Knowledge Vault 3/98 - G.TEC BCI & Neurotechnology Spring School 2024 - Day 10
Clinical aspects of high-gamma mapping
Milena Korostenskaja, g.tec neurotechnology USA (USA)
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Concept Graph & Resume using Claude 3 Opus | Chat GPT4 | Llama 3:

graph LR classDef korostenskaja fill:#f9d4d4, font-weight:bold, font-size:14px; classDef research fill:#d4f9d4, font-weight:bold, font-size:14px; classDef intracranial fill:#d4d4f9, font-weight:bold, font-size:14px; classDef system fill:#f9f9d4, font-weight:bold, font-size:14px; classDef mapping fill:#f9d4f9, font-weight:bold, font-size:14px; A[Milena Korostenskaja] --> B[ EEG, MEG,
intracranial EEG brain research. 1] A --> C[Studied drug effects on
cognition with EEG/MEG. 2] A --> D[Determining brain activity sources:
inverse problem, infinite solutions. 3] D --> E[Intracranial depth electrodes pinpoint
mismatch negativity sources. 4] A --> F[Intracranial recordings: unique insights,
gold standard, limited availability. 5] F --> G[Custom in-house systems: error-prone,
difficult to use. 6] F --> H[BCI2000 and g.tec: cumbersome
in clinical setting. 7] F --> I[New standardized g.tec system:
expanded intracranial research globally. 8] I --> J[FDA-approved, user-friendly, minimal in-house
development, error-resistant, quick learning. 9] A --> K[Dr. Korostenskaja: clinical perspective at
Cincinnati and Florida epilepsy centers. 10] K --> L[20-30% epilepsy patients drug-resistant,
undergo surgery. 11] L --> M[Surgery impacts critical functions,
causing deficits. 12] L --> N[Pre-surgical functional mapping: fMRI,
MEG localize eloquent cortex. 13] A --> O[Intracranial recordings, cortical stimulation gold
standard when non-invasive inconclusive. 14] O --> P[Cortical stimulation: time-consuming, seizure risk,
difficult for impaired pediatric patients. 15] O --> Q[High gamma alternative/adjunct to
cortical stimulation proposed. 16] Q --> R[High gamma real-time recording, analysis
with g.tec parallel clinical system. 17] Q --> S[Validated paradigms available, new
ones flexibly designed. 18] Q --> T[High gamma mapping done extraoperatively
or intraoperatively for tumors. 19] Q --> U[Block design paradigms used, high
gamma decreases with repetition. 20] Q --> V[High gamma results need stimulation
confirmation, may reduce time. 21] V --> W[Machine learning may classify electrodes,
guide stimulation. 22] A --> X[Cortic-G: professional, standardized, user-friendly
intracranial research and clinical solution. 23] X --> Y[Enhanced patient comfort, reduced seizures,
efficient procedures, quick learning, improved outcomes. 24] A --> Z[Dr. Korostenskaja invites podcast listeners,
welcomes Cortic-G questions. 25] A --> AA[EMG muscle vs MEG brain
activity clarified. 26] Q --> AB[High gamma largest on first
task, decreases after. 27] A --> AC[ECOG research potential remains, especially
with SEEG, for speech neuroplasticity. 28] A --> AD[Flexibility, creativity needed for pediatric
cognitive paradigms - gamification, imitation. 29] A --> AE[OPM sensors may expand MEG
for epilepsy, pending validation. 30] class A,B,K,Z korostenskaja; class C,D,E,AA,AC,AD,AE research; class F,G,H,I,O,Q,R,AB intracranial; class J,X,Y system; class L,M,N,P,S,T,U,V,W mapping;


1.- Dr. Milena Korostenskaja discusses her research using EEG, MEG, and intracranial EEG recordings to study the brain and help epilepsy patients.

2.- She studied the effect of drugs on cognition using mismatch negativity response recorded with EEG and MEG during her PhD.

3.- Determining the source of brain activity from scalp recordings is an inverse problem that can have infinite solutions, especially with EEG.

4.- Intracranial recordings with depth electrodes during epilepsy surgery provided a solution to pinpoint the sources of mismatch negativity response.

5.- Intracranial recordings offer unique insights and are considered a gold standard, but were limited due to lack of standardized systems.

6.- Custom in-house systems used by few centers worldwide for intracranial research had limitations - prone to errors, difficult to use.

7.- BCI2000 software and g.tec amplifiers provided a solution, but the system was still cumbersome to use in a clinical setting.

8.- A new complete easy-to-use standardized system developed by g.tec allowed intracranial research to expand to more centers globally.

9.- The system is FDA-approved, user-friendly, minimizes need for in-house development, resistant to errors, and quick to learn.

10.- Dr. Korostenskaja gained a clinical perspective working at Cincinnati Children's Hospital and Florida Hospital for Children epilepsy centers.

11.- 20-30% of epilepsy patients are resistant to anti-epileptic drugs and undergo surgeries to remove seizure-generating brain areas.

12.- Removing brain areas can impact critical functions like language and motor skills, causing post-surgical deficits in some patients.

13.- Functional mapping is done pre-surgically using non-invasive methods like fMRI and MEG to try to localize eloquent cortex.

14.- When non-invasive functional mapping is inconclusive, intracranial recordings and cortical stimulation provide the gold standard for localization.

15.- Cortical stimulation has drawbacks - time-consuming, can trigger seizures, difficult for pediatric patients with cognitive impairments.

16.- High gamma activity recorded from intracranial electrodes is proposed as an alternative/adjunct to cortical stimulation for functional mapping.

17.- High gamma can be recorded and analyzed in real-time using the g.tec system connected in parallel to the clinical recording.

18.- Validated paradigms for somatosensory, motor, language and auditory mapping are available and new ones can be flexibly designed.

19.- High gamma mapping can be done extraoperatively at the bedside or intraoperatively to guide tumor resections in real-time.

20.- Block design paradigms alternating active and control conditions are used, but the high gamma response may decrease with repetition.

21.- High gamma mapping results need to be confirmed with cortical stimulation currently, but has potential to reduce stimulation time.

22.- Combining high gamma and stimulation results using machine learning may help classify electrodes and guide stimulation.

23.- Cortic-G system enables widespread availability of professional, standardized, user-friendly solution for intracranial research and clinical mapping.

24.- Advantages for neurosurgery - enhanced patient comfort, reduced seizure risk, efficient procedures, quick learning curve, improved outcomes.

25.- Dr. Korostenskaja invites people to listen to the Neuro-Inspired Careers podcast and contact her with questions about Cortic-G.

26.- Difference between EMG (muscle activity) and MEG (magnetic fields from brain electrical activity) is clarified.

27.- High gamma response is largest on first task repetition and decreases subsequently, so 1-2 repeats may be sufficient.

28.- ECOG research still has potential, especially combined with SEEG, and is used for applications like studying speech neuroplasticity.

29.- Flexibility and creativity is needed when doing cognitive paradigms with pediatric patients, e.g. gamification, imitation.

30.- New OPM sensors may make MEG more widely available for epilepsy, but more work is needed on accuracy and validation.

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