement, besides identifying the regions involved in the task, as it was expected. On the other hand, connectivity assessment highlighted that stronger connections are those that involved the motor regions for which graph analysis revealed reduced accessibility and an increased centrality during the movement. Jointly, the last two methods allow identifying the cortical areas that are functionally related in the active condition as well as the topological organization of the functional network. Results support the hypothesis that network analysis brings complementary knowledge with respect to established approaches for modeling motor-induced functional connectivity and could be profitably exploited in clinical contexts.

The development of an innovative functional assessment procedure based on the combination of electroencephalography (EEG) and robot-assisted upper limb devices may provide new insights into the dynamics of cortical reorganization promoted by rehabilitation. The aim of this study was to evaluate changes in event-related synchronization/desynchronization (ERS/ERD) in alpha and beta bands in a patient with pure sensory stroke who underwent a specific rehabilitation program for somatic sensation recovery. A 49-year-old, right-handed woman (time since stroke, 12 months) with severe upper limb somatic sensation deficits was tested using validated clinical scales and a standardized video-EEG system combined with the Bi-Manu-Track robot-assisted arm trainer protocol. The patient underwent a 3-month home-based rehabilitation program for promoting upper limb recovery (1 hour a day for 5 days a week). She was tested before treatment, at 1-month, and at 3-month during treatment. Results showed progressive recovery of upper limb function over time. These effects were associated with specific changes in the modulation of alpha and beta event-related synchronization/desynchronization. This unique study provides new perspectives for the assessment of functional deficits and changes in cortical activity promoted by rehabilitation in poststroke patients.

The combined use of electroencephalography (EEG) and functional magnetic resonance imaging (EEG-fMRI) in epilepsy allows the noninvasive hemodynamic characterization of epileptic discharge-related neuronal activations. The aim of this study was to investigate pathophysiologic mechanisms underlying epileptic activity by exploring the spatial and temporal distribution of fMRI signal modifications during seizure in a single patient with posttraumatic epilepsy. EEG and fMRI data were acquired during two scanning sessions: a spontaneous critical episode was observed during the first, and interictal events were recorded during the second. The EEG-fMRI data were analyzed using the general linear model (GLM). Blood oxygenation level–dependent (BOLD) localization derived from the preictal and artifact-free postictal phase was concordant with the BOLD localization of the interictal epileptiform discharges identified in the second session, pointing to a left perilesional mesiofrontal area. Of note, BOLD signal modifications were already visible several seconds before seizure onset. In brief, BOLD activations from the preictal, postictal, and interictal epileptiform discharge analysis appear to be concordant with the clinically driven localization hypothesis, whereas a widespread network of activations is detected during the ictal phase in a partial seizure.

Blood oxygenation level–dependent (BOLD) activation associated with interictal epileptiform discharges in a patient with fixation-off sensitivity (FOS) was studied using a combined electroencephalography–functional magnetic resonance imaging (EEG–fMRI) technique. An automatic approach for combined EEG–fMRI analysis and a subject-specific hemodynamic response function was used to improve general linear model analysis of the fMRI data. The EEG showed the typical features of FOS, with continuous epileptiform discharges during elimination of central vision by eye opening and closing and fixation; modification of this pattern was clearly visible and recognizable. During all 3 recording sessions EEG–fMRI activations indicated a BOLD signal decrease related to epileptiform activity in the parietal areas. This study can further our understanding of this EEG phenomenon and can provide some insight into the reliability of the EEG–fMRI technique in localizing the irritative zone.

Falls due to balance impairment are a major cause of injury and disability in the elderly. The study of neurophysiological correlates during static and dynamic balance tasks is an emerging area of research that could lead to novel rehabilitation strategies and reduce fall risk.