Magnetic seizure therapy (MST) is emerging as a safe and well-tolerated experimental intervention for major depressive disorder (MDD), with very minimal cognitive side-effects. However, the ...underlying mechanism of action of MST remains uncertain. Here, we used resting-state electroencephalography (RS-EEG) to characterise the physiological effects of MST for treatment resistant MDD. We recorded RS-EEG in 21 patients before and after an open label trial of MST applied over the prefrontal cortex using a bilateral twin coil. RS-EEG was analysed for changes in functional connectivity, network topology, and spectral power. We also ran further baseline comparisons between the MDD patients and a cohort of healthy controls (n = 22). Network-based connectivity analysis revealed a functional subnetwork of significantly increased theta connectivity spanning frontal and parieto-occipital channels following MST. The change in theta connectivity was further found to predict clinical response to treatment. An additional widespread subnetwork of reduced beta connectivity was also elucidated. Graph-based topological analyses showed an increase in functional network segregation and reduction in integration in the theta band, with a decline in segregation in the beta band. Finally, delta and theta power were significantly elevated following treatment, while gamma power declined. No baseline differences between MDD patients and healthy subjects were observed. These results highlight widespread changes in resting-state brain dynamics following a course of MST in MDD patients, with changes in theta connectivity providing a potential physiological marker of treatment response. Future prospective studies are required to confirm these initial findings.
•We utilised rest EEG to characterise physiological changes following MST in MDD.•MST significantly altered functional connectivity, network topology, and spectral power.•Changes in theta connectivity predicted clinical response to MST.•Rest EEG is a sensitive marker of neural response to MST.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
BACKGROUND:Conventional management for concussion involves prescribed rest and progressive return to activity. Recent evidence challenges this notion and suggests that active approaches may be ...effective for some patients. Previous concussion consensus statements provide limited guidance regarding active treatment.
OBJECTIVE:To describe the current landscape of treatment for concussion and to provide summary agreements related to treatment to assist clinicians in the treatment of concussion.
METHODS:On October 14 to 16, 2015, the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion meeting was convened in Pittsburgh, Pennsylvania. Thirty-seven concussion experts from neuropsychology, neurology, neurosurgery, sports medicine, physical medicine and rehabilitation, physical therapy, athletic training, and research and 12 individuals representing sport, military, and public health organizations attended the meeting. The 37 experts indicated their agreement on a series of statements using an audience response system clicker device.
RESULTS:A total of 16 statements of agreement were supported covering (1) Summary of the Current Approach to Treating Concussion, (2) Heterogeneity and Evolving Clinical Profiles of Concussion, (3) TEAM Approach to Concussion TreatmentSpecific Strategies, and (4) Future DirectionsA Call to Research. Support (ie, response of agree or somewhat agree) for the statements ranged from to 97% to 100%.
CONCLUSION:Concussions are characterized by diverse symptoms and impairments and evolving clinical profiles; recovery varies on the basis of modifying factors, injury severity, and treatments. Active and targeted treatments may enhance recovery after concussion. Research is needed on concussion clinical profiles, biomarkers, and the effectiveness and timing of treatments.
ABBREVIATIONS:ARS, audience response systemCDC, Centers for Disease Control and PreventionDoD, Department of DefensemTBI, mild traumatic brain injuryNCAA, National Collegiate Athletic AssociationNFL, National Football LeagueNIH, National Institutes of HealthRCT, randomized controlled trialRTP, return to playSRC, sport- and recreation-related concussionTBI, traumatic brain injuryTEAM, Targeted Evaluation and Active Management
Spontaneous brain activity as assessed with resting-state fMRI exhibits rich spatiotemporal structure. However, the principles by which brain-wide patterns of spontaneous fMRI activity reconfigure ...and interact with each other remain unclear. We used a framewise clustering approach to map spatiotemporal dynamics of spontaneous fMRI activity with voxel resolution in the resting mouse brain. We show that brain-wide patterns of fMRI co-activation can be reliably mapped at the group and subject level, defining a restricted set of recurring brain states characterized by rich network structure. Importantly, we document that the identified fMRI states exhibit contrasting patterns of functional activity and coupled infraslow network dynamics, with each network state occurring at specific phases of global fMRI signal fluctuations. Finally, we show that autism-associated genetic alterations entail the engagement of atypical functional states and altered infraslow network dynamics. Our results reveal a novel set of fundamental principles guiding the spatiotemporal organization of resting-state fMRI activity and its disruption in brain disorders.
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•A limited number of recurring states govern spontaneous fMRI network dynamics•fMRI network states undergo phase-coupled infraslow fluctuations•fMRI network states occur at specific phases of fMRI global signal fluctuations•Autism-related mutations engage atypical brain states and infraslow dynamics
Gutierrez-Barragan et al. report that spontaneous fMRI network activity can be decomposed into a series of transitions between a limited number of fluctuating brain-wide states. State changes are phase locked to fluctuations in fMRI global signal. These results reveal a novel fundamental spatiotemporal structure of resting-state fMRI activity.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Fatigue-related crashes, which are mainly caused by drowsy or distracted driving, account for a significant portion of fatal accidents on highways. Smart vehicle technologies can address this issue ...of road safety to improve the sustainability of transportation systems. Advanced driver-assistance system (ADAS) can aid drowsy drivers by recommending and guiding them to rest locations. Past research shows a significant correlation between driving distance and driver fatigue, which has been actively studied in the analysis of resting behavior. Previous research efforts have mainly relied on survey methods at specific locations, such as rest areas or toll booths. However, such traditional methods, like field surveys, are expensive and often produce biased results, based on sample location and time. This research develops methods to better estimate travel resting behavior by utilizing a large-scale dataset obtained from car navigation systems, which contain 591,103 vehicle trajectories collected over a period of four months in 2014. We propose an algorithm to statistically categorize drivers according to driving distances and their number of rests. The main algorithm combines a statistical hypothesis test and a random sampling method based on the renowned Monte-Carlo simulation technique. We were able to verify that cumulative travel distance shares a significant relationship with one’s resting decisions. Furthermore, this research identifies the resting behavior pattern of drivers based upon their travel distances. Our methodology can be used by sustainable traffic safety operators to their driver guiding strategies criterion using their own data. Not only will our methodology be able to aid sustainable traffic safety operators in constructing their driver guidance strategies criterion using their own data, but it could also be implemented in actual car navigation systems as a mid-term solution. We expect that ADAS combined with the proposed algorithm will contribute to improving traffic safety and to assisting the sustainability of road systems.
At rest, the brain's sensorimotor and higher cognitive systems engage in organized patterns of correlated activity forming resting-state networks. An important empirical question is how functional ...connectivity and structural connectivity within and between resting-state networks change with age. In this study we use network modeling techniques to identify significant changes in network organization across the human lifespan. The results of this study demonstrate that whole-brain functional and structural connectivity both exhibit reorganization with age. On average, functional connections within resting-state networks weaken in magnitude while connections between resting-state networks tend to increase. These changes can be localized to a small subset of functional connections that exhibit systematic changes across the lifespan. Collectively, changes in functional connectivity are also manifest at a system-wide level, as components of the control, default mode, saliency/ventral attention, dorsal attention, and visual networks become less functionally cohesive, as evidenced by decreased component modularity. Paralleling this functional reorganization is a decrease in the density and weight of anatomical white-matter connections. Hub regions are particularly affected by these changes, and the capacity of those regions to communicate with other regions exhibits a lifelong pattern of decline. Finally, the relationship between functional connectivity and structural connectivity also appears to change with age; functional connectivity along multi-step structural paths tends to be stronger in older subjects than in younger subjects. Overall, our analysis points to age-related changes in inter-regional communication unfolding within and between resting-state networks.
•We model changes in functional and structural connectivity as a function of age.•Functional connections within/between RSNs decrease/increase with age.•Structural hubs become less-efficiently connected to other regions with age.•With age, functional connections are supported by longer structural paths.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
•Pediatric cardiac catheterization, which is performed by accessing the femoral vessel, requires immobilization and bed rest for 4 to 6 h to prevent postprocedure vascular complications.•Studies in ...adults suggest that after use of the same access site, the immobilization time can be safely reduced to 1.5–2 h after catheterization.•There were no significant hemostatic complications after 2 h of bed rest following pediatric catheterization; therefore, 2 h of bed rest was as safe as 4 h of bed rest.
Pediatric cardiac catheterization, which is performed by accessing the femoral vessel, requires immobilization and bed rest for 4–6 h to prevent vascular complications. Studies in adults suggest that the immobilization time for the same access can be safely reduced to approximately 2 h after catheterization. However, it is unclear whether bed-rest time can be safely decreased after catheterization in children.
To assess the effects of bed-rest duration on bleeding, vascular complications, pain level, and the use of additional sedatives after transfemoral cardiac catheterization in children with congenital heart disease.
This study was an open-label, randomized, controlled, posttest-only design, including 86 children who underwent cardiac catheterization. Children were allocated to receive either 2 h of bed rest (n = 42) in the experimental group or 4 h of bed rest (n = 42) in the control group following catheterization.
The mean age of children was 3.93 (±3.82) years in the experimental group and 5.63 (±3.97) years in the control group. There was no difference in site bleeding incidence (P = 0.214), vascular complication score (P = 0.082), pain level (P = 0.445), or additional sedation use (P = 1.000) between the two groups.
There were no significant hemostatic complications after 2 h of bed rest following pediatric catheterization; therefore, 2 h of bed rest was as safe as 4 h of bed rest. (Trial registration: KCT0007737).
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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•Comprehensive examination of 17 cortical resting-state fMRI (rs-fMRI) networks.•Resting-state networks responded differentially to changes in rest condition.•More external ...stimulation led to more changes in rs-fMRI functional connectivity.•Default-mode network was affected by eyes open and closed conditions.•Internal cognitive processing was not observed to affect connectivity.
Optimal conditions for resting-state functional magnetic resonance imaging (rs-fMRI) are still highly debated. Here, we comprehensively assessed the effects of various rest conditions on all cortical resting-state networks (RSNs) defined by an established atlas. Twenty-two healthy college students (22 ± 4 years old, 12 females) were scanned on a GE 3T MRI scanner. Rs-fMRI datasets were collected under four different conditions for each subject: (1) eyes open in dim light (Eyes-Open), (2) eyes closed and awake (Eyes-Closed), (3) eyes closed while remembering four numbers through the scan session (Eyes-Closed-Number) and (4) asked to watch a movie (Movie). We completed a thorough examination of the 17 functional RSNs defined by Yeo and colleagues. Importantly, the movie led to changes in global connectivity and should be avoided as a rest condition. Conversely, there were no significant connectivity differences between conditions within the frontoparietal control and limbic networks and the following subnetworks as defined by Yeo et al.: default-B, dorsal-attention-B and salience/ventral-attention-B. These were not even significant when compared to the highly stimulative Movie condition. A significant difference was not found between Eyes-Closed and Eyes-Closed-Number conditions in whole-brain, within-network and between-network comparisons. When considering other rest conditions, however, we observed connectivity changes in some subnetworks, including those of the default-mode network. Overall, we found conditions with more external stimulation led to more changes in functional connectivity during rs-fMRI. In conclusion, the comprehensive results of our study can aid in choosing rest conditions for the study of overall and specific functional networks.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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