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Eskandar, E. N.

Publications and source records attributed to Eskandar, E. N..

10 recordsLinked to original sources

Electrical stimulation of the human pulvinar generates visual percepts

Visual prostheses have targeted early structures in the visual pathway, including the retina, optic nerve, lateral geniculate nucleus, and visual cortex, to generate visual percepts. Stimulation of higher-order visual regions, which may better encode complex visual features, remains relatively unexplored. We tested whether electrical stimulation of the medial and inferior pulvinar elicits visual percepts in a patient with medically refractory epilepsy undergoing invasive seizure monitoring with intracranial electroencephalography. Bipolar stimulation (30 biphasic pulses, 0.5 ms per phase, 3 mA, 1 Hz) was delivered between adjacent pulvinar contacts while eye movements were tracked. Stimulation of different electrode pairs elicited visual percepts at distinct retinotopic locations (p = 0.010). Stimulation also altered cortical activity, producing an early power increase followed by gamma desynchronization in occipital and parietal regions (p < 0.001) and beta desynchronization in the lateral temporal region (p < 0.01). These findings suggest that pulvinar stimulation can generate visual percepts and modulate distributed cortical networks, supporting further investigation of the pulvinar as a target for vision restoration.

neuroscience↗

Characterizing ketamine-induced dissociation using human intracranial neurophysiology: brain dynamics, network activity, and interactions with propofol

Subanesthetic doses of ketamine produce rapid and sustained anti-depressant effects in patients with treatment-resistant depression. Unfortunately, the usefulness of ketamine as a treatment is limited by its potential for abuse because of psychotropic side effects such as dissociation. Understanding the brain dynamics and the neural circuits involved in ketamines effects could lend insight into improved therapies for depression with fewer adverse effects. It is believed that ketamine acts via NMDA receptor and hyperpolarization-activated cyclic nucleotide-gated 1 (HCN1) channels to produce changes in oscillatory brain dynamics. Here we show, in humans, a detailed description of the principal oscillatory changes in cortical and subcortical structures by administration of a subanesthetic dose of ketamine. Using recordings from intracranial electrodes, we found that ketamine increased gamma oscillations within prefrontal cortical areas and the hippocampus--structures previously implicated in ketamines antidepressant effects. Furthermore, our studies provide direct evidence of a ketamine-induced 3 Hz oscillation in posteromedial cortex that has been proposed as a mechanism for its dissociative effects. By analyzing changes in neural oscillations after the addition of propofol, whose GABAergic activity antagonizes ketamines NMDA-mediated disinhibition alongside a shared HCN1 inhibitory effect, we identified brain dynamics that could be attributed to NMDA-mediated disinhibition versus HCN1 inhibition. Overall, our results imply that ketamine engages different neural circuits in distinct frequency-dependent patterns of activity to produce its antidepressant and dissociative sensory effects. These insights may help guide the development of novel brain dynamic biomarkers and therapeutics for depression.

neuroscience↗

Propofol disrupts alpha dynamics in distinct thalamocortical networks underlying sensory and cognitive function during loss of consciousness

During propofol-induced general anesthesia, alpha rhythms undergo a striking shift from posterior to anterior, termed anteriorization. We combined human intracranial recordings with diffusion imaging to show that anteriorization occurs with opposing dynamics in two distinct thalamocortical subnetworks. The cortical and thalamic anatomy involved, as well as their known functional roles, suggest multiple means by which propofol dismantles sensory and cognitive processes to achieve loss of consciousness.

neuroscience↗

Impact of stimulation location relative to grey and white matter on single pulse electrical stimulation responses in the human brain

BackgroundElectrical neuromodulation is an increasingly common therapy for a wide variety of neuropsychiatric diseases. Unfortunately, therapeutic efficacy is inconsistent, possibly a result of our limited understanding of the mechanisms and the massive stimulation parameter space. Objective/HypothesisTo better understand the role different parameters play in inducing a response, we systematically examined single pulse-induced cortico-cortico evoked potentials (CCEP) as a function of stimulation amplitude, duration and location in the brain and relative to grey and white matter. MethodsWe measured voltage peak amplitudes and area under the curve of intracranially recorded stimulation responses as a function of distance from the stimulation site, pulse width, current injected, location relative to grey and white matter, and brain region stimulated (N=52, n=719 stimulation sites). ResultsIncreasing stimulation pulse width increased response values near the stimulation location. Increasing stimulation amplitude (current) increased responses nonlinearly. Locally (<15 mm from the stimulation site), stimulation closer to the grey matter-white matter boundary induced larger responses. In contrast, for distant sites (>15 mm), white matter stimulation consistently produced larger responses than stimulation in or near grey matter. These relationships were different between cingulate, lateral prefrontal, and lateral temporal cortical stimulation. ConclusionThese results demonstrate the importance of location and stimulation parameters in inducing a specific output and indicate that a stronger local response may require stimulation in the grey-white boundary while stimulation in the white matter may be needed for network activation, suggesting that stimulation location can be tailored for a specific outcome, key to informed neuromodulatory therapy. HighlightsO_LIIntracranial single pulse electrical stimulation (SPES) response increases with increased pulse duration mostly near the stimulation site C_LIO_LISPES response varies nonlinearly with injected current with an effect of distance from the stimulation site. C_LIO_LISPES near the grey-white boundary and 90{degrees} to the nearest cortical axis induces larger local responses, but white matter stimulation produces larger distant responses. C_LIO_LIThe relationship between SPES location and responses depends on brain region stimulated C_LI

neuroscience↗

Cortical ripples provide the conditions for consolidation during NREM sleep in humans

Hippocampal ripples index the reconstruction of spatiotemporal neuronal firing patterns essential for the consolidation of memories in the cortex during non-rapid eye movement sleep (NREM). Recently, cortical ripples in humans have been shown to enfold the replay of neuron firing patterns during cued recall. Here, using intracranial recordings from 18 patients (12 female), we show that cortical ripples also occur during NREM in humans, with similar density, oscillation frequency ([~]90 Hz), duration, and amplitude to waking. Ripples occurred in all cortical regions with similar characteristics, unrelated to putative hippocampal connectivity, and were less dense and robust in higher association areas. Putative pyramidal and interneuron spiking phase-locked to cortical ripples during NREM, with phase delays consistent with ripple generation through pyramidal-interneuron feedback. Cortical ripples were smaller in amplitude than hippocampal ripples, but were similar in density, frequency, and duration. Cortical ripples during NREM typically occurred just prior to the upstate peak, often during spindles. Upstates and spindles have previously been associated with memory consolidation, and we found that cortical ripples grouped co-firing between units within the window of spike-timing-dependent plasticity. Thus, human NREM cortical ripples are: ubiquitous and stereotyped with a tightly focused oscillation frequency; similar to hippocampal ripples; associated with upstates and spindles; and associated with unit co-firing. These properties are consistent with cortical ripples possibly contributing to memory consolidation and other functions during NREM in humans. Significance StatementIn rodents, hippocampal ripples organize replay during sleep to promote memory consolidation in the cortex, where ripples also occur. However, evidence for cortical ripples in human sleep is limited, and their anatomical distribution and physiological properties are unexplored. Here, using human intracranial recordings, we demonstrate that ripples occur throughout the cortex during waking and sleep with highly stereotyped characteristics. During sleep, cortical ripples tend to occur during spindles on the down-to-upstate transition, and thus participate in a sequence of sleep waves that is important for consolidation. Furthermore, cortical ripples organize single unit spiking with timing optimal to facilitate plasticity. Therefore, cortical ripples in humans possess essential physiological properties to support memory and other cognitive functions.

neuroscience↗

Widespread ripples synchronize human cortical activity

Declarative memory encoding, consolidation, and retrieval require the integration of elements encoded in widespread cortical locations. The mechanism whereby such binding of different components of mental events into unified representations occurs is unknown. The binding-bysynchrony theory proposes that distributed encoding areas are bound by synchronous oscillations enabling enhanced communication. However, evidence for such oscillations is sparse. Brief high-frequency oscillations ( ripples) occur in the hippocampus and cortex, and help organize memory recall and consolidation. Here, using intracranial recordings in humans, we report that these ~70ms duration 90Hz ripples often couple (within {+/-}500ms), co-occur ([&ge;]25ms overlap), and crucially, phase-lock (have consistent phase-lags) between widely distributed focal cortical locations during both sleep and waking, even between hemispheres. Cortical ripple co-occurrence is facilitated through activation across multiple sites, and phaselocking increases with more cortical sites co-rippling. Ripples in all cortical areas co-occur with hippocampal ripples but do not phase-lock with them, further suggesting that cortico-cortical synchrony is mediated by cortico-cortical connections. Ripple phase-lags vary across sleep nights, consistent with participation in different networks. During waking, we show that hippocampo-cortical and cortico-cortical co-ripples increase preceding successful delayed memory recall, when binding between the cue and response is essential. Ripples increase and phase-modulate unit firing, and co-ripples increase high-frequency correlations between areas, suggesting synchronized unit-spiking facilitating information exchange. Co-occurrence, phasesynchrony, and high-frequency correlation are maintained with little decrement over very long distances (25cm). Hippocampo-cortico-cortical co-ripples appear to possess the essential properties necessary to support binding-by-synchrony during memory retrieval, and perhaps generally in cognition. Significance StatementDifferent elements of a memory, or any mental event, are encoded in locations distributed across the cortex. A prominent hypothesis proposes that widespread networks are integrated with bursts of synchronized high-frequency oscillations called ripples, but evidence is limited. Here, using recordings inside the human brain, we show that ripples occur simultaneously in multiple lobes in both cortical hemispheres, and the hippocampus, generally during sleep and waking, and especially during memory recall. Ripples phase-lock local cell firing, and phase-synchronize with little decay between locations separated by up to 25cm, enabling long-distance integration. Indeed, co-rippling sites have increased correlation of very high-frequency activity which reflects cell firing. Thus, ripples may help bind information across the cortex in memory and other mental events.

neuroscience↗

Travelling spindles create necessary conditions for spike-timing-dependent plasticity in humans

Sleep spindles facilitate memory consolidation in the cortex during mammalian non-rapid eye movement (NREM) sleep. In rodents, phase-locked firing during spindles may facilitate spike-timing-dependent plasticity (STDP) by grouping pre- and post-synaptic cell firing within [~]25ms. Currently, microphysiological evidence in humans for conditions conducive for STDP during spindles is absent. We analyzed local field potentials and supragranular unit spiking during spindles from 10x10 arrays of microelectrodes at 400{micro}m pitch in humans. We found strong tonic and phase-locked increases in firing and co-firing within 25ms during spindles. Co-firing, spindle co-occurrence, and spindle coherence were greatest between sites within [~]2mm, and high co-firing of units on different electrodes was largely restricted to moments of high spindle coherence between those electrodes. Spindles propagated at [~]0.23m/s in distinct patterns, with correlated cell co-firing sequences. These results suggest that spindles may organize spatiotemporal patterns of neuronal co-firing which promote memory consolidation during NREM sleep.

neuroscience↗

Closed loop enhancement and neural decoding of human cognitive control

Cognitive control is the ability to withhold a default, prepotent response in favor of a more adaptive choice. Control deficits are common across mental disorders, including depression, anxiety, and addiction. Thus, a method for improving cognitive control could be broadly useful in disorders with few effective treatments. Here, we demonstrate closed-loop enhancement of one aspect of cognitive control by direct brain stimulation in humans. We stimulated internal capsule/striatum in participants undergoing intracranial epilepsy monitoring as they performed a cognitive control/conflict task. Stimulation enhanced performance, with the strongest effects from dorsal capsule/striatum stimulation. We then developed a framework to detect control lapses and stimulate in response. This closed-loop approach produced larger behavioral changes than open-loop stimulation, with a slight improvement in performance change per unit of energy delivered. Finally, we decoded task performance directly from activity on a small number of electrodes, using features compatible with existing closed-loop brain implants. Our findings are proof of concept for a new approach to treating severe mental disorders, based on directly remediating underlying cognitive deficits.

bioengineering↗

Bidirectional modulation of human emotional conflict resolution using intracranial stimulation

The ability to regulate emotions in the service of meeting ongoing goals and task demands is a key aspect of adaptive human behavior in our volatile social world. Consequently, difficulties in processing and responding to emotional stimuli underlie many psychiatric diseases ranging from depression to anxiety, the common thread being effects on behavior. Behavior, which is made up of shifting, difficult to measure hidden states such as attention and emotion reactivity, is a product of integrating external input and latent mental processes. Directly measuring, and differentiating, separable hidden cognitive, emotional, and attentional states contributing to emotion conflict resolution, however, is challenging, particularly when only using task-relevant behavioral measures such as reaction time. State-space representations are a powerful method for investigating hidden states underlying complex systems. Using state-space modeling of behavior, we identified relevant hidden cognitive states and predicted behavior in a standardized emotion regulation task. After identifying and validating models which best fit the behavior and narrowing our focus to one model, we used targeted intracranial stimulation of the emotion regulation-relevant neurocircuitry, including prefrontal structures and the amygdala, to causally modulate separable states. Finally, we focused on this one validated state-space model to perform real-time, bidirectional closed-loop adaptive stimulation in a subset of participants. These approaches enable an improved understanding of how to sample and understand emotional processing in a way which could be leveraged in neuromodulatory therapy for disorders of emotional regulation.

neuroscience↗

COMPASS: An Open-Source, General-Purpose Software Toolkit for Computational Psychiatry

Mathematical modeling of behavior during psychophysical tasks, referred to as \"computational psychiatry\", could greatly improve our understanding of mental disorders. One barrier to broader adoption of computational methods is that they often require advanced programming skills. We developed the Computational Psychiatry Adaptive State-Space (COMPASS) toolbox, an open-source MATLAB-based software package. After specifying a few parameters in a small set of user-friendly functions, COMPASS allows the user to efficiently fit of a wide range of computational behavioral models. The model output can be analyzed as an experimental outcome or used as a regressor for neural data, and can be tested using goodness-of-fit methods. Here, we demonstrate that COMPASS can replicate two computational behavior analyses from different groups. COMPASS replicates and, in one case, slightly improves on the original modeling results. This flexible, general-purpose toolkit should accelerate the use of computational modeling in psychiatric neuroscience.

bioengineering↗