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Kaitlyn Casimo, Fabio Grassia, Sandra L. Poliachik, Edward Novotny, Andrew Poliakov and Jeffrey G. Ojemann

Prior studies of functional connectivity following callosotomy have disagreed in the observed effects on interhemispheric functional connectivity. These connectivity studies, in multiple electrophysiological methods and functional MRI, have found conflicting reductions in connectivity or patterns resembling typical individuals. The authors examined a case of partial anterior corpus callosum connection, where pairs of bilateral electrocorticographic electrodes had been placed over homologous regions in the left and right hemispheres. They sorted electrode pairs by whether their direct corpus callosum connection had been disconnected or preserved using diffusion tensor imaging and native anatomical MRI, and they estimated functional connectivity between pairs of electrodes over homologous regions using phase-locking value. They found no significant differences in any frequency band between pairs of electrodes that had their corpus callosum connection disconnected and those that had an intact connection. The authors’ results may imply that the corpus callosum is not an obligatory mediator of connectivity between homologous sites in opposite hemispheres. This interhemispheric synchronization may also be linked to disruption of seizure activity.

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Fabio Grassia, Andrew V. Poliakov, Sandra L. Poliachik, Kaitlyn Casimo, Seth D. Friedman, Hillary Shurtleff, Carlo Giussani, Edward J. Novotny Jr., Jeffrey G. Ojemann and Jason S. Hauptman

OBJECTIVE

Functional connectivity magnetic resonance imaging (fcMRI) is a form of fMRI that allows for analysis of blood oxygen level–dependent signal changes within a task-free, resting paradigm. This technique has been shown to have efficacy in evaluating network connectivity changes with epilepsy. Presurgical data from patients with unilateral temporal lobe epilepsy were evaluated using the fcMRI technique to define connectivity changes within and between the diseased and healthy temporal lobes using a within-subjects design.

METHODS

Using presurgical fcMRI data from pediatric patients with unilateral temporal lobe epilepsy, the authors performed seed-based analyses within the diseased and healthy temporal lobes. Connectivity within and between temporal lobe seeds was measured and compared.

RESULTS

In the cohort studied, local ipsilateral temporal lobe connectivity was significantly increased on the diseased side compared to the healthy temporal lobe. Connectivity of the diseased side to the healthy side, on the other hand, was significantly reduced when compared to connectivity of the healthy side to the diseased temporal lobe. A statistically significant regression was observed when comparing the changes in local ipsilateral temporal lobe connectivity to the changes in inter–temporal lobe connectivity. A statistically significant difference was also noted in ipsilateral connectivity changes between patients with and those without mesial temporal sclerosis.

CONCLUSIONS

Using fcMRI, significant changes in ipsilateral temporal lobe and inter–temporal lobe connectivity can be appreciated in unilateral temporal lobe epilepsy. Furthermore, fcMRI may have a role in the presurgical evaluation of patients with intractable temporal lobe epilepsy.

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Chao-Hung Kuo, Timothy M. Blakely, Jeremiah D. Wander, Devapratim Sarma, Jing Wu, Kaitlyn Casimo, Kurt E. Weaver and Jeffrey G. Ojemann

OBJECTIVE

The activation of the sensorimotor cortex as measured by electrocorticographic (ECoG) signals has been correlated with contralateral hand movements in humans, as precisely as the level of individual digits. However, the relationship between individual and multiple synergistic finger movements and the neural signal as detected by ECoG has not been fully explored. The authors used intraoperative high-resolution micro-ECoG (µECoG) on the sensorimotor cortex to link neural signals to finger movements across several context-specific motor tasks.

METHODS

Three neurosurgical patients with cortical lesions over eloquent regions participated. During awake craniotomy, a sensorimotor cortex area of hand movement was localized by high-frequency responses measured by an 8 × 8 µECoG grid of 3-mm interelectrode spacing. Patients performed a flexion movement of the thumb or index finger, or a pinch movement of both, based on a visual cue. High-gamma (HG; 70–230 Hz) filtered µECoG was used to identify dominant electrodes associated with thumb and index movement. Hand movements were recorded by a dataglove simultaneously with µECoG recording.

RESULTS

In all 3 patients, the electrodes controlling thumb and index finger movements were identifiable approximately 3–6-mm apart by the HG-filtered µECoG signal. For HG power of cortical activation measured with µECoG, the thumb and index signals in the pinch movement were similar to those observed during thumb-only and index-only movement, respectively (all p > 0.05). Index finger movements, measured by the dataglove joint angles, were similar in both the index-only and pinch movements (p > 0.05). However, despite similar activation across the conditions, markedly decreased thumb movement was observed in pinch relative to independent thumb-only movement (all p < 0.05).

CONCLUSIONS

HG-filtered µECoG signals effectively identify dominant regions associated with thumb and index finger movement. For pinch, the µECoG signal comprises a combination of the signals from individual thumb and index movements. However, while the relationship between the index finger joint angle and HG-filtered signal remains consistent between conditions, there is not a fixed relationship for thumb movement. Although the HG-filtered µECoG signal is similar in both thumb-only and pinch conditions, the actual thumb movement is markedly smaller in the pinch condition than in the thumb-only condition. This implies a nonlinear relationship between the cortical signal and the motor output for some, but importantly not all, movement types. This analysis provides insight into the tuning of the motor cortex toward specific types of motor behaviors.