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control
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familiar speech
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Example: Coherence of left
contact 0/3 with Cz/Fz.
Black
curve:
familiar
speech, red curve: control,
black line: p=0.05 level of
significant coherence
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Conclusions
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1.Schiff ND, Giacino JT, Kalmar K et al. Behavioural improvements with thalamic
stimulation after severe traumatic brain injury. Nature 2007;448:600-3.
2.Eickhoff SB, Dafotakis M, Grefkes C et al. fMRI reveals cognitive and emotional
processing in a long-term comatose patient. Exp Neurol 2008;214:240-6.
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The study provides electrophysiological evidence by
means of increased oscillatory activity in the theta
band for the responsiveness of the central thalamus to
emotionally relevant and directly addressing speech.
The finding that oscillatory power changes could also
be recorded with bipolar reference indicates that this
activity is generated in the thalamus rather than being
far field potentials from the amygdala or STS. This
local thalamic activation reflects involvement of the
central thalamus in emotional and cognitive
processing in a comatose patient.
C
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•Time frequency analysis for stimulus-specific induced
power changes from baseline
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d.
Mean (SD) of LFP-sEEG
coherence (3-9 Hz) across
all channels for familiar
versus
control
stimuli,
*** p<0.001
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0.01
•Stimulus specific LFP-sEEG coherence analysis
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C
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1000
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1 cm
F1
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+40µV
Induced power changes
from baseline (-500 to 0
msec). Difference between
familiar addressing speech
and neutral speech stimuli,
contact 0/1 bipolar
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5
•Auditory control stimuli (4sec, 137 trials): non familiar
speaker pronouncing neutral words without addressing
the patient
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•Auditory stimuli (4sec, 137 trials) that evoked strongest
activity in the previous fMRI experiment: recordings of
the patient’s children addressing the patient
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p
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-40 µv
C
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•Postoperative intracranial LFP and surface EEG
(sEEG) recordings
yr
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yr
Hz
•LFP-sEEG coherence (3-9 Hz) was significant higher
during familiar speech
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•Significant differences could be recorded both from
monopolar and bipolar electrode references
-500
•DBS electrodes were bilaterally implanted in the
internal medullary lamina and the nucleus
reticularis thalami
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•This effect was found bilaterally
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•Power significantly increased (t=5, p< 0.001) about
200 ms after speech onset and during stimulus
presentation in the 5-7 Hz band during familiar speech
compared to control stimuli
Po
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There is evidence for possible arousal effects in
patients with minimal conscious state by deep brain
stimulation (DBS) of the central thalamus.[1]
Functional magnetic resonance tomography imaging
(fMRI) revealed emotional and cognitive processing
by activity increase in the superior temporal sulcus
(STS) and the amygdala in response to familiar
speech in a long-term comatose patient that was later
on selected for central-thalamic DBS.[2] The objective
of this study was to determine by means of
postoperative local field potential (LFP) recordings
from implanted DBS electrodes if the central thalamus
is also activated by these emotionally relevant stimuli.
Thus, activation could reflect involvement of the
central thalamus in emotional and cognitive
processing.
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3)
Eickhoff ,
Results
Planned trajectory (drawing from: J.K. Mai, Atlas of the Human Brain, coronar
slice, 10.7 mm behind AC) for stimulation of the internal medullary lamina
(iml) and the Ncl. reticluaris thalami (Rt), red line: AC-PC line
C
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S.
D.
S.
J. Vesper4), A. Schnitzler1)2)
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1)
Petri ,
Po
s
1)2)
Elben ,
1) Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University Düsseldorf
2) Department of Neurology / Centre for Movement Disorders and Neuromodulation, Heinrich-Heine-University Düsseldorf
3) Translational Brain Medicine in Psychiatry und Neurology, Department of Psychiatry and Psychotherapy, RWTH Aachen
4) Department of Stereotactic and Functional Neurosurgery / Centre for Movement Disorders and Neuromodulation, Heinrich-HeineUniversity Düsseldorf
all in Germany
Objectives
Introduction
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1)2)
Wojtecki ,
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Increase of central thalamic theta oscillations in response to
familiar speech in a long term comatose patient