References of "Massimini, Marcello"
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See detailGlobal structural integrity and effective connectivity in patients with disorders of consciousness
BODART, Olivier ULiege; Amico, Enrico; Gomez, Francisco et al

in Brain Stimulation (in press)

Background Previous studies have separately reported impaired functional, structural, and effective connectivity in patients with disorders of consciousness (DOC). The perturbational complexity index (PCI ... [more ▼]

Background Previous studies have separately reported impaired functional, structural, and effective connectivity in patients with disorders of consciousness (DOC). The perturbational complexity index (PCI) is a transcranial magnetic stimulation (TMS) derived marker of effective connectivity. The global fractional anisotropy (FA) is a marker of structural integrity. Little is known about how these parameters are related to each other. Objective We aimed at testing the relationship between structural integrity and effective connectivity. Methods We assessed 23 patients with severe brain injury more than 4 weeks post-onset, leading to DOC or locked-in syndrome, and 14 healthy subjects. We calculated PCI using repeated single pulse TMS coupled with high-density electroencephalography, and used it as a surrogate of effective connectivity. Structural integrity was measured using the global FA, derived from diffusion weighted imaging. We used linear regression modelling to test our hypothesis, and computed the correlation between PCI and FA in different groups. Results Global FA could predict 74% of PCI variance in the whole sample and 56% in the patients' group. No other predictors (age, gender, time since onset, behavioural score) improved the models. FA and PCI were correlated in the whole population (r = 0.86, p < 0.0001), the patients, and the healthy subjects subgroups. Conclusion We here demonstrated that effective connectivity correlates with structural integrity in brain-injured patients. Increased structural damage level decreases effective connectivity, which could prevent the emergence of consciousness. [less ▲]

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See detailTracking dynamic interactions between structural and functional connectivity: a TMS/EEG-dMRI study
Amico, Enrico; Bodart, Olivier ULiege; Rosanova, Mario et al

in Brain connectivity (2017)

Transcranial magnetic stimulation (TMS) in combination with neuroimaging techniques allows to measure the effects of a direct perturbation of the brain. When coupled to high density electroencephalography ... [more ▼]

Transcranial magnetic stimulation (TMS) in combination with neuroimaging techniques allows to measure the effects of a direct perturbation of the brain. When coupled to high density electroencephalography (TMS/hd-EEG), TMS pulses revealed electrophysiological signatures of different cortical modules in health and disease. However, the neural underpinnings of these signatures remain unclear. Here, by applying multimodal analyses of cortical response to TMS recordings and diffusion magnetic resonance imaging (dMRI) tractography, we investigated the relationship between functional and structural features of different cortical modules in a cohort of awake healthy volunteers. For each subject we computed directed functional connectivity interactions between cortical areas from the source reconstructed TMS/hd- EEG recordings and correlated them with the correspondent structural connectivity matrix extracted from dMRI tractography, in three different frequency bands (alpha, beta, gamma) and two sites of stimulation (left precuneus and left premotor). Each stimulated area appeared to mainly respond to TMS by being functionally elicited in specific frequency bands, i.e. beta for precuneus and gamma for premotor. We also observed a temporary decrease in the whole-brain correlation between directed functional connectivity and structural connectivity after TMS in all frequency bands. Notably, when focusing on the stimulated areas only, we found that the structurefunction correlation significantly increases over time in the premotor area contralateral to TMS. Our study points out the importance of taking into account the major role played by different cortical oscillations when investigating the mechanisms for integration and segregation of information in the human brain. [less ▲]

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See detailCircadian dynamics in measures of cortical excitation and inhibition balance
Chellappa, Sarah; Gaggioni, Giulia ULiege; LY, Julien ULiege et al

in Scientific Reports (2016), 6:33661

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See detailStratification of unresponsive patients by an independently validated index of brain complexity
Casarotto, Silvia; Commanducci, Angel; Rosanova, Mario et al

in Annals of Neurology (2016), 80(5),

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See detailCircadian regulation of human cortical excitability
LY, Julien ULiege; Gaggioni, Giulia ULiege; Chellappa, Sarah et al

in Nature Communications (2016)

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See detailSleep deprivation affects global cortical responsiveness
Gaggioni, Giulia ULiege; Ly, Julien; Chellappa, Sarah et al

Conference (2015, November 02)

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See detailNeuronal excitation/inhibition balance is set by the need for sleep and the biological clock
Phillips, Christophe ULiege; Chellappa, Sarah Laxhmi ULiege; Ly, Julien et al

in NeuroImage (2015, June)

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See detailHuman cortical excitability depends on time awake and circadian phase
Gaggioni, Giulia ULiege; Ly, Julien; Chellappa, Sarah Laxhmi ULiege et al

Poster (2015, January 27)

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See detailTranscranial magnetic stimulation and electroencephalography
Gosseries, Olivia ULiege; Bodart, Olivier ULiege; massimini, Marcello

in Rossetti, Andrea; Laureys, Steven (Eds.) Clinical Neurophysiology in Disorders of Consciousness: Brain monitoring in the ICU and Beyond (2015)

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See detailHuman cortical excitability depends on time spent awake and circadian phase
Ly, Julien ULiege; Gaggioni, Giulia ULiege; Chellappa, Sarah Laxhmi ULiege et al

Scientific conference (2014, October 04)

At any point in time, human performance results from the interaction of two main factors: a circadian signal varying with the time of the day and the sleep need accrued throughout the preceding waking ... [more ▼]

At any point in time, human performance results from the interaction of two main factors: a circadian signal varying with the time of the day and the sleep need accrued throughout the preceding waking period. But what’s happen at the cortical cerebral level? We used a novel technique coupling transcranial magnetic stimulation with electroencephalography (TMS/EEG) to assess the influence of time spent awake and circadian phasis on human cortical excitability. Twenty-two healthy young men underwent 8 TMS/EEG sessions during a 28 hour sleep deprivation protocole. We found that cortical excitability depends on both time spent awake and circadian phasis. [less ▲]

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See detailHuman cortical excitability depends on time awake and circadian phase
Ly, Julien ULiege; Chellappa, Sarah Laxhmi ULiege; Gaggioni, Giulia ULiege et al

Conference (2014, September 17)

At any point in time, human performance results from the interaction of two main factors: a circadian signal varying with the time of the day and the sleep need accrued throughout the preceding waking ... [more ▼]

At any point in time, human performance results from the interaction of two main factors: a circadian signal varying with the time of the day and the sleep need accrued throughout the preceding waking period. But what’s happen at the cortical cerebral level? We used a novel technique coupling transcranial magnetic stimulation with electroencephalography (TMS/EEG) to assess the influence of time spent awake and circadian phasis on human cortical excitability. Twenty-two healthy young men underwent 8 TMS/EEG sessions during a 28 hour sleep deprivation protocole. We found that cortical excitability depends on both time spent awake and circadian phasis. [less ▲]

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See detailDIRECTED INFORMATION TRANSFER IN SCALP ELECTROENCEPHALOGRAPHIC RECORDINGS: INSIGHTS ON DISORDERS OF CONSCIOUSNESS
Marinazzo, Daniele; Gosseries, Olivia ULiege; Boly, Mélanie ULiege et al

in Clinical EEG and Neuroscience : Official Journal of the EEG and Clinical Neuroscience Society (ENCS) (2014)

Introduction: The neural mechanisms underlying electrophysiological changes observed in patients with disorders of consciousness following a coma remain poorly understood. The aim of this article is to ... [more ▼]

Introduction: The neural mechanisms underlying electrophysiological changes observed in patients with disorders of consciousness following a coma remain poorly understood. The aim of this article is to investigate the mechanisms underlying the differences in spontaneous electroencephalography between patients in vegetative/unresponsive wakefulness syndrome, minimally conscious state, emergence of the minimally conscious state and age-matched healthy control subjects. <br />Methods: Forty recording of spontaneous scalp electroencephalography were performed in 27 patients who were comatose on admission, and on healthy controls. Multivariate Granger Causality and Transfer Entropy were applied on the data. <br />Results: Distinctive patterns of putative bottlenecks of information were associated to each conscious state. Healthy controls are characterized by a greater amount of synergetic contributions from duplets of variables. <br />Conclusion: A novel set of measures was tested to get a novel insight on the pattern of information transfer in a network of scalp electrodes in patients with disorders of consciousness. [less ▲]

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See detailCortical excitability depends on time awake and circadian phase
Ly, Julien; Gaggioni, Giulia ULiege; Chellappa, Sarah Laxhmi ULiege et al

Conference (2014)

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See detailRecovery of cortical effective connectivity and recovery of consciousness in vegetative patients.
Rosanova, Mario; Gosseries, Olivia ULiege; Casarotto, Silvia et al

in Brain : A Journal of Neurology (2012), 135(Pt 4), 1308-20

Patients surviving severe brain injury may regain consciousness without recovering their ability to understand, move and communicate. Recently, electrophysiological and neuroimaging approaches, employing ... [more ▼]

Patients surviving severe brain injury may regain consciousness without recovering their ability to understand, move and communicate. Recently, electrophysiological and neuroimaging approaches, employing simple sensory stimulations or verbal commands, have proven useful in detecting higher order processing and, in some cases, in establishing some degree of communication in brain-injured subjects with severe impairment of motor function. To complement these approaches, it would be useful to develop methods to detect recovery of consciousness in ways that do not depend on the integrity of sensory pathways or on the subject's ability to comprehend or carry out instructions. As suggested by theoretical and experimental work, a key requirement for consciousness is that multiple, specialized cortical areas can engage in rapid causal interactions (effective connectivity). Here, we employ transcranial magnetic stimulation together with high-density electroencephalography to evaluate effective connectivity at the bedside of severely brain injured, non-communicating subjects. In patients in a vegetative state, who were open-eyed, behaviourally awake but unresponsive, transcranial magnetic stimulation triggered a simple, local response indicating a breakdown of effective connectivity, similar to the one previously observed in unconscious sleeping or anaesthetized subjects. In contrast, in minimally conscious patients, who showed fluctuating signs of non-reflexive behaviour, transcranial magnetic stimulation invariably triggered complex activations that sequentially involved distant cortical areas ipsi- and contralateral to the site of stimulation, similar to activations we recorded in locked-in, conscious patients. Longitudinal measurements performed in patients who gradually recovered consciousness revealed that this clear-cut change in effective connectivity could occur at an early stage, before reliable communication was established with the subject and before the spontaneous electroencephalogram showed significant modifications. Measurements of effective connectivity by means of transcranial magnetic stimulation combined with electroencephalography can be performed at the bedside while by-passing subcortical afferent and efferent pathways, and without requiring active participation of subjects or language comprehension; hence, they offer an effective way to detect and track recovery of consciousness in brain-injured patients who are unable to exchange information with the external environment. [less ▲]

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See detailBrain connectivity in disorders of consciousness.
Boly, Mélanie ULiege; Massimini, Marcello; Garrido, Marta Isabel et al

in Brain connectivity (2012), 2(1), 1-10

The last 10 years witnessed a considerable increase in our knowledge of brain function in survivors to severe brain injuries with disorders of consciousness (DOC). At the same time, a growing interest ... [more ▼]

The last 10 years witnessed a considerable increase in our knowledge of brain function in survivors to severe brain injuries with disorders of consciousness (DOC). At the same time, a growing interest developed for the use of functional neuroimaging as a new diagnostic tool in these patients. In this context, particular attention has been devoted to connectivity studies-as these, more than measures of brain metabolism, may be more appropriate to capture the dynamics of large populations of neurons. Here, we will review the pros and cons of various connectivity methods as potential diagnostic tools in brain-damaged patients with DOC. We will also discuss the relevance of the study of the level versus the contents of consciousness in this context. [less ▲]

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