Withers, C. P. | Search bioRxiv

bioRxiv2025

Generalized brain-state modeling with KenazLBM

The large-scale functional state of a human brain remains difficult to characterize, much less predict. Regardless, techniques have been engineered to electrically neuromodulate the brain to treat a subset of neurologic and psychiatric disorders with moderate efficacy. Accurate characterization of a brains instantaneous functional state has stymied the development of more effective neuromodulation paradigms. Advanced computational methods are required to address this gap and enable large-scale neuroscience. Here we define the concept of generalized brain-state modeling across humans as Large Brain-State Modeling (LBM) and present KenazLBM as the worlds first example. KenazLBM can instantaneously characterize the functional state of a persons brain with raw iEEG data, and predict future brain-states. KenazLBM was trained on over 17.9 billion unique multichannel tokens from people undergoing intracranial electroencephalography (iEEG) recordings, and has learned to interrelate brain-states between people into a common interpretable topology. Most importantly, the model generalizes to unseen subject data with significant recording channel heterogeneity from the training set. We offer KenazLBM as a first generalized brain-state model to serve as a new paradigm of basic neuroscience inquiry and potential translation into neuromodulation therapeutics.

neuroscience↗

bioRxiv2024

Collapse of Interictal Suppressive Networks Permits Seizure Spread

How do networks in the brain limit seizure activity? In the Interictal Suppression Hypothesis (ISH), we recently postulated that high inward connectivity to seizure onset zones (SOZs) from non-involved zones (NIZs) is a sign of broader network suppression at rest. If broad networks appear to be responsible for interictal SOZ suppression, what changes during seizure initiation, spread, and termination? For patients with drug resistant epilepsy, intracranial monitoring offers a view into the electrographic networks which organize around and in response to the SOZ. In this manuscript, we investigate network dynamics in the peri-ictal periods to assess possible mechanisms of seizure suppression and the consequences of this suppression being overwhelmed. Peri-ictal network dynamics were derived from stereo electroencephalography (SEEG) recordings from 75 patients with drug-resistant epilepsy undergoing pre-surgical evaluation at Vanderbilt University Medical Center. We computed directed connectivity from 5-second windows in the periods between, immediately before, during, and after seizures. After aligning all network connectivity matrices between seizures and patients, we calculated net connectivity changes from the SOZ, propagative zone (PZ), and NIZ. Across all seizure types, we observed two distinct phases as seizures initiated and evolved: a large rapid increase in directed communication towards the SOZ from NIZ followed by a collapse in network connectivity. During this first phase, SOZs could be distinguished from all other regions (One-Way ANOVA, p=8.32x10-19 - 2.22x10-7, lower range to upper range of p-values). In the second phase and post-ictal period, SOZ inward connectivity decreased yet remained distinct (One-Way ANOVA, p= 2.58x10-10-1.66x10-2). Furthermore, NIZs appeared to drive the increase in inward SOZ connectivity while global connectivity between NIZs concordantly decreased. Stratifying by seizure subtype, we found that consciousness-impairing seizures show loss of inward connectivity from the NIZ earlier than conscious sparing seizures (one-way ANOVA, p<0.01 after false discovery correction). Tracking network reorganization against a surrogate for seizure involvement highlighted a possible antagonism between seizure propagation to the NIZ and the NIZs ability to maintain high connectivity to the SOZ. Finally, we found that inclusion of peri-ictal connectivity improved SOZ classification accuracy from previous models to a combined area under the curve of 93%. Overall, NIZs appear to actively respond to seizure onset and increase inhibitory signaling towards the SOZ, possibly in an attempt to thwart seizure activity. This inhibition appears to be insufficient to prevent seizure onset, and furthermore, loss of normal communication in the rest of the brain between NIZs may contribute to loss of consciousness during larger seizures. Dynamic connectivity patterns uncovered in this work may: i) allow more accurate delineation of surgical targets in focal epilepsy, ii) reveal why inward suppression of SOZs interictally may nonetheless be insufficient to prevent all seizures, and iii) provide insight into mechanisms of loss of consciousness during certain seizures.

neuroscience↗

bioRxiv2022

Sub-type selective muscarinic acetylcholine receptor modulation for the treatment of parkinsonian tremor

Parkinsons Disease is characterized by hallmark motor symptoms including resting tremor, akinesia, rigidity, and postural instability. In patient surveys of Parkinsons Disease symptoms and quality of life, tremor consistently ranks among the top concerns of patients with disease. However, the gold standard of treatment, levodopa, has inconsistent or incomplete anti-tremor effects in patients, necessitating new therapeutic strategies to help relieve this burden. Non-selective anti-muscarinic acetylcholine receptor therapeutic agents which target each of the 5 muscarinic receptor subtypes have been used as an adjunct therapy in this disease, as well as other movement disorders, and have been shown to have anti-tremor efficacy. Despite this, anti-muscarinic therapy is poorly tolerated due to adverse effects. Recent pharmacological advances have led to the discovery of muscarinic subtype selective antagonists that may keep the anti-tremor efficacy of non-selective compounds, while reducing or eliminating adverse effects. Here, we directly test this hypothesis using pharmacological models of parkinsonian tremor combined with recently discovered selective positive allosteric modulators and antagonists of the predominant brain expressed muscarinic receptors M1, M4, and M5. Surprisingly, we find that selective modulation of M1, M4, or M5 does not reduce tremor in these pre-clinical models, suggesting that central or peripheral M2 or M3 receptors may be responsible for the anti-tremor efficacy of non-selective anti-muscarinic therapies currently used in the clinic.

neuroscience↗