Article (Scientific journals)
On the cerebral origin of EEG responses to TMS: Insights from severe cortical lesions
Gosseries, Olivia; Sarasso, Simone; Casarotto, Silvia et al.
2015In Brain Stimulation, 8 (1), p. 142-149
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Keywords :
Biological artifacts; Brain-injury; Electroencephalography; Transcranial magnetic stimulation; Article; Adult; Aged, 80 and over; Case-Control Studies; Cerebral Cortex; Evoked Potentials; Female; Humans; Male; Middle Aged; Persistent Vegetative State; Young Adult
Abstract :
[en] Background Transcranial magnetic stimulation combined with electroencephalography (TMS/EEG) represents a valuable tool to probe cortical excitability and connectivity. Although several procedures have been devised to abolish TMS-related artifacts, direct evidence that it is possible to record TMS-evoked potentials (TEPs) that purely reflect cortical responses to TMS are still lacking.Objective To demonstrate that when TMS is delivered on a human head with intact nerves, scalp and ocular muscles, TEPs are present only if a functional portion of cortex is targeted and is absent otherwise.Methods We performed extensive navigated TMS/EEG mappings in three vegetative state patients and in eight healthy controls. Patients were selected based on the extension of their cortical lesions as revealed by structural/functional imaging: the cerebral cortex was globally damaged in Patient 1 due to cerebral anoxia, Patient 2 showed a traumatic damage affecting one cerebral hemisphere, while Patient 3 was characterized by one left sided and one right-sided focal ischemic lesion.Results In Patient 1, TMS performed at any targeted cortical site did not elicit statistically significant TEPs. In Patient 2, TEPs were absent when the damaged hemisphere was targeted, while were present over the healthy side. In Patient 3, significant TEPs were absent when cortical lesions were targeted and present otherwise. Significant TEPs were always present in healthy controls.Conclusions These findings suggest that, provided that appropriate experimental procedures are employed, TEPs are genuine cortical responses detectable only when preserved cortical tissue is stimulated. Hence, a dependable assessment of cortical excitability and connectivity in brain-injured patients requires the use of neuronavigated TMS. © 2015 Elsevier Inc. All rights reserved.
Disciplines :
Neurology
Author, co-author :
Gosseries, Olivia  ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Sarasso, Simone;  Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Hospital Luigi Sacco, Via GB Grassi 74, Milan, Italy
Casarotto, Silvia;  Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Hospital Luigi Sacco, Via GB Grassi 74, Milan, Italy
Boly, Mélanie ;  Coma Science Group, Cyclotron Research Center and Neurology Department, University and University Hospital of Liège, Liège, Belgium
Schnakers, Caroline ;  Coma Science Group, Cyclotron Research Center and Neurology Department, University and University Hospital of Liège, Liège, Belgium
Napolitani, Martino;  Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Hospital Luigi Sacco, Via GB Grassi 74, Milan, Italy
Bruno, Marie-Aurélie ;  Coma Science Group, Cyclotron Research Center and Neurology Department, University and University Hospital of Liège, Liège, Belgium
LEDOUX, Didier  ;  Centre Hospitalier Universitaire de Liège - CHU > Service des soins intensifs généraux
Tshibanda, Jean Flory Luaba;  Coma Science Group, Cyclotron Research Center and Neurology Department, University and University Hospital of Liège, Liège, Belgium
Massimini, Marcello;  Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Hospital Luigi Sacco, Via GB Grassi 74, Milan, Italy, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
Laureys, Steven  ;  Université de Liège - ULiège > GIGA : Coma Group
Rosanova, Mario;  Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, Hospital Luigi Sacco, Via GB Grassi 74, Milan, Italy, Fondazione Europea di Ricerca Biomedica, FERB Onlus, Milan, Italy
Language :
English
Title :
On the cerebral origin of EEG responses to TMS: Insights from severe cortical lesions
Publication date :
2015
Journal title :
Brain Stimulation
ISSN :
1935-861X
eISSN :
1876-4754
Publisher :
Elsevier Inc.
Volume :
8
Issue :
1
Pages :
142-149
Peer reviewed :
Peer Reviewed verified by ORBi
Name of the research project :
600806
Funders :
JSMF - James S McDonnell Foundation [US-MO]
Available on ORBi :
since 14 July 2018

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