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- ItemDynamic patterns of expertise: The case of orthopedic medical diagnosis(San Francisco, CA : Public Library of Science (PLoS), 2016) Assaf, D.; Amar, E.; Marwan, N.; Neuman, Y.; Salai, M.; Rath, E.
- ItemBrain anomaly networks uncover heterogeneous functional reorganization patterns after stroke([Amsterdam u.a.] : Elsevier, 2018) Zou, Yong; Zhao, Zhiyong; Yin, Dazhi; Fan, Mingxia; Small, Michael; Liu, Zonghua; Hilgetag, Claus C.; Kurths, JürgenStroke has a large physical, psychological, and financial burden on patients, their families, and society. Based on functional networks (FNs) constructed from resting state fMRI data, network connectivity after stroke is commonly conjectured to be more randomly reconfigured. We find that this hypothesis depends on the severity of stroke. Head movement-corrected, resting-state fMRI data were acquired from 32 patients after stroke, and 37 healthy volunteers. We constructed anomaly FNs, which combine time series information of a patient with the healthy control group. We propose data-driven techniques to automatically identify regions of interest that are stroke relevant. Graph analysis based on anomaly FNs suggests consistently that strong connections in healthy controls are broken down specifically and characteristically for brain areas that are related to sensorimotor functions and frontoparietal control systems, but new links in stroke patients are rebuilt randomly from all possible areas. Entropic measures of complexity are proposed for characterizing the functional connectivity reorganization patterns, which are correlated with hand and wrist function assessments of stroke patients and show high potential for clinical use.
- ItemApplication of optical coherence tomography for in vivo monitoring of the meningeal lymphatic vessels during opening of blood–brain barrier: mechanisms of brain clearing(Bellingham, Wash. : SPIE, 2017) Semyachkina-Glushkovskaya, Oxana; Abdurashitov, Arkady; Dubrovsky, Alexander; Bragin, Denis; Bragina, Olga; Shushunova, Natalia; Maslyakova, Galina; Navolokin, Nikita; Bucharskaya, Alla; Tuchind, Valery; Kurths, Jürgen; Shirokov, AlexanderThe meningeal lymphatic vessels were discovered 2 years ago as the drainage system involved in the mechanisms underlying the clearance of waste products from the brain. The blood–brain barrier (BBB) is a gatekeeper that strongly controls the movement of different molecules from the blood into the brain. We know the scenarios during the opening of the BBB, but there is extremely limited information on how the brain clears the substances that cross the BBB. Here, using the model of sound-induced opening of the BBB, we clearly show how the brain clears dextran after it crosses the BBB via the meningeal lymphatic vessels. We first demonstrate successful application of optical coherence tomography (OCT) for imaging of the lymphatic vessels in the meninges after opening of the BBB, which might be a new useful strategy for noninvasive analysis of lymphatic drainage in daily clinical practice. Also, we give information about the depth and size of the meningeal lymphatic vessels in mice. These new fundamental data with the applied focus on the OCT shed light on the mechanisms of brain clearance and the role of lymphatic drainage in these processes that could serve as an informative platform for a development of therapy and diagnostics of diseases associated with injuries of the BBB such as stroke, brain trauma, glioma, depression, or Alzheimer disease.
- ItemCardio-respiratory coordination increases during sleep apnea(San Francisco, CA : Public Library of Science (PLoS), 2014) Riedl, M.; Müller, A.; Kraemer, J.F.; Penzel, T.; Kurths, J.; Wessel, N.Cardiovascular diseases are the main source of morbidity and mortality in the United States with costs of more than $170 billion. Repetitive respiratory disorders during sleep are assumed to be a major cause of these diseases. Therefore, the understanding of the cardio-respiratory regulation during these events is of high public interest. One of the governing mechanisms is the mutual influence of the cardiac and respiratory oscillations on their respective onsets, the cardiorespiratory coordination (CRC). We analyze this mechanism based on nocturnal measurements of 27 males suffering from obstructive sleep apnea syndrome. Here we find, by using an advanced analysis technique, the coordigram, not only that the occurrence of CRC is significantly more frequent during respiratory sleep disturbances than in normal respiration (p-value<10-51) but also more frequent after these events (p-value<10-15). Especially, the latter finding contradicts the common assumption that spontaneous CRC can only be observed in epochs of relaxed conditions, while our newly discovered epochs of CRC after disturbances are characterized by high autonomic stress. Our findings on the connection between CRC and the appearance of sleep-disordered events require a substantial extension of the current understanding of obstructive sleep apneas and hypopneas.
- ItemSleep apnea-hypopnea quantification by cardiovascular data analysis(San Francisco, CA : Public Library of Science (PLoS), 2014) Camargo, S.; Riedl, M.; Anteneodo, C.; Kurths, J.; Penzel, T.; Wessel, N.Sleep disorders are a major risk factor for cardiovascular diseases. Sleep apnea is the most common sleep disturbance and its detection relies on a polysomnography, i.e., a combination of several medical examinations performed during a monitored sleep night. In order to detect occurrences of sleep apnea without the need of combined recordings, we focus our efforts on extracting a quantifier related to the events of sleep apnea from a cardiovascular time series, namely systolic blood pressure (SBP). Physiologic time series are generally highly nonstationary and entrap the application of conventional tools that require a stationary condition. In our study, data nonstationarities are uncovered by a segmentation procedure which splits the signal into stationary patches, providing local quantities such as mean and variance of the SBP signal in each stationary patch, as well as its duration L. We analysed the data of 26 apneic diagnosed individuals, divided into hypertensive and normotensive groups, and compared the results with those of a control group. From the segmentation procedure, we identified that the average duration 〈L〉, as well as the average variance 〈σ2〉, are correlated to the apnea-hypoapnea index (AHI), previously obtained by polysomnographic exams. Moreover, our results unveil an oscillatory pattern in apneic subjects, whose amplitude S∗ is also correlated with AHI. All these quantities allow to separate apneic individuals, with an accuracy of at least 79%. Therefore, they provide alternative criteria to detect sleep apnea based on a single time series, the systolic blood pressure.
- ItemCoupling between leg muscle activation and EEG during normal walking, intentional stops, and freezing of gait in Parkinson's disease(Lausanne : Frontiers Media, 2019) Günther, Moritz; Bartsch, Ronny P.; Miron-Shahar, Yael; Hassin-Baer, Sharon; Inzelberg, Rivka; Kurths, Jürgen; Plotnik, Meir; Kantelhardt, Jan W.In this paper, we apply novel techniques for characterizing leg muscle activation patterns via electromyograms (EMGs) and for relating them to changes in electroencephalogram (EEG) activity during gait experiments. Specifically, we investigate changes of leg-muscle EMG amplitudes and EMG frequencies during walking, intentional stops, and unintended freezing-of-gait (FOG) episodes. FOG is a frequent paroxysmal gait disturbance occurring in many patients suffering from Parkinson's disease (PD). We find that EMG amplitudes and frequencies do not change significantly during FOG episodes with respect to walking, while drastic changes occur during intentional stops. Phase synchronization between EMG signals is most pronounced during walking in controls and reduced in PD patients. By analyzing cross-correlations between changes in EMG patterns and brain-wave amplitudes (from EEGs), we find an increase in EEG-EMG coupling at the beginning of stop and FOG episodes. Our results may help to better understand the enigmatic pathophysiology of FOG, to differentiate between FOG events and other gait disturbances, and ultimately to improve diagnostic procedures for patients suffering from PD. Copyright © 2019 Günther, Bartsch, Miron-Shahar, Hassin-Baer, Inzelberg, Kurths, Plotnik and Kantelhardt.
- ItemIncreasing Human Performance by Sharing Cognitive Load Using Brain-to-Brain Interface(Lausanne : Frontiers Research Foundation, 2018) Maksimenko, Vladimir A.; Hramov, Alexander E.; Frolov, Nikita S.; Lüttjohann, Annika; Nedaivozov, Vladimir O.; Grubov, Vadim V.; Runnova, Anastasia E.; Makarov, Vladimir V.; Kurths, Jürgen; Pisarchik, Alexander N.Brain-computer interfaces (BCIs) attract a lot of attention because of their ability to improve the brain's efficiency in performing complex tasks using a computer. Furthermore, BCIs can increase human's performance not only due to human-machine interactions, but also thanks to an optimal distribution of cognitive load among all members of a group working on a common task, i.e., due to human-human interaction. The latter is of particular importance when sustained attention and alertness are required. In every day practice, this is a common occurrence, for example, among office workers, pilots of a military or a civil aircraft, power plant operators, etc. Their routinely work includes continuous monitoring of instrument readings and implies a heavy cognitive load due to processing large amounts of visual information. In this paper, we propose a brain-to-brain interface (BBI) which estimates brain states of every participant and distributes a cognitive load among all members of the group accomplishing together a common task. The BBI allows sharing the whole workload between all participants depending on their current cognitive performance estimated from their electrical brain activity. We show that the team efficiency can be increased due to redistribution of the work between participants so that the most difficult workload falls on the operator who exhibits maximum performance. Finally, we demonstrate that the human-to-human interaction is more efficient in the presence of a certain delay determined by brain rhythms. The obtained results are promising for the development of a new generation of communication systems based on neurophysiological brain activity of interacting people. Such BBIs will distribute a common task between all group members according to their individual physical conditions.
- ItemNeural Interactions in a Spatially-Distributed Cortical Network During Perceptual Decision-Making(Lausanne : Frontiers Media, 2019) Maksimenko, Vladimir A.; Frolov, Nikita S.; Hramov, Alexander E.; Runnova, Anastasia E.; Grubov, Vadim V.; Kurths, Jürgen; Pisarchik, Alexander N.Behavioral experiments evidence that attention is not maintained at a constant level, but fluctuates with time. Recent studies associate such fluctuations with dynamics of attention-related cortical networks, however the exact mechanism remains unclear. To address this issue, we consider functional neuronal interactions during the accomplishment of a reaction time (RT) task which requires sustained attention. The participants are subjected to a binary classification of a large number of presented ambiguous visual stimuli with different degrees of ambiguity. Generally, high ambiguity causes high RT and vice versa. However, we demonstrate that RT fluctuates even when the stimulus ambiguity remains unchanged. The analysis of neuronal activity reveals that the subject's behavioral response is preceded by the formation of a distributed functional network in the β-frequency band. This network is characterized by high connectivity in the frontal cortex and supposed to subserve a decision-making process. We show that neither the network structure nor the duration of its formation depend on RT and stimulus ambiguity. In turn, RT is related to the moment of time when the β-band functional network emerges. We hypothesize that RT is affected by the processes preceding the decision-making stage, e.g., encoding visual sensory information and extracting decision-relevant features from raw sensory information. © Copyright © 2019 Maksimenko, Frolov, Hramov, Runnova, Grubov, Kurths and Pisarchik.
- ItemBistable firing pattern in a neural network model(Lausanne : Frontiers Media, 2019) Protachevicz, Paulo R.; Borges, Fernando S.; Lameu, Ewandson L.; Ji, Peng; Iarosz, Kelly C.; Kihara, Alexandre H.; Caldas, Ibere L.; Szezech Jr., Jose D.; Baptista, Murilo S.; Macau, Elbert E.N.; Antonopoulos, Chris G.; Batista, Antonio M.; Kurths, JürgenExcessively high, neural synchronization has been associated with epileptic seizures, one of the most common brain diseases worldwide. A better understanding of neural synchronization mechanisms can thus help control or even treat epilepsy. In this paper, we study neural synchronization in a random network where nodes are neurons with excitatory and inhibitory synapses, and neural activity for each node is provided by the adaptive exponential integrate-and-fire model. In this framework, we verify that the decrease in the influence of inhibition can generate synchronization originating from a pattern of desynchronized spikes. The transition from desynchronous spikes to synchronous bursts of activity, induced by varying the synaptic coupling, emerges in a hysteresis loop due to bistability where abnormal (excessively high synchronous) regimes exist. We verify that, for parameters in the bistability regime, a square current pulse can trigger excessively high (abnormal) synchronization, a process that can reproduce features of epileptic seizures. Then, we show that it is possible to suppress such abnormal synchronization by applying a small-amplitude external current on > 10% of the neurons in the network. Our results demonstrate that external electrical stimulation not only can trigger synchronous behavior, but more importantly, it can be used as a means to reduce abnormal synchronization and thus, control or treat effectively epileptic seizures. © 2019 Protachevicz, Borges, Lameu, Ji, Iarosz, Kihara, Caldas, Szezech, Baptista, Macau, Antonopoulos, Batista and Kurths.
- ItemFood and agricultural approaches to reducing malnutrition (FAARM): Protocol for a cluster-randomised controlled trial to evaluate the impact of a Homestead Food Production programme on undernutrition in rural Bangladesh(London : BMJ Publishing Group, 2019) Wendt, Amanda S.; Sparling, Thalia M.; Waid, Jillian L.; Mueller, Anna A.; Gabrysch, SabineIntroduction Chronic undernutrition affects over 150 million children worldwide and has serious consequences. The causes are complex and include insufficient dietary diversity and poor hygiene practices. Systematic reviews of nutrition-sensitive agricultural interventions concluded that while these hold promise, there is insufficient evidence for their impact on child growth. The Food and Agricultural Approaches to Reducing Malnutrition (FAARM) project is a 1:1 cluster-randomised trial aiming to evaluate the impact of a Homestead Food Production (HFP) programme implemented by Helen Keller International on women's and children's undernutrition. Methods and analysis The HFP intervention comprises training of women's groups and asset distribution to support year-round home gardening, poultry rearing and improved nutrition and hygiene practices. Formal trainings are supplemented by behaviour change communication during household visits, and facilitated links between producer groups and market actors. The FAARM trial will examine if and how this complex intervention reduces undernutrition. In 2015, FAARM enrolled married women and their children (0-3 years) in 96 rural settlements of Habiganj district in Sylhet division, Bangladesh. Covariate-constrained randomisation was used to assign 48 settlements to receive a 3-year HFP intervention, with the other 48 acting as controls, targeting over 2700 women. To study impact pathways, a surveillance system collects data on all participants every 2 months. In late 2019, children 0-3 years of age (born during the intervention period) will be surveyed, thus capturing impact during the critical first 1000 days of life. Children's length/height-for-age z-scores will be compared between intervention and control arms using mixed-effects linear regression. Secondary outcomes include women's and children's micronutrient status, dietary intake, dietary diversity and other indicators of child growth, development and morbidity. Ethics and dissemination Ethical approval was received in Bangladesh and Germany. Results will be disseminated through peer-reviewed publications and presentations in Bangladesh and internationally. Trial registration number NCT02505711; Pre-results. © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.
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