Brain Communications

BackgroundEpilepsy affects approximately 50 million individuals worldwide, with nearly one-third developing drug-resistant epilepsy (DRE). The centromedian nucleus of the thalamus (CM) and the brainstem are integral components of seizure-modulating networks and represent promising targets for neuromodulation. This study aimed to map structural connectivity between CM and specific brainstem nuclei using probabilistic tractography and to evaluate whether connectivity patterns correlate with seizur...

About half of patients who undergo epilepsy surgery for drug-resistant epilepsy have seizure recurrence, supporting the need for approaches that more accurately identify the epileptogenic zone, defined as the brain areas whose removal causes cessation of seizures. Altered network connectivity has emerged as a candidate biomarker of the epileptogenic zone, but how connectivity is altered in the epileptogenic zone remains uncertain, with prior studies reporting inconsistent results. We hypothesize...

ObjectiveTo delineate the phenotype of juvenile myoclonic epilepsy (JME) with a focus on obsessive-compulsive personality disorder (OCPD) using multimodal psychiatric, neuropsychological, quantitative EEG (qEEG), and structural MRI markers within a predictive-processing/free-energy framework. MethodsWe prospectively studied 65 patients with JME and 68 matched healthy controls (HC). Participants completed DSM-IV SCID I/II interviews and a neuropsychological battery assessing working memory, psyc...

Effective connectivity of the human insula, mainly assessed at rest using cortico-cortical evoked potentials (CCEPs), is not yet fully characterized at high-resolution. Here, we significantly extend prior CCEP studies of the insula by leveraging an extensive multicenter CCEP database and fine-grained anatomical atlases of the insula. We analyzed CCEP datasets from 897 patients with refractory focal epilepsy (459 females, age: 26{+/-}14 years) explored by stereo electroencephalography and with a...

ObjectiveQuantitative assessment of extent of tissue resection following epilepsy surgery requires accurate delineation of the resection cavity on postoperative MRI. Current methods for resection cavity masking are time-consuming and labour-intensive, while existing automated approaches exhibit variable segmentation accuracy, particularly on extra-temporal resections. We developed MELD-PostOp, a deep learning tool trained and evaluated on a large, international, heterogeneous cohort to automatic...

Epilepsy is among the most prevalent neurological disorders, affecting millions of individuals worldwide at every stage of life. Characterised by recurrent seizures, epilepsy can significantly disrupt daily functioning, education, employment, and overall quality of life. Despite advances in neuroimaging, current approaches often overlook the individualised nature of brain disruptions in epilepsy. Here, we introduce an individualised functional Magnetic Resonance Imaging (fMRI) framework, Adjuste...

Lesion network mapping (LNM) links focal brain lesions to distributed neural circuits by projecting lesion locations through a normative functional connectome. van den Heuvel and colleagues recently showed how commonly used LNM procedures generate maps that converge on nonspecific, low-dimensional properties of the connectome, introducing a bias. Consequently, many published maps of different conditions appear strikingly similar. Here, we offer an alternative approach that does highlight distinc...

White matter microstructural abnormalities are increasingly found to be associated with cognitive impairment in Alzheimers Disease (AD). Here, we investigated the relationship between visual short-term memory (VSTM) performance, measured using a digital cognitive task, and integrity of brain white matter tracts. 52 AD and 60 age-matched healthy controls were recruited from the Oxford Cognitive Disorders Clinic. An established digital VSTM test - the Oxford Memory Task (OMT) - was used to measur...

BackgroundDeep brain stimulation has emerged as an effective investigational treatment for select cases of severe Gilles de la Tourette Syndrome. Defining the optimal stimulation sites within different targets and the specific tic improvement network across targets will be important to guide neuromodulation therapies. MethodsThis retrospective multi-center cohort study analyzed stimulation locations in patients who received bilateral deep brain stimulation for Gilles de la Tourette Syndrome acr...

Biomarkers from diverse methodological domains are increasingly important in the detection, diagnosis and tracking of neurological diseases and brain health, yet they are often evaluated in isolation. Statistical integration approaches, such as factor analysis, provide a means to combine complementary biomarkers and capture higher-order domains of brain health. Exploratory factor analysis has previously been employed to identify latent brain health constructs using multimodal MRI, fluid biomarke...

BackgroundOscillations underpin a large spectrum of brain function. Brain oscillations are altered by neuromodulation approaches including deep brain stimulation (DBS), but a mechanistic understanding of the brain oscillation - DBS interaction is missing. DBS is predominantly used in the treatment of Parkinsons disease. DBS can induce or alter pre-existing narrow frequency band gamma oscillations at half the stimulation frequency. Such half-harmonic responses have been interpreted as entrainmen...

IntroductionSleep spindles are electroencephalographic elements characteristic of non-rapid eye movement sleep generated by thalamo-cortical interactions. Spindles have been linked to some of the cognitive benefits afforded by sleep and high spindle activity is associated with increased arousal threshold (deeper sleep). Here, we demonstrate that targeting the thalamus with Transcranial Electrical Stimulation with Temporal Interference (TES-TI) can enhance spindle activity. Methods24 participant...

ImportanceTracking and predicting seizure frequency in patients with epilepsy is important for prognostication and therapy management. Interictal spikes have been proposed as a biomarker of seizure burden, but their association with seizure frequency has not been well quantified across epilepsy subtypes. ObjectiveTo measure the association between spike rate and seizure frequency and how this varies by epilepsy subtype. Design, Setting and ParticipantsWe studied 3,614 consecutive routine outpa...

ObjectivesFunctional neurological symptoms which do not meet clinical definitions of functional neurological disorder (FND) are common in clinical practice. Understanding the distinction between these benign functional symptoms and FND is crucial in defining FND as an entity for study, and as a clinical syndrome. We aimed to measure the frequency of functional symptoms in people who do not have FND. MethodsA survey was administered to 95 clinicians who attended an international conference on F...

Type 1 narcolepsy (NT1), a disorder caused by the loss of hypocretin/orexin transmission, is characterized by daytime sleepiness and symptoms where Rapid Eye Movement (REM) sleep, a state normally occurring from middle to late in the night, can intermingle with wakefulness. This results in cataplexy and sleep paralysis, episodes of muscle paralysis when awake, or in the generation of dream-like hallucinations and vivid dreaming, periods of visual imagery or sensory experiences that occur while a...

Oscillatory coupling between respiration, heart rate, and cortical function is fundamental to physiological regulation yet remains poorly characterized in humans. Diminished respiratory heart rate variability (RespHRV)--the rhythmic heart rate modulation accompanying respiration--has emerged as a transdiagnostic biomarker of mental and physical health, reduced in anxiety, depression, cardiovascular disease, and aging (Beauchaine & Thayer, 2015; Menuet & Gourine et al., 2025). However, the cortic...

While 18F-Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) is an established biomarker in amyotrophic lateral sclerosis (ALS), the metabolic correlates of motor neuron disease motor variants remain poorly defined. This is why we investigated patterns of cerebral glucose metabolism across the spectrum of motor neuron disorders (MND), including progressive muscular atrophy (PMA), primary lateral sclerosis (PLS) and amyotrophic lateral sclerosis (ALS). We retrospectively included 18 PMA, ...

Restoring communication for people with dysarthria secondary to pontine stroke remains a critical challenge. Intracortical brain-computer interfaces (iBCIs) have demonstrated great potential for speech restoration in people with amyotrophic lateral sclerosis (ALS), with 1-24% word error rates (WERs) on a 125,000-word vocabulary. In pontine stroke, electrocorticography (ECoG) BCIs achieved 25.5% WERs with a smaller 1,024-word vocabulary. Whether intracortical BCI performance improvements extend t...

BackgroundHuntingtons disease (HD) causes progressive loss of function, cognition, and motor control, with no approved therapy yet shown to slow disease progression. In the PROOF-HD phase 3 trial, pridopidine did not meet the primary or key secondary outcomes in the overall population, but participants who remained off antidopaminergic medications (ADMs) showed benefits compared to placebo during the double-blind phase. Whether such benefits continue with longer duration treatment and how they c...

Visual Snow Syndrome (VSS) is a neurological condition characterized by continuous visual disturbances resembling television static across the visual field. Despite its significant impact on quality of life, objective assessment methods remain limited, with diagnosis relying primarily on subjective patient reports. Current understanding of VSS pathophysiology suggests cortical hyperexcitability, but precise mechanisms remain unclear. Here we developed an integrated protocol combining transcrania...