@article{ca2c8552709c4c3a82602d9fc3b58c48,
title = "Cognitive effort decreases beta, alpha, and theta coherence and ends afterdischarges in human brain",
abstract = "Objective: Mental activation has been reported to modify the occurrence of epileptiform activity. We studied its effect on afterdischarges. Method: In 15 patients with implanted electrodes we presented cognitive tasks when afterdischarges occurred. We developed a wavelet cross-coherence function to analyze the electrocorticography before and after the tasks and compared findings when cognitive tasks did or did not result in afterdischarge termination. Six patients returned for functional MRI (fMRI) testing, using similar tasks. Results: Cognitive tasks often could terminate afterdischarges when direct abortive stimulation could not. Wavelet cross-coherence analysis showed that, when afterdischarges stopped, there was decreased coherence throughout the brain in the 7.13–22.53 Hz frequency ranges (p values 0.008–0.034). This occurred a) regardless of whether an area activated on fMRI and b) regardless of whether there were afterdischarges in the area. Conclusions: It is known that cognitive tasks can alter localized or network synchronization. Our results show that they can change activity throughout the brain. These changes in turn can terminate localized epileptiform activity. Significance: Cognitive tasks result in diffuse brain changes that can modify focal brain activity. Combined with a seizure detection device, cognitive activation might provide a non-invasive method of terminating or modifying seizures.",
keywords = "Afterdischarges, Attention, Cognition, Coherence, Effort",
author = "Lesser, {Ronald P.} and Webber, {W. R.S.} and Miglioretti, {Diana L.} and Pillai, {Jay J.} and Shruti Agarwal and Susumu Mori and Morrison, {Peter F.} and Stefano Castagnola and Adeshola Lawal and Lesser, {Helen J.}",
note = "Funding Information: Rebecca Fisher, Karen George, Viktar Kanasevich, and Noelle Stewart performed clinical stimulation testing, Nathan Crone directed clinical CT/MRI reconstructions, and advised regarding use of Photoshop to annotate the reconstructions. Cameron Davis and Mel Gross in the Argye Hillis lab performed neglect testing. Joe Gillen assembled test sequences for, and Terri Brawner, Kathleen Kahl, and Ivana Kusevic performed, the fMRI evaluations. We thank Danielle Bassett, Dana Boatman, Nathan Crone, Nancy Kopell, Sarah Muldoon, Amir-Homayoon Najmi, Bill Sutherling, and Roger Traub for discussions, and thank the patients and controls who came for the fMRI studies. RPL conceived the AST paradigms for the clinical evaluations and fMRI studies, participated in assessing and marking ECoG recordings, instructed subjects regarding and was present for fMRI studies, analyzed the data and wrote the paper, together with WRSW and DLM. WRSW participated in and directed assessment and marking of ECoG recordings, developed the software for viewing, and participated in marking, the ECoG, carried out waveform and coherence analyses. SC, AL and HJL participated in marking the ECoG recordings. DLM performed statistical analyses of the results. PFM cared for the initial patient. JJP participated in developing the fMRI paradigms. JJP and SA analyzed the fMRI recordings. SM performed fMRI reconstructions. All co-authors reviewed the manuscript. RPL and JJP are co-senior authors for this manuscript. The study was funded by gifts from patients and their families. Dr. Lesser or his wife has stock in the following companies which sell health care products: Abbott Labs, Abbvie, Apple, Avanos, Celgene, Express Scripts, Johnson and Johnson, Merck & Company, Pfizer. These have been disclosed to and approved by the Johns Hopkins University in accordance with its conflict of interest policies. Dr. Mori is the partial owner and CEO of AnatomyWorks. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies. Under a license agreement between AnatomyWorks and the Johns Hopkins University, Dr. Mori and the University are entitled to royalty distributions related to the brain segmentation technology described in the study. The other authors report no conflicts. Publisher Copyright: {\textcopyright} 2019 International Federation of Clinical Neurophysiology",
year = "2019",
month = nov,
doi = "10.1016/j.clinph.2019.07.007",
language = "English (US)",
volume = "130",
pages = "2169--2181",
journal = "Clinical Neurophysiology",
issn = "1388-2457",
publisher = "Elsevier Ireland Ltd",
number = "11",
}