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Research ArticleNew Research, Cognition and Behavior

Electrical Stimulation Modulates High γ Activity and Human Memory Performance

Michal T. Kucewicz, Brent M. Berry, Vaclav Kremen, Laura R. Miller, Fatemeh Khadjevand, Youssef Ezzyat, Joel M. Stein, Paul Wanda, Michael R. Sperling, Richard Gorniak, Kathryn A. Davis, Barbara C. Jobst, Robert E. Gross, Bradley Lega, S. Matt Stead, Daniel S. Rizzuto, Michael J. Kahana and Gregory A. Worrell
eNeuro 24 January 2018, 5 (1) ENEURO.0369-17.2018; https://doi.org/10.1523/ENEURO.0369-17.2018
Michal T. Kucewicz
1Department of Neurology, Mayo Clinic, Rochester, MN 55905
2Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905
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Brent M. Berry
1Department of Neurology, Mayo Clinic, Rochester, MN 55905
2Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905
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Vaclav Kremen
1Department of Neurology, Mayo Clinic, Rochester, MN 55905
2Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905
5Czech Institute of Informatics, Robotics and Cybernetics, Czech Technical University, Prague, 166 36 Czech Republic
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Laura R. Miller
1Department of Neurology, Mayo Clinic, Rochester, MN 55905
2Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905
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Fatemeh Khadjevand
1Department of Neurology, Mayo Clinic, Rochester, MN 55905
2Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905
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Youssef Ezzyat
3Department of Psychology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104
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Joel M. Stein
4Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104
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Paul Wanda
3Department of Psychology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104
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Michael R. Sperling
6Department of Neurology, Thomas Jefferson University Hospital, Philadelphia, PA 19107
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Richard Gorniak
7Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107
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Kathryn A. Davis
8Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104
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Barbara C. Jobst
9Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756
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Robert E. Gross
10Department of Neurosurgery, Emory University, Atlanta, GA 30307
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Bradley Lega
11Department of Neurosurgery, UT Southwestern Medical Center, Dallas, TX 75390
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S. Matt Stead
1Department of Neurology, Mayo Clinic, Rochester, MN 55905
2Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905
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Daniel S. Rizzuto
3Department of Psychology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104
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Michael J. Kahana
3Department of Psychology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104
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Gregory A. Worrell
1Department of Neurology, Mayo Clinic, Rochester, MN 55905
2Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905
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  • Figure 1.
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    Figure 1.

    Free recall tasks to study electrophysiological modulation of verbal memory encoding. A, Diagram of the task design, in which subjects memorized word lists for subsequent recall. Thunderbolt marks the words with stimulation on the STIM lists. The remaining word trials were used for electrophysiological analysis and are labeled according to the lists type (NON-STIM or STIM) and their encoding based on subsequent recall (GOOD or POOR). B, Example of an 8 × 8 electrode grid implanted over the lateral TC highlights in red two adjacent contacts used for brain stimulation (connected red dots) in subject 1050. C, Broadband spectrogram (left column) shows trial-averaged power changes aligned to the time of word presentation for encoding, in contrast to the power changes in the signal prefiltered in the four studied frequency bands (middle column), as recorded from a representative electrode example from subject 1111. Line plots on the right summarize the mean power change response independently for the four bands (rows) and separately for the good and poor encoding trials (columns) in the two conditions of list stimulation, color-coded as in A. Notice the difference in peaks of the response (NM index) caused by stimulation in the poor encoding trials specifically in the high γ frequency band.

  • Figure 2.
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    Figure 2.

    Stimulation modulates high γ responses in localized areas activated in the tasks. A, Values of the peak power of the γ responses and the NM index from all 8 × 8 grid electrodes (blue dots, stimulating electrodes in red) of subject 1050, as in Figure 1B, are interpolated and visualized as surface plots overlaid on this subject's brain surface (left side). The first two columns present peaks of the high γ power in the STIM (first) and the NON-STIM (second) conditions, the third column presents the NM index, i.e., the effective difference between the first two columns. Arrows point to a discrete area of peak power modulated by stimulation particularly in the poor encoding trials. B, C, Analogous plots from two other cases of subject 1111 (brain surface rendering was turned upside down to aid visualization) and 1177, respectively. Notice that the high γ modulation is observed also at a distance from the stimulation site in subject 1111 and is not observed in subject 1177.

  • Figure 3.
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    Figure 3.

    Stimulation selectively modulates task responses in the high γ frequency band. A, Spectrogram of trial-averaged high γ response to word presentations recorded on an electrode in the brain area activated in the tasks. B, Active electrodes showing this response were identified as positive outliers of the peak value distribution of this response (red data points above the solid line of UAV). C, Mean NM index of all active electrodes in one stimulated patient (n = 36) is compared among four frequency bands in the poor and good memory encoding conditions. Subplots on the right show post hoc comparison of the group means, dashed lines mark the 95% CI intervals (error bars) for the high γ group, and red indicates significant group with the intervals that do not overlap with any other group. D, Scatterplots with least-square lines show correlations of the NM index values in the poor encoding condition plotted against peak value of the task response (left) and against the distance from the stimulation site (right) for the active electrodes from C. Notice that NM index was proportional to the induced power response and inversely proportional to the distance from the stimulation site.

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    Figure 4.

    High γ responses are positively and negatively modulated in different brain regions. Four electrode examples show modulation of the task-induced high γ activities by stimulation in the lateral TC (red) and the HP (green), as presented in another example from Figure 1C. Arrows mark the positive and negative NM index changes in the three patients who showed the greatest positive (upper rows) and negative (lower rows) behavioral effects of stimulation (Fig. 5).

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    Figure 5.

    Modulation of high γ activity in different brain regions is correlated with behavior. A, Localization of the stimulation sites in the lateral TC (red contact pairs) and the other three brain regions studied (black contact pairs) is visualized in a unified transparent brain surface. B, Stimulation-induced change in memory performance for every subject (each bar is one subject) reveals that stimulation in the TC had a positive effect on performance compared to the other brain regions (PF). Post hoc group comparison (right side) shows that TC scores are greater than PH, HP, PF (dashed lines are 95% CI of the TC group). C, NM index values reveal the same pattern as in B, averaged from all active electrodes in a given group [n = 38 (PH), n = 80 (HP), n = 36 (TC), n = 44 (PFC)]. D, The behavioral and NM index scores averaged for each subject (color-coded dots) are correlated. Least-square line is added in black, crossing the two dashed lines at point 0 indicating no stimulation-induced changes.

Tables

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    Table 1.

    Clinical profile of the study participants

    Subjectno.AgeGenderHandednessSOZMRIBrain pathologyLanguage laterality(method)Stimulation mapping overlapvIQVerbalmemorydeficits
    100148FRRight TCNormalGliosisL (fMRI)-81None
    100620FRRight FCMCDGliosisL (fMRI)-91None
    101631FRLeft FCNormalGliosis-None71None
    101847MLLeft FC,left FPCNormal-L (fMRI)-85None
    102048FLRight TC,right FCAbnormalGliosisL (fMRI)-98Mild
    102224MRAtrophyGliosis/encephalomalacia-L (fMRI)-81None
    102436FRRight OPCNormalGliosisL (unknown)-100None
    102624FRLeft aTCleft OCMTS, gliosis-Bilateral (Wada)-112None
    102748MRRight TC right ICright/left FCAbnormal-L (fMRI)-93None
    102827FRRight MTLAbnormalCD, GliosisL (Wada)-103None
    102933FRLeft FCAbnormal---108Mild
    103023MLLeft MTLNormalGliosisL (fMRI)-106None
    103124MRRight FC right TCAbnormal-L (aphasia)-110Moderate
    103331FRRight TCAtrophy-L (Wada)-85None
    103649MLLeft aTC,left MTLMTSHSBilateral (Wada)-93Moderate
    104227FLRight TCMCD-R (fMRI)None114None
    105020MRLeft PCNeoplasmDNETBilateral (Wada)None95Mild
    106036FRRight TCNormalGliosisL (Wada)-95Mild
    106926MRLeft FCMCD-L (Wada)--Mild
    111120MRLeft TC left OPCleft OCGliosisGliosisL (fMRI)-108None
    117641FRRight MTL right ICMTS-L (Wada)-85Moderate
    117723FRLeft TCTS-L (aphasia)None87Moderate
    • Patient demographic data are presented together with clinical observations from structural MRI, clinically identified seizure onset zones (SOZs), pathology for those subjects who underwent respective surgery, hemispheric laterality of language functions together with the method of determination (“aphasia” means that the determination was done based on an identified lesion/pathology in a specific hemisphere), overlap of the stimulating electrodes with the language areas for patients who have undergone cortical stimulation mapping (“-”; means that the stimulation mapping was not performed or the report was not available), verbal IQ (vIQ), and the clinical qualitative description of verbal memory deficits as concluded in the neuropsychological assessment. FC, frontal cortex; PC, parietal cortex; OC, occipital cortex; IC, insular cortex; aTC, anterior TC; MTL, mesial temporal lobe; TPC, temporo-parietal cortex; FPC, fronto-parietal cortex; OPC, occipito-parietal cortex; CD, cortical dysplasia; HS, hippocampal sclerosis; MCD, malformation of cortical development; MTS, mesial temporal sclerosis; PMG, polymicrogyria; DNET, dysembryoplastic neuroepithelial tumor.

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    Table 2.

    Summary of the experiments used to assess effect of stimulation on encoding of word lists

    SubjectSessionsLocalizationRegionElectrodeAmplitude
    10012Left HPHPDepth1.0
    10062Right HPHPDepth1.0
    10162Left PFPFSubdural3.5
    10182Left PFPFDepth1.5
    10204Right HPHPDepth1.0
    10222Left HPHPDepth1.0
    10243Left HPHPDepth1.0
    10264Left ECPHDepth0.5
    10272Left HPHPDepth1.0
    10283Right ECPHSubdural1.0
    10292Left PFPFSubdural3.5
    10304Left PHCPHDepth0.5
    10312Right PRCPHDepth1.5
    10332Left PRCPHDepth1.5
    10364Left PRCPHDepth1.0
    10422Right PFPFSubdural1.5
    10502Left TCTCSubdural1.5
    10603Right PFPFSubdural3.0
    10692Left PFPFSubdural2.5
    11113Left PHCPHDepth0.75
    11113Left TCTCSubdural1.5
    11763Left TCTCDepth1.0
    11774Left TCTCSubdural1.0
    • Analysis was focused on 23 subject experiments that had at least two sessions with any one stimulation target in four of the studied brain regions. PHC, PH cortex; PRC, perirhinal cortex; EC, entorhinal cortex.

    • View popup
    Table 3.

    Statistical tables for the analyses of variance

    Source of variationSum od squaresDegrees of freedomMean squaresF ratioProbability > F
    NM index in different frequency bands during the poor encoding trials
    Groups0.1017230.0339114.79<0.0001
    Error0.19262840.00229
    Total0.2943487
    NM index in different frequency bands during the good encoding trials
    Groups0.0122630.004091.710.1708
    Error0.20053840.00239
    Total0.2127987
    Effect of stimulation in different brain regions on memory performance
    Groups1.8331130.611047.310.0019
    Error1.58778190.08357
    Total3.420922
    Effect of stimulation in different brain regions on NM
    Groups0.2676530.0892223.27<0.001
    Error0.743631940.00383
    Total1.01128197
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Electrical Stimulation Modulates High γ Activity and Human Memory Performance
Michal T. Kucewicz, Brent M. Berry, Vaclav Kremen, Laura R. Miller, Fatemeh Khadjevand, Youssef Ezzyat, Joel M. Stein, Paul Wanda, Michael R. Sperling, Richard Gorniak, Kathryn A. Davis, Barbara C. Jobst, Robert E. Gross, Bradley Lega, S. Matt Stead, Daniel S. Rizzuto, Michael J. Kahana, Gregory A. Worrell
eNeuro 24 January 2018, 5 (1) ENEURO.0369-17.2018; DOI: 10.1523/ENEURO.0369-17.2018

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Electrical Stimulation Modulates High γ Activity and Human Memory Performance
Michal T. Kucewicz, Brent M. Berry, Vaclav Kremen, Laura R. Miller, Fatemeh Khadjevand, Youssef Ezzyat, Joel M. Stein, Paul Wanda, Michael R. Sperling, Richard Gorniak, Kathryn A. Davis, Barbara C. Jobst, Robert E. Gross, Bradley Lega, S. Matt Stead, Daniel S. Rizzuto, Michael J. Kahana, Gregory A. Worrell
eNeuro 24 January 2018, 5 (1) ENEURO.0369-17.2018; DOI: 10.1523/ENEURO.0369-17.2018
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Keywords

  • brain stimulation
  • cognitive enhancement
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