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Di Lazzaro, V.

Publications and source records attributed to Di Lazzaro, V..

5 recordsLinked to original sources

Circuits and mechanisms for TMS-induced corticospinal waves: Connecting sensitivityanalysis to the network graph

Transcranial magnetic stimulation (TMS) is a non-invasive, FDA-cleared treatment for neuropsychiatric disorders with broad potential for new applications, but the neural circuits that are engaged during TMS are still poorly understood. Recordings of neural activity from the corticospinal tract provide a direct readout of the response of motor cortex to TMS, and therefore a new opportunity to model neural circuit dynamics. The study goal was to use epidural recordings from the cervical spine of human subjects to develop a computational model of a motor cortical macrocolumn through which the mechanisms underlying the response to TMS, including direct and indirect waves, could be investigated. An in-depth sensitivity analysis was conducted to identify important pathways, and machine learning was used to identify common circuit features among these pathways. Sensitivity analysis identified neuron types that preferentially contributed to single corticospinal waves. Single wave preference could be predicted using the average connection probability of all possible paths between the activated neuron type and L5 pyramidal tract neurons (PTNs). For these activations, the total conduction delay of the shortest path to L5 PTNs determined the latency of the corticospinal wave. Finally, there were multiple neuron type activations that could preferentially modulate a particular corticospinal wave. The results support the hypothesis that different pathways of circuit activation contribute to different corticospinal waves with participation of both excitatory and inhibitory neurons. Moreover, activation of both afferents to the motor cortex as well as specific neuron types within the motor cortex initiated different I-waves, and the results were interpreted to propose the cortical origins of afferents that may give rise to certain I-waves. The methodology provides a workflow for performing computationally tractable sensitivity analyses on complex models and relating the results to the network structure to both identify and understand mechanisms underlying the response to acute stimulation. AUTHOR SUMMARYUnderstanding circuit mechanisms underlying the response to transcranial magnetic stimulation remains a significant challenge for translational and clinical research. Computational models can reconstruct network activity in response to stimulation, but basic sensitivity analyses are insufficient to identify the fundamental circuit properties that underly an evoked response. We developed a data-driven neuronal network model of motor cortex, constrained with human recordings, that reproduced the corticospinal response to magnetic stimulation. The model supported several hypotheses, e.g., the importance of stimulating incoming fibers as well as neurons within the cortical column and the relevance of both excitatory and inhibitory neurons. Following a sensitivity analysis, we conducted a secondary structural analysis that linked the results of the sensitivity analysis to the network using machine learning. The structural analysis pointed to anatomical mechanisms that contributed to specific peaks in the response. Generally, given the anatomy and circuit of a neural region, identifying strongly connected paths in the network and the conduction delays of these paths can screen for important contributors to response peaks. This work supports and expands on hypotheses explaining the response to transcranial magnetic stimulation and adds a novel method for identifying generalizable neural circuit mechanisms.

neuroscience↗

Assessing cortical excitability with electroencephalography: a pilot study with EEG-iTBS.

Cortical excitability measures neural reactivity to stimuli, usually delivered via Transcranial Magnetic Stimulation (TMS). Excitation/inhibition balance (E/I) is the ongoing equilibrium between excitatory and inhibitory activity of neural circuits. According to some studies, E/I could be estimated in-vivo and non-invasively through the modeling of electroencephalography (EEG) signals. Several measures have been proposed (phase consistency in the gamma band, sample entropy, exponent of the power spectral density 1/f curve, E/I index extracted from detrend fluctuation analysis, and alpha power). It remains to be investigated to what extent they scale with excitability and how they relate to each other. Intermittent theta burst stimulation (iTBS) of the primary motor cortex (M1) is a non-invasive neuromodulation technique allowing controlled and focal enhancement of cortical excitability and E/I of the stimulated hemisphere. M1 excitability and several E/I estimates extracted from resting state EEG recordings were assessed before and after iTBS in a cohort of healthy subjects. Enhancement of M1 excitability, as measured through motor-evoked potentials (MEPs), and phase consistency of the cortex in high gamma band correlated with each other. Other measures of E/I showed some expected results, but no correlation with TMS excitability measures or consistency with each other. EEG E/I estimates offer an intriguing opportunity to map cortical excitability non-invasively, with high spatio-temporal resolution and with a stimulus independent approach. While different EEG E/I estimates may reflect the activity of diverse excitatory-inhibitory circuits, spatial phase synchrony in the gamma band is the measure that best captures excitability changes in the primary motor cortex.

neuroscience↗

EEG spectral exponent as a synthetic index for the longitudinal assessment of stroke recovery.

BackgroundQuantitative EEG (qEEG) can capture changes in brain activity that follow a stroke. Accordingly, EEG metrics could be used to monitor patients state and recovery. Although qEEG metrics traditionally focus on oscillatory activity, recent findings highlight the importance of aperiodic (power-law) structure in characterizing pathological brain states. ObjectiveTo assess neurophysiological impairment and recovery from mono-hemispheric stroke by means of the Spectral Exponent (SE), a metric that reflects EEG slowing and quantifies the power-law decay of the EEG Power Spectral Density (PSD). To relate neurophysiological recovery with patients functional outcome. MethodsEighteen patients (n=18) with Middle Cerebral Artery (MCA) ischaemic stroke were retrospectively enrolled for this study. Patients underwent EEG recording in the sub-acute phase (T0) and after 2 months of physical rehabilitation (T1). Sixteen healthy controls (HC; n=16) matched by age and sex were enrolled as a normative group. SE values and narrow-band PSD were estimated for each recording. We compared SE and band-power between patients and HC, and between the affected (AH) and unaffected hemisphere (UH) at T0 and T1 in patients. ResultsAt T0, stroke patients showed significantly more negative SE values than HC (p=0.003), reflecting broad-band EEG slowing. Moreover, SE over the AH was consistently more negative compared to the UH and showed a renormalization at T1 in our patient sample. This SE renormalization significantly correlated with NIHSS improvement (R= 0.63, p=0.005). ConclusionsSE is a reliable readout of the electric changes occurring in the brain after an ischaemic cortical lesion. Moreover, SE holds the promise to be a robust method to assess stroke impairment as well as to monitor and predict functional outcome.

neuroscience↗

Large-scale analysis of interindividual variability in single and paired-pulse TMS data: results from the 'Big TMS Data Collaboration'

ObjectiveInterindividual variability of single and paired-pulse TMS data has limited the clinical and experimental applicability of these methods. This study brought together over 60 TMS researchers to create the largest known sample of individual participant single and paired-pulse TMS data to date, enabling a more comprehensive evaluation of factors driving response variability. Methods118 corresponding authors provided deidentified individual TMS data. Mixed-effects regression investigated a range of individual and study level variables for their contribution to variability in response to single and pp TMS data. Results687 healthy participants TMS data was pooled across 35 studies. Target muscle, pulse waveform, neuronavigation use, and TMS machine significantly predicted an individuals single pulse TMS amplitude. Baseline MEP amplitude, M1 hemisphere, and biphasic AMT significantly predicted SICI response. Baseline MEP amplitude, test stimulus intensity, interstimulus interval, monophasic RMT, monophasic AMT, and biphasic RMT significantly predicted ICF response. Age, M1 hemisphere, and TMS machine significantly predicted motor threshold. ConclusionsThis large-scale analysis has identified a number of factors influencing participants responses to single and paired pulse TMS. We provide specific recommendations to increase the standardisation of TMS methods within and across laboratories, thereby minimising interindividual variability in single and pp TMS data. HighlightsO_LI687 healthy participants TMS data was pooled across 35 studies C_LIO_LISignificant relationships between age and resting motor threshold C_LIO_LISignificant relationships between baseline MEP amplitude and SICI/ICF C_LI

neuroscience↗

Cyclin-dependent-like kinase 5 is required for pain signalling in both human neurons and mouse models

Cyclin-dependent-like kinase 5 (Cdkl5) gene mutations lead to an X-linked disorder that is characterized by infantile epileptic encephalopathy, developmental delay and hypotonia. However, we found that a substantial percentage of these patients also report a previously unrecognised anamnestic deficiency in pain perception. Consistent with a role in nociception, we discovered that Cdkl5 is expressed selectively in nociceptive dorsal root ganglia (DRG) neurons in mice and in iPS-derived human nociceptors. CDKL5 deficient mice display defective epidermal innervation and conditional deletion of Cdkl5 in DRG sensory neurons significantly impairs nociception, phenocopying CDKL5 deficiency disorder in patients. Mechanistically, Cdkl5 interacts with CaMKII to control outgrowth as well as TRPV1-dependent signalling, which are disrupted in both Cdkl5 mutant murine DRG and human iPS-derived nociceptors. Together, these findings unveil a previously unrecognized role for Cdkl5 in nociception, proposing an original regulatory mechanism for pain perception with implications for future therapeutics in CDKL5 deficiency disorder.\n\nOne Sentence SummaryCyclin-dependent-like kinase 5 (Cdkl5) controls nociception in patients and murine models of Cdkl5 deficiency disorder via CaMKII-dependent mechanisms

neuroscience↗