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Sepsis-associated encephalopathy (SAE) contributes to mortality and neurocognitive impairment of sepsis patients. Neurofilament (Nf) light (NfL) and heavy (NfH) chain levels as biomarkers for neuroaxonal injury were not evaluated in cerebrospinal fluid (CSF) and plasma of patients with sepsis-associated encephalopathy (SAE) before. We conducted a prospective, pilot observational study including 20 patients with septic shock and five patients without sepsis serving as controls. The assessment of SAE comprised a neuropsychiatric examination, electroencephalography (EEG), magnetic resonance imaging (MRI) and delirium screening methods including the confusion assessment method for the ICU (CAM-ICU) and the intensive care delirium screening checklist (ICDSC). CSF Nf measurements in sepsis patients and longitudinal plasma Nf measurements in all participants were performed on days 1, 3 and 7 after study inclusion. Plasma NfL levels increased in sepsis patients over time (p = 0.0063) and remained stable in patients without sepsis. Plasma NfL values were significantly higher in patients with SAE (p = 0.011), significantly correlated with the severity of SAE represented by ICDSC values (R = 0.534, p = 0.022) and correlated with a poorer functional outcome after 100 days (R = -0.535, p = 0.0003). High levels of CSF Nf were measured in SAE patients. CSF NfL levels were higher in non-survivors (p = 0.012) compared with survivors and correlated with days until death (R = -0.932, p<0.0001) and functional outcome after 100 days (R = -0.749, p<0.0001). The present study showed for the first time that Nf levels provide complementary prognostic information in SAE patients indicating a higher chance of death and poorer functional/cognitive outcome in survivors. [ABSTRACT FROM AUTHOR]

Oxidative stress has been considered as one of pathogenesis of brain damage led by epilepsy. Reducing oxidative stress can ameliorate brain damage during seizures. However, expression levels of important antioxidative enzymes such as thioredoxin-1 (TRX1), thioredoxin-like 1 protein (TXNL1) and thioredoxin reductase 1 (TXNRD1) during seizures have not been investigated. In this study, we examined protein and mRNA expression levels of TRX1, TXNL1 and TXNRD1 in different brain regions in PTZ induced seizure model mice. We found that protein expression levels of TRX1, TXNL1 and TXNRD1 are simultaneously up-regulated by 2- or 3-fold in the cortex of both acute and chronic seizure model mice. But there is no unified expression pattern change of these enzymes in the hippocampus, cerebellum and diencephalon in the seizure model mice. Less extent up-regulation of mRNA expression of these enzymes were also observed in the cortex of seizure mice. These data suggest that antioxidative enzymes may provide a protective effect against oxidative stress in the cortex during seizures. [ABSTRACT FROM AUTHOR]

The amplitude of auditory steady-state responses (ASSRs) generated in the brainstem of rats exponentially decreases over the sequential averaging of EEG epochs. This behavior is partially due to the adaptation of the ASSR induced by the continuous and monotonous stimulation. In this study, we analyzed the potential clinical relevance of the ASSR adaptation. ASSR were elicited in eight anesthetized adult rats by 8-kHz tones, modulated in amplitude at 115 Hz. We called independent epochs to those EEG epochs acquired with sufficiently long inter-stimulus interval, so the ASSR contained in any given epoch is not affected by the previous stimulation. We tested whether the detection of ASSRs is improved when the response is computed by averaging independent EEG epochs, containing only unadapted auditory responses. The improvements in the ASSR detection obtained with standard, weighted and sorted averaging were compared. In the absence of artifacts, when the ASSR was elicited by continuous acoustic stimulation, the computation of the ASSR amplitude relied upon the averaging method. While the adaptive behavior of the ASSR was still evident after the weighting of epochs, the sorted averaging resulted in under-estimations of the ASSR amplitude. In the absence of artifacts, the ASSR amplitudes computed by averaging independent epochs did not depend on the averaging procedure. Averaging independent epochs resulted in higher ASSR amplitudes and halved the number of EEG epochs needed to be acquired to achieve the maximum detection rate of the ASSR. Acquisition protocols based on averaging independent EEG epochs, in combination with appropriate averaging methods for artifact reduction might contribute to develop more accurate hearing assessments based on ASSRs. [ABSTRACT FROM AUTHOR]

Oculometric measures have been proven to be useful markers of mind-wandering during visual tasks such as reading. However, little is known about ocular activity during mindfulness meditation, a mental practice naturally involving mind-wandering episodes. In order to explore this issue, we extracted closed-eyes ocular movement measurements via a covert technique (EEG recordings) from expert meditators during two repetitions of a 7-minute mindfulness meditation session, focusing on the breath, and two repetitions of a 7-minute instructed mind-wandering task. Power spectral density was estimated on both the vertical and horizontal components of eye movements. The results show a significantly smaller average amplitude of eye movements in the delta band (1–4 Hz) during mindfulness meditation than instructed mind-wandering. Moreover, participants’ meditation expertise correlated significantly with this average amplitude during both tasks, with more experienced meditators generally moving their eyes less than less experienced meditators. These findings suggest the potential use of this measure to detect mind-wandering episodes during mindfulness meditation and to assess meditation performance. [ABSTRACT FROM AUTHOR]

Despite sleep’s recognized biological importance, it has been remarkably difficult to demonstrate changes in brain physiology with reduced sleep durations. In a study of adolescents, we varied sleep durations by restricting time in bed for four nights of either 10, 8.5 or 7 h. Shorter sleep durations significantly decreased waking electroencephalogram (EEG) power in a wide range of frequencies with both eyes closed and eyes open in central and occipital leads. These findings suggest new research directions and raise the possibility that waking EEG power density could provide a non-invasive test for biologically sufficient sleep. [ABSTRACT FROM AUTHOR]

The grammar, or syntax, of human language is typically understood in terms of abstract hierarchical structures. However, theories of language processing that emphasize sequential information, not hierarchy, successfully model diverse phenomena. Recent work probing brain signals has shown mixed evidence for hierarchical information in some tasks. We ask whether sequential or hierarchical information guides the expectations that a human listener forms about a word’s part-of-speech when simply listening to every-day language. We compare the predictions of three computational models against electroencephalography signals recorded from human participants who listen passively to an audiobook story. We find that predictions based on hierarchical structure correlate with the human brain response above-and-beyond predictions based only on sequential information. This establishes a link between hierarchical linguistic structure and neural signals that generalizes across the range of syntactic structures found in every-day language. [ABSTRACT FROM AUTHOR]

Faces play important roles in the social lives of humans. Besides real faces, people also encounter numerous cartoon faces in daily life which convey basic emotional states through facial expressions. Using event-related potentials (ERPs), we conducted a facial expression recognition experiment with 17 university students to compare the processing of cartoon faces with that of real faces. This study used face type (real vs. cartoon), emotion valence (happy vs. angry) and participant gender (male vs. female) as independent variables. Reaction time, recognition accuracy, and the amplitudes and latencies of emotion processing-related ERP components such as N170, VPP (vertex positive potential), and LPP (late positive potential) were used as dependent variables. The ERP results revealed that cartoon faces caused larger N170 and VPP amplitudes as well as a briefer N170 latency than did real faces; that real faces induced larger LPP amplitudes than did cartoon faces. In addition, the results showed a significant difference in the brain regions as reflected in a right hemispheric advantage. The behavioral results showed that the reaction times for happy faces were shorter than those for angry faces; that females showed a higher accuracy than did males; and that males showed a higher recognition accuracy for angry faces than happy faces. Due to the sample size, these results may suggestively but not rigorously demonstrate differences in facial expression recognition and neurological processing between cartoon faces and real faces. Cartoon faces showed a higher processing intensity and speed than real faces during the early processing stage. However, more attentional resources were allocated for real faces during the late processing stage. [ABSTRACT FROM AUTHOR]

Objective: The use of activity and sleep trackers that operate through dedicated smartphone applications has become popular in the general population. However, the validity of the data they provide has been disappointing and only Total Sleep Time (TST) is reliably recorded in healthy individuals for any of the devices tested. The purpose of this study was to evaluate the ability of two sleep trackers (Withings pulse 02 (W) and Jawbone Up (U)) to measure sleep parameters in patients suffering from obstructive sleep apnea (OSA). Methods: All patients evaluated for OSA in our sleep laboratory underwent overnight polysomnography (PSG). PSG was conducted simultaneously with three other devices: two consumer-level sleep monitors (U and W) and one actigraph (Bodymedia SenseWear Pro Armband (SWA)). Results: Of 36 patients evaluated, 22 (17 men) were diagnosed with OSA (mean apnea-hypopnea index of 37+ 23/h). Single comparisons of sleep trackers (U and W) and actigraph (SWA) were performed. Compared to PSG, SWA correctly assessed TST and Wake After Sleep Onset (WASO), and U and W correctly assessed Time In Bed (TIB) and light sleep. Intraclass correlations (ICC) revealed poor validity for all parameters and devices, except for WASO assessed by SWA. Conclusions: This is the first study assessing the validity of sleep trackers in OSA patients. In this series, we have confirmed the limited performance of wearable sleep monitors that has been previously observed in healthy subjects. In OSA patients, wearable app-based health technologies provide a good estimation of TIB and light sleep but with very poor ICC. [ABSTRACT FROM AUTHOR]

The auditory system needs to fuse the direct wave (lead) from a sound source and its time-delayed reflections (lag) to achieve a single sound image perception. This lead-lag fusion plays crucial roles in auditory processing in reverberant environments. Here, we investigated neural correlates of the lead-lag fusion by tracking human cortical potentials evoked by a break in the correlation (BIC) between the lead and lag when the time delay between the two was 0, 2, or 4 ms. The BIC evoked a scalp potential consisting of an N1 and a P2 component. Both components were modulated by the delay. The effects of the delay on the amplitude of the two components were similar, an increase of the delay resulting in a decrease of the amplitude. In contrast, the delay differently modulated the latency of the two components, an increase of the delay resulting in an increase of the P2 latency but not an increase of the N1 latency. Similar to the P2 latency, the reaction time for subjective detection of the BIC also increased with the delay. These findings suggest that both the N1 and the P2 evoked by the BIC are neural correlates of the lead-lag fusion and that, relative to the N1, the P2 may be more closely related to listeners’ perception of the fusion. Our study thus provides a neurophysiological and objective approach for investigating the fusion between the direct sound wave from a sound source and its reflections. [ABSTRACT FROM AUTHOR]

Evidence shows that selective attention to visual stimuli modulates the gain of cochlear responses, probably through auditory-cortex descending pathways. At the cerebral cortex level, amplitude and phase changes of neural oscillations have been proposed as a correlate of selective attention. However, whether sensory receptors are also influenced by the oscillatory network during attention tasks remains unknown. Here, we searched for oscillatory attention-related activity at the cochlear receptor level in humans. We used an alternating visual/auditory selective attention task and measured electroencephalographic activity simultaneously to distortion product otoacoustic emissions (a measure of cochlear receptor-cell activity). In order to search for cochlear oscillatory activity, the otoacoustic emission signal, was included as an additional channel in the electroencephalogram analyses. This method allowed us to evaluate dynamic changes in cochlear oscillations within the same range of frequencies (1–35 Hz) in which cognitive effects are commonly observed in electroencephalogram works. We found the presence of low frequency (<10 Hz) brain and cochlear amplifier oscillations during selective attention to visual and auditory stimuli. Notably, switching between auditory and visual attention modulates the amplitude and the temporal order of brain and inner ear oscillations. These results extend the role of the oscillatory activity network during cognition in neural systems to the receptor level. [ABSTRACT FROM AUTHOR]

Highlights • We validate a convolutional neural network identifying abnormal EEGs in a large diverse set of 8522 EEGs. • Including age and sleep stage in the model results in minimal performance gain. • Extensive prediction error analysis reveals promising future research directions. Abstract Objectives Electroencephalography (EEG) is a central part of the medical evaluation for patients with neurological disorders. Training an algorithm to label the EEG normal vs abnormal seems challenging, because of EEG heterogeneity and dependence of contextual factors, including age and sleep stage. Our objectives were to validate prior work on an independent data set suggesting that deep learning methods can discriminate between normal vs abnormal EEGs, to understand whether age and sleep stage information can improve discrimination, and to understand what factors lead to errors. Methods We train a deep convolutional neural network on a heterogeneous set of 8522 routine EEGs from the Massachusetts General Hospital. We explore several strategies for optimizing model performance, including accounting for age and sleep stage. Results The area under the receiver operating characteristic curve (AUC) on an independent test set (n = 851) is 0.917 marginally improved by including age (AUC = 0.924), and both age and sleep stages (AUC = 0.925), though not statistically significant. Conclusions The model architecture generalizes well to an independent dataset. Adding age and sleep stage to the model does not significantly improve performance. Significance Insights learned from misclassified examples, and minimal improvement by adding sleep stage and age suggest fruitful directions for further research. [ABSTRACT FROM AUTHOR]

Brain-Computer Interfaces (BCIs) have become more and more popular these last years. Researchers use this technology for several types of applications, including attention and workload measures but also for the direct control of objects by the means of BCIs. In this work we present a first, multidimensional feature space for EEG-based BCI applications to help practitioners to characterize, compare and design systems, which use EEG-based BCIs. Our feature space contains 4 axes and 9 sub-axes and consists of 41 options in total as well as their different combinations. We presented the axes of our feature space and we positioned our feature space regarding the existing BCI and HCI taxonomies and we showed how our work integrates the past works, and/or complements them. [ABSTRACT FROM AUTHOR]

Our aim is to explore if cognitive challenge combined with objective physiology can reveal abnormal frontal alpha event-related desynchronization (ERD), in early Alzheimer’s disease (AD). We used quantitative electroencephalography (qEEG) to investigate brain activities during N-back working memory (WM) processing at two different load conditions (N = 0 or 2) in an aging cohort. We studied 60–100 year old participants, with normal cognition, and who fits one of two subgroups from cerebrospinal fluid (CSF) proteins: cognitively healthy (CH) with normal amyloid/tau ratio (CH-NAT, n = 10) or pathological amyloid/tau ratio (CH-PAT, n = 14). We recorded behavioral performances, and analyzed alpha power and alpha spectral entropy (SE) at three occasions: during the resting state, and at event-related desynchronization (ERD) [250 ~ 750 ms] during 0-back and 2-back. During 0-back WM testing, the behavioral performance was similar between the two groups, however, qEEG notably differentiated CH-PATs from CH-NATs on the simple, 0-back testing: Alpha ERD decreased from baseline only in the parietal region in CH-NATs, while it decreased in all brain regions in CH-PATs. Alpha SE did not change in CH-NATs, but was increased from baseline in the CH-PATs in frontal and left lateral regions (p<0.01), and was higher in the frontal region (p<0.01) of CH-PATs compared to CH-NATs. The alpha ERD and SE analyses suggest there is frontal lobe dysfunction during WM processing in the CH-PAT stage. Additional power and correlations with behavioral performance were also explored. This study provide pilot information to further evaluate whether this biomarker has clinical significance. [ABSTRACT FROM AUTHOR]

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Following a traumatic spinal cord injury, a 53-year-old male developed a central cord syndrome with at-level neuropathic pain. Magnetic resonance imaging revealed a classical “snake eye” appearance myelopathy, with marked hyperintensities at C5-C7. Clinical examination revealed intact pinprick sensation coupled with lost or diminished thermal/heat sensation. This dissociation could be objectively confirmed through multi-modal neurophysiological assessments. Specifically, contact heat evoked potentials were lost at-level, while pinprick evoked potentials were preserved. This pattern corresponds with that seen after surgical commissural myelotomy. To our knowledge, this is the first time such a dissociation has been objectively documented, highlighting the diagnostic potential of multi-modal neurophysiological assessments. In future studies, a comprehensive assessment of different nociceptive modalities may help elucidate the pathophysiology of neuropathic pain.

The motor stereotype in patients with cerebral palsy (CP) is determined by the magnitude of spasticity and central paresis of muscles, the impaired mechanisms of intermuscular interaction, and the presence of consensual reactions and pathologic synkineses. There are cases of a concomitance of the suprasegmental and segmental structures damages in CP. An attempt has been made to identify and estimate the contribution of the peripheral neuromuscular system lesion in CP patients in its late residual stage. Central nervous system lesion at the central and segmental levels were detected in 12.3% of cases in CP with spastic diplegia with progressive deformities of the lower extremities joints. Needle EMG is the most sensitive technique to detect a lesion at the segmental level: increased duration and higher amplitude motor unit potentials (MUPs) and fewer recruited MUPs were registrated. A turn-amplitude analysis has indicated the shift of cloudy diagram to the left and upwards and the decreased ratio of the number of turns to their mean amplitude. The residual pattern of revealed changes is confirmed by the absence of signs of a current denervation process. The contribution of possible myelodysplasia and transneuronal degeneration of spinal motor neurons at the lumbosacral level to the clinical picture of the CP and orthopedic surgery and rehabilitation tactics are discussed.

Several authors have reported finding retained primitive reflexes (RPRs) in individuals with autism spectrum disorders (ASD). This case report describes the reduction of RPRs and changes in cognitive function after transcutaneous electrical nerve stimulation (TENS) of muscle. Three individuals were examined in a study at the Institute for Neurology and Neurosurgery in Havana, Cuba. Two child neurologists, not involved in the study, conducted clinical examinations on each participant and diagnosed each with ASD based on DSM-V criteria and the Autism Diagnostic Interview-Revised (an autism evaluation tool). Each child with ASD possessed a triad of impairments in three domains: social interaction, communication, and repetitive behaviour. Individuals were evaluated by quantitative electroencephalographic measures and tested by standardised cognitive function tests before and after 12 weeks of intervention. These interventions were associated with reduced ASD symptoms in the three domains, significant changes in qEEG network connectivity and significantly improved performance on standardised cognitive tests., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: to study the clinical and neurophysiological features in the Chornobyl clean-up workers with a verified chronic cerebrovascular disease/cerebral small vessels disease (SVD) exposed to low doses of ionizing radiation (IR), employees of the Chornobyl Nuclear Power Plant (SSE ChNPP), who were exposed to the stress factor of a full-scale war as a result of being held captive by the Russian military at their workplaces, and individuals of the non-irradiated comparison group.Design, object and methods. A cross-sectional clinical study with parallel external control groups. We studied and carried out an expert statistical analysis of the clinical and neurophysiological characteristics of 62 male subjects, from which three examination groups were formed: 1) a randomized sample from the Clinical Epidemiological Register (CER) of the State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine» (NRCRM) of 22 Chornobyl clean-up workers ('Chornobyl liquidators') in 1986-1990,examined during 2020-2021, aged 50-68 years at the time of examination (M ± SD: (58.1 ± 5.2) years) with a documented external radiation dose of 0.03-2.30 Sv; 2) 24 SSE ChNPP employees exposed to the stress factor impact of a full-scale war as a result of being held captive by the Russian military at their workplaces. The average age of the examined was (54.5 ± 5.8) years (range 46-71 years). 3) Comparison group - 16 non-exposed men with verified chronic cerebrovascular disease/cerebral small vessels disease (SVD). The average age of the examined was (57.8 ± 5.6) years (range 50-70 years)., Results: Neurophysiological studies confirm the presence of the pronounced dysfunction of the cortico-limbic system of the left dominant hemisphere of the brain with special involvement of the hippocampus in the Chornobyl clean-up workers. In the SSE ChNPP group, for the first time, the disorders of cerebral neurodynamics were detected in the form of functional hypofrontality and hyperfunction of the cortico-limbic system with lateralization to the right hemisphere., Conclusions: Today there exists a long-term thorough methodological and evidence base for a possible neurophysiological diagnosis and differential diagnosis of the combined cerebral effects of IR and psycho-emotional stress associated with the conditions of military conflicts. Neurophysiological technologies can be used in the objective professional and qualification selection of employees in a number of professions that require quick and responsible decision-making. Employees of SSE ChNPP need further medical and psychological support due to an increased risk of developing mental health disorders., (K. V. Kuts, T. K. Loganovska, G. Yu. Kreinis, I. V. Perchuk, K. Yu. Antypchuk, V. O. Sushko, I. M. Dykan.)

There are significant differences in duration and intensity of clinical neurophysiology specialty training within the countries of the Europe, Middle East and Africa Chapter of the International Federation of Clinical Neurophysiology. We address these differences by proposing recommendations which may facilitate harmonisation of training and education within the Chapter. They arose from two workshops whose recommendations were then circulated widely within national societies in the Chapter for feedback and for consensus. The recommendations are applicable to clinical neurophysiology as a medical monospecialty and/or as a subspecialty (usually of neurology). We make a number of recommendations on governance and regulation of training, on the requirements for competence and the numbers of various examinations and tests performed by trainees, some under supervision. We also recommend a modular approach considering primary and complementary modules. Primary modules are electroencephalography, electromyography, nerve conduction studies and evoked potentials, while complementary ones include sleep analysis, intraoperative monitoring, small fibre testing, peripheral nerve and muscle ultrasound, intracortical recordings, and analysis of movement disorders. It is recommended that national examinations should include a variety of techniques to assess knowledge and judgement, practical skills, teamwork, communication skills, as well as safety and quality. The aim of the suggested recommendations is to harmonize clinical neurophysiology training in the member societies throughout the Chapter. It is realised that this may mean that the numbers for competence are aspirational for some, though ways to mitigate this, for instance through supranational training centres, are also discussed., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 International Federation of Clinical Neurophysiology. All rights reserved.)

Competing Interests: Competing interests: None declared.

A man in his mid-60s presented with a 3-month history of progressive muscle twitching, agitation, cognitive impairment, insomnia, hyperhidrosis and lower limb pain. He had fasciculations, myokymia, myoclonus, exaggerated startle response and significant postural hypotension. Electrophysiological studies showed evidence of peripheral nerve hyperexcitability with neuromyotonia. Contactin-associated protein-like 2 antibodies (CASPR2) were strongly positive. A diagnosis of Morvan syndrome was made. CT of the chest, abdomen and pelvis was undertaken to identify any occult malignancy, and a large bowel carcinoma in situ was identified and resected. His central nervous system and autonomic symptoms significantly improved following surgery, but neuromyotonia persisted, and this was treated with intravenous immunoglobulins and steroids. Early detection of bowel cancer in this patient enabled curative treatment., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

The development of pseudoaneurysm is an uncommon, life-threatening complication of head and neck microvascular surgery. Only a handful of reports have been published describing microvascular pseudoaneurysms, which usually occur at the arterial anastomosis and present as a pulsatile neck mass or as haemorrhage in case of pseudoaneurysm rupture. Management is highly variable, especially in the acute setting. In patients with pseudoaneurysm where flap inosculation is inadequate, endovascular approaches may be appropriate. In this report, we describe a ruptured distal pedicle pseudoaneurysm of a radial forearm free flap salvaged with a flow-diverting stent with complete flap survival and pedicle preservation. We demonstrate further evidence and feasibility of endovascular treatment of a non-anastomotic pseudoaneurysm arising from small vessels when parent vascular integrity is critical to flap survival., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: Sensitivity and specificity of Repetitive Nerve Stimulation (RNS) is typically reported from outpatient centers, and we hypothesized that these values might not apply to hospitalized patients with higher grades of weakness. RNS may be helpful in rapidly confirming diagnosis of myasthenia gravis (MG) in the inpatient setting, as results from confirmatory antibody testing are often delayed. We sought to characterize the sensitivity and specificity of RNS in the inpatient setting to assist in the early diagnosis of MG., Methods: We performed a retrospective analysis of all adult patients who had inpatient RNS at our center from 2016 to 2021. Inclusion criteria included RNS performed at least at one site and a neurological evaluation which prompted an electrodiagnostic study to evaluate for neuromuscular junction (NMJ) pathology. Descriptive statistics and Fisher exact analysis were performed., Results: Of the 32 identified hospitalized patients, 6 had greater than 10% decrement on slow RNS, confirming NMJ dysfunction. Five were diagnosed with MG, and 1 with Lambert-Eaton myasthenic syndrome. Of the 26 patients with normal RNS, 25 ultimately had alternative causes of weakness. One was later diagnosed as seronegative MG based on clinical improvement with acetylcholinesterase inhibitors. In our inpatient population, the overall sensitivity and specificity of RNS were 83.3% and 96.2% respectively. There was a statistically significant association between a positive RNS and diagnosis of MG ( P = .0002)., Conclusions: RNS is a highly sensitive and specific test for the diagnosis of MG in an inpatient setting, and these results are likely more rapidly available compared to antibody testing., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Objective: To determine the presence and potential utility of independent high-frequency activity recorded from scalp electrodes in the electroencephalogram (EEG) of newborns., Methods: We compare interburst intervals and continuous activity at different frequencies for EEGs retrospectively recorded at 256 Hz from 4 newborn groups: 1) 36 preterms (<32 weeks' gestational age, GA); 2) 12 preterms (32-37 weeks' GA); 3) 91 healthy full terms; 4) 15 full terms with hypoxic-ischemic encephalopathy (HIE). At 4 standard frequency bands (delta, 0.5-3 Hz; theta, 3-8 Hz; alpha, 8-15 Hz; beta, 15-30 Hz) and 3 higher-frequency bands (gamma1, 30-48 Hz; gamma2, 52-99 Hz; gamma3, 107-127 Hz), we compared power spectral densities (PSDs), quantitative features, and machine learning model performance. Feature selection and further machine learning methods were performed on one cohort., Results: We found significant (P < 0.01) differences in PSDs, quantitative analysis, and machine learning modelling at the higher-frequency bands. Machine learning models using only high-frequency features performed best in preterm groups 1 and 2 with a median (95% confidence interval, CI) Matthews correlation coefficient (MCC) of 0.71 (0.12-0.88) and 0.66 (0.36-0.76) respectively. Interburst interval-detector models using both high- and standard-bandwidths produced the highest median MCCs in all four groups. High-frequency features were largely independent of standard-bandwidth features, with only 11/84 (13.1%) of correlations statistically significant. Feature selection methods produced 7 to 9 high-frequency features in the top 20 feature set., Conclusions: This is the first study to identify independent high-frequency activity in newborn EEG using in-depth quantitative analysis. Expanding the EEG bandwidths of analysis has the potential to improve both quantitative and machine-learning analysis, particularly in preterm EEG., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Selective brain responses to objects arise within a few hundreds of milliseconds of neural processing, suggesting that visual object recognition is mediated by rapid feed-forward activations. Yet disruption of neural responses in early visual cortex beyond feed-forward processing stages affects object recognition performance. Here, we unite these discrepant findings by reporting that object recognition involves enhanced feedback activity (recurrent processing within early visual cortex) when target objects are embedded in natural scenes that are characterized by high complexity. Human participants performed an animal target detection task on natural scenes with low, medium or high complexity as determined by a computational model of low-level contrast statistics. Three converging lines of evidence indicate that feedback was selectively enhanced for high complexity scenes. First, functional magnetic resonance imaging (fMRI) activity in early visual cortex (V1) was enhanced for target objects in scenes with high, but not low or medium complexity. Second, event-related potentials (ERPs) evoked by target objects were selectively enhanced at feedback stages of visual processing (from ~220 ms onwards) for high complexity scenes only. Third, behavioral performance for high complexity scenes deteriorated when participants were pressed for time and thus less able to incorporate the feedback activity. Modeling of the reaction time distributions using drift diffusion revealed that object information accumulated more slowly for high complexity scenes, with evidence accumulation being coupled to trial-to-trial variation in the EEG feedback response. Together, these results suggest that while feed-forward activity may suffice to recognize isolated objects, the brain employs recurrent processing more adaptively in naturalistic settings, using minimal feedback for simple scenes and increasing feedback for complex scenes. [ABSTRACT FROM AUTHOR]

In this study, we investigated the effects of context-related semantic anomalies on the fixation-related brain potentials of 12–13-year-old Finnish children in grade 6 during sentence reading. The detection of such anomalies is typically reflected in the N400 event-related potential. We also examined whether the representation invoked by the sentence context extends to the orthographic representation level by replacing the final words of the sentence with an anomalous word neighbour of a plausible word. The eye-movement results show that the anomalous word neighbours of plausible words cause similar first-fixation and gaze duration reactions, as do other anomalous words. Similarly, we observed frontal negativity in the fixation-related potential of the unrelated anomalous words and in the anomalous word neighbours. This frontal negativity was larger in both anomalous conditions than in the response elicited by the plausible condition. We thus show that the brain successfully uses context to separate anomalous words from plausible words on a single letter level during free reading. From the P600 response of the scalp waveform, we observed that the P600 was delayed in the anomalous word neighbour condition. We performed group-level decomposition on the data with ICA (independent component analysis) and analysed the time course and source structure of the decomposed data. This analysis of decomposed brain signals not only confirmed the delay of the P600 response but also revealed that the frontal negativity concealed s more typical and separate N400 response, which was similarly delayed in the anomalous word neighbour condition, as was the P600 response. Source analysis of these independent components implicated the right frontal eye field as the cortical source for the frontal negativity and the middle temporal and parietal regions as cortical sources for the components resembling the N400 and P600 responses. We interpret the delays present in N400 and P600 responses to anomalous word neighbours to reflect competition with the representation of the plausible word just one letter different. [ABSTRACT FROM AUTHOR]

Almost all attention and learning—in particular, most early learning—take place in social settings. But little is known of how our brains support dynamic social interactions. We recorded dual electroencephalography (EEG) from 12-month-old infants and parents during solo play and joint play. During solo play, fluctuations in infants’ theta power significantly forward-predicted their subsequent attentional behaviours. However, this forward-predictiveness was lower during joint play than solo play, suggesting that infants’ endogenous neural control over attention is greater during solo play. Overall, however, infants were more attentive to the objects during joint play. To understand why, we examined how adult brain activity related to infant attention. We found that parents’ theta power closely tracked and responded to changes in their infants’ attention. Further, instances in which parents showed greater neural responsivity were associated with longer sustained attention by infants. Our results offer new insights into how one partner influences another during social interaction. [ABSTRACT FROM AUTHOR]

The relationship between cardiovascular disease and abnormalities in sleep architecture is complex and bi-directional. Sleep disordered breathing (SDB) often confounds human studies examining sleep in the setting of heart failure, and the independent impact of isolated right or left heart failure on sleep is difficult to assess. We utilized an animal model of right heart failure using pulmonary artery banding (PAB) in mice to examine the causal effect of right heart failure on sleep architecture. Four weeks after PAB or sham (control) surgery, sleep was measured by polysomnography for 48 hours and right ventricular (RV) hypertrophy confirmed prior to sacrifice. PAB resulted in right ventricular hypertrophy based on a 30% increase in the Fulton Index (p < 0.01). After PAB, mice spent significantly more time in NREM sleep compared to the control group over a 24 hour period (53.5 ± 1.5% vs. 46.6 ± 1.4%; p < 0.01) and exhibited an inability to both cycle into REM sleep and decrease delta density across the light/sleep period. Our results support a phenotype of impaired sleep cycling and increased ‘sleepiness’ in a mouse model of RV dysfunction. [ABSTRACT FROM AUTHOR]

Background: The gold standard for pediatric sleep apnea hypopnea syndrome (SAHS) is overnight polysomnography, which has several limitations. Thus, simplified diagnosis techniques become necessary. Objective: The aim of this study is twofold: (i) to analyze the blood oxygen saturation (SpO2) signal from nocturnal oximetry by means of features from the wavelet transform in order to characterize pediatric SAHS; (ii) to evaluate the usefulness of the extracted features to assist in the detection of pediatric SAHS. Methods: 981 SpO2 signals from children ranging 2–13 years of age were used. Discrete wavelet transform (DWT) was employed due to its suitability to deal with non-stationary signals as well as the ability to analyze the SAHS-related low frequency components of the SpO2 signal with high resolution. In addition, 3% oxygen desaturation index (ODI3), statistical moments and power spectral density (PSD) features were computed. Fast correlation-based filter was applied to select a feature subset. This subset fed three classifiers (logistic regression, support vector machines (SVM), and multilayer perceptron) trained to determine the presence of moderate-to-severe pediatric SAHS (apnea-hypopnea index cutoff ≥ 5 events per hour). Results: The wavelet entropy and features computed in the D9 detail level of the DWT reached significant differences associated with the presence of SAHS. All the proposed classifiers fed with a selected feature subset composed of ODI3, statistical moments, PSD, and DWT features outperformed every single feature. SVM reached the highest performance. It achieved 84.0% accuracy (71.9% sensitivity, 91.1% specificity), outperforming state-of-the-art studies in the detection of moderate-to-severe SAHS using the SpO2 signal alone. Conclusion: Wavelet analysis could be a reliable tool to analyze the oximetry signal in order to assist in the automated detection of moderate-to-severe pediatric SAHS. Hence, pediatric subjects suffering from moderate-to-severe SAHS could benefit from an accurate simplified screening test only using the SpO2 signal. [ABSTRACT FROM AUTHOR]

Repetitive transcranial magnetic stimulation (rTMS) can induce excitability changes of a stimulated brain area through synaptic plasticity mechanisms. High-frequency (100 Hz) triplets of rTMS synchronized to the negative but not the positive peak of the ongoing sensorimotor μ-rhythm isolated with the concurrently acquired electroencephalography (EEG) resulted in a reproducible long-term potentiation like increase of motor evoked potential (MEP) amplitude, an index of corticospinal excitability (Zrenner et al. 2018, Brain Stimul 11:374–389). Here, we analyzed the EEG and TMS-EEG data from (Zrenner et al., 2018) to investigate the effects of μ-rhythm-phase-dependent burst-rTMS on EEG-based measures of cortical excitability. We used resting-state EEG to assess μ- and β-power in the motor cortex ipsi- and contralateral to the stimulation, and single-pulse TMS-evoked and induced EEG responses in the stimulated motor cortex. We found that μ-rhythm-phase-dependent burst-rTMS did not significantly change any of these EEG measures, despite the presence of a significant differential and reproducible effect on MEP amplitude. We conclude that EEG measures of cortical excitability do not reflect corticospinal excitability as measured by MEP amplitude. Most likely this is explained by the fact that rTMS induces complex changes at the molecular and synaptic level towards both excitation and inhibition that cannot be differentiated at the macroscopic level by EEG. [ABSTRACT FROM AUTHOR]

As the big data science develops, efficient methods are demanded for various data analysis. Granger causality provides the prime model for quantifying causal interactions. However, this theoretic model does not meet the requirement for real-world data analysis, because real-world time series are diverse whose models are usually unknown. Therefore, model-free measures such as information transfer measures are strongly desired. Here, we propose the multi-scale extension of conditional mutual information measures using MORLET wavelet, which are named the WM and WPM. The proposed measures are computational efficient and interpret information transfer by multi-scales. We use both synthetic data and real-world examples to demonstrate the efficiency of the new methods. The results of the new methods are robust and reliable. Via the simulation studies, we found the new methods outperform the wavelet extension of transfer entropy (WTE) in both computational efficiency and accuracy. The features and properties of the proposed measures are also discussed. [ABSTRACT FROM AUTHOR]

Foreign accents have been shown to have considerable impact on how language is processed []. However, the impact of a foreign accent on semantic processing is not well understood. Conflicting results have been reported by previous event-related potential (ERP) studies investigating the impact of foreign-accentedness on the N400 effect elicited by semantic violations. Furthermore, these studies have only examined a subset of the four characteristics of the N400 (i.e. onset latency, latency, amplitude, and scalp distribution), and have been conducted in linguistic environments where foreign-accented speech is relatively uncommon. The current study therefore compared the N400 effect elicited by semantic violations in native Australian English vs. Mandarin-accented English, in a context where foreign-accented speech is common. Factors which may be responsible for individual variability in N400 amplitude were also investigated. The results showed no differences between the N400s elicited by native and foreign-accented speech in any of the four aforementioned characteristics. However, the analysis of individual variability revealed an effect of familiarity with foreign-accented speech on the amplitude of N400 effects for semantic violations. An effect of working memory capacity on N400 amplitude was also found. These findings highlight the relevance of the ambient linguistic environment for studies of speech processing, and demonstrate the interacting influences of both speaker- and listener-related factors on semantic processing. [ABSTRACT FROM AUTHOR]

Cardiac electrical alternans (CEA), manifested as T-wave alternans in ECG, is a clinical biomarker for predicting cardiac arrhythmias and sudden death. However, the mechanism underlying the spontaneous transition from CEA to arrhythmias remains incompletely elucidated. In this study, multiscale rabbit ventricular models were used to study the transition and a potential role of INa in perpetuating such a transition. It was shown CEA evolved into either concordant or discordant action potential (AP) conduction alternans in a homogeneous one-dimensional tissue model, depending on tissue AP duration and conduction velocity (CV) restitution properties. Discordant alternans was able to cause conduction failure in the model, which was promoted by impaired sodium channel with either a reduced or increased channel current. In a two-dimensional homogeneous tissue model, a combined effect of rate- and curvature-dependent CV broke-up alternating wavefronts at localised points, facilitating a spontaneous transition from CEA to re-entry. Tissue inhomogeneity or anisotropy further promoted break-up of re-entry, leading to multiple wavelets. Similar observations have also been seen in human atrial cellular and tissue models. In conclusion, our results identify a mechanism by which CEA spontaneously evolves into re-entry without a requirement for premature ventricular complexes or pre-existing tissue heterogeneities, and demonstrated the important pro-arrhythmic role of impaired sodium channel activity. These findings are model-independent and have potential human relevance. [ABSTRACT FROM AUTHOR]