1 Processing Strategies for Real-Time Neurofeedback Using fmri Jeremy Magland 1 Anna Rose Childress 2 1 Department of Radiology 2 Department of Psychiatry University of Pennsylvania School of Medicine MITACS-Fields Conference on the Mathematics of Medical Imaging 23 June, 2011
2 Cognitive Control Ability to regulate ones thoughts, feelings, and actions. Varies substantially between individuals. Often the target of clinical research. Deficits in cognitive control are linked to: ADHD, substance abuse, depression, Parkinson s, aging,
3 Measurement of Cognitive Control Deficit Using fmri Functional MRI (fmri) tasks have recently been developed to quantify cognitive control in the context of disorders. For example, the GO-NOGO task
4 Real-time fmri for Therapeutics However, mere quantification is insufficient for therapeutics. Real-time fmri: Inform patients about ongoing brain activity while in the scanner. Reward patients in real-time (e.g. by scoring points) as they Increase (frontal) cognitive control circuitry Decrease (limbic) impulse circuitry Etc.
5 Real-time fmri: Special challenges for data processing What do conventional task-based fmri analyses provide?... A picture of brain activity over time? A picture of task-correlated brain activity over time? A spatial map of an individual s brain regions participating in a task throughout a 10-minute scan? A spatial map of brain regions participating in a task throughout 10-minute scans, averaged over a cohort of subjects. No. No. Usually Not. Yes!
6 Real-time fmri: Special challenges for data processing Key differences between real-time and conventional fmri: Moment-to-moment measurement: repetition time (TR) 2 seconds. No statistical time (or group) averaging. Temporal filtering must be prospective. Need to perform analyses on the fly. Requires particularly robust/reliable measurements.
7 What is BOLD? (empirically) BOLD: Blood Oxygen Level Dependent Empirically, when local neuronal activity increases, MRI signal increases slightly (1-4%). Thus, MRI can be used to probe brain activity!!! but why does the NMR signal increase? Image from web: What is Functional Magnetic Resonance Imaging (fmri)? By Hannah Devlin. psychcentral.com
8 What causes BOLD? Hemoglobin (Hb) is diamagnetic when oxygenated, but paramagnetic when deoxygenated. Deoxyhemoglobin in blood vessels induces microscopic field distortions. Increased blood oxygenation slightly reduces the microscopic inhomogeneous fields slightly increases the local T2* of the tissue slightly increases the local MR signal But why does blood oxygenation increase with neuronal activity? Physiologic phenomenon: Increased neuronal activity leads to increased local cerebral blood flow (CBF), which overcompensates for the increased local cerebral metabolic rate of oxygen (CMRO 2 ).
9 BOLD: An Indirect Measure of Brain Activity BOLD Signal does not directly measure neuronal activity, and is therefore susceptible to changes in: Cerebral Blood Flow (CBF) Cerebral Metabolic Rate of Oxygen (CMRO 2 ) Cerebral Blood Volume (CBV) The collective signal change due to these effects is known as the Hemodynamic Response
10 Hemodynamic Delay (Unfortunately) there is a somewhat variable physiologic delay (typically 4-6 seconds) between neuronal activity and the peak of the resulting hemodynamic response. R.B. Buxton et al. / NeuroImage 23 (2004) S220 S233
11 BOLD Acquisition Typical BOLD Acquisition Multi-slice 2D Echo-Planar Imaging, TR 1-3 seconds TE milliseconds Resolution 3x3 mm in-plane, 5 mm thickness Also used: Spiral, 3D SSFP Key Requirements: Sensitive to changes in T2* High temporal resolution. Good brain coverage
12 BOLD Acquisition: Low-res, Susceptibility Artifacts EPI and related techniques can suffer from geometric distortions and signal loss due to susceptibility-induced inhomogeneous fields.
13 Block Design Most basic fmri experiment: block design. Subject alternates between performing a cognitive task and resting.
14 Example: Visual Attention Block Design Alternating Visual Stimuli 10 seconds Think about playing basketball 10 seconds Focus on the painting
15 Example: Visual Attention Block Design Raw data from fmri pixel Shift design by 4 seconds Difference of means t-test: t>10 p < Temporal filter (detrend)
16 fmri: Conventional Processing Within-scan motion correction (alignment) Registration with prior scans or to standard template Spatial Smoothing Temporal Filter Low-pass: remove noise, physiologic processes High-pass: remove low-frequency drift (detrend) Statistical test at each image pixel or within a priori region of interest: can the variation in the fmri time series be explained (in part) by the experimental design function?
17 fmri: Conventional Processing General Linear Model Statistical test to see how significantly the design explains the BOLD signal. The test is performed at every pixel throughout the brain, and the results are displayed in a parametric map. Ax = b Predictor variables are: Task design function convolved with hemodynamic response kernels Other control variables eye tracking, motion tracking, etc. Dependent variable is the raw fmri time series at each pixel, after temporal filtering.
18 fmri Technical Challenges Technical Challenge in fmri Thermal noise Low-frequency Drift (BOLD drift) Subject motion Typical Remedy Spatial smoothing, scanning at higher field strength (3T, 7T), low-pass temporal filter, increase scan time, average results over multiple subjects High-pass filter during pre-processing. Places limitations on task design (e.g., tasks periods should not last more than 1 minute). Head restraint, registration/realignment, use of motion parameters as covariates in statistical analyses.
19 Subject motion
20 How to adapt fmri for Real-time? t=1 t=2 t=3 t=n Need to make a measurement specific to a single frame.
21 Strategies for Providing Feedback METHOD 1: Regional BOLD Feedback racc - Rostral anterior cingulate cortex Region of Interest (ROI) selected according to target application. BOLD signal fluctuations are shown to the subject during the scan. Subject attempts to control the feedback using his/her thoughts. Cons: Noisy: physiologic variation and drift in BOLD signal. Requires ROI selection May not be well understood where activation should take place. Time decharms et al. Proc Natl Acad Sci U S A Dec 20;102(51):
22 Application to Chronic Pain: decharms 2005 PNAS Chronic pain patients learned to control activation in the rostral anterior cingulate cortex, and reported a reduction in ongoing pain. Feedback consisted of the BOLD signal in the ROI as a scrolling line graph.
23 Strategies for Providing Feedback METHOD 1: Regional BOLD Feedback METHOD 2: Whole Brain-State Feedback Whole brain classifier developed on the basis of training portion of the scan. Many pixels throughout the brain contribute to the feedback signal. Whole brain classifier map for Tennis / Room-to-Room task. LaConte et al. Real-time fmri using brain state classification. Hum Brain Mapp Oct;28(10):
25 Strategies for Providing Feedback METHOD 1: Regional BOLD Feedback METHOD 2: Whole Brain-State Feedback Pros: No ROI selection required. Automatically customized classifier for each particular patient / application. Automatic removal of irrelevant physiologic and cognitive processes. Cons: No spatial information in feedback Requires training period Susceptible to movement Whole brain classifier map for Tennis / Room-to-Room task.
26 Whole-brain classification: Highly under-determined system Each pixel is a predictor variable (~ 40,000 predictors) Design function is dependent variable Each time point gives an equation (every 2 seconds) Model needs to be computed in real time (within a few seconds) Raw data from fmri pixel Choices for classification model: - Support vector machine (SVM) - Principal component regression (PC-R) - Partial Least-Square Regression (PLS-R) - Ridge regression, and other techniques
27 Whole-brain classification: Highly under-determined system Choices for classification model: - Support vector machine (SVM) - Principal component regression (PC-R) - Partial Least-Square Regression (PLS-R) - Ridge regression, and other techniques Raw data from fmri pixel Tried SVM, PC-R, and PLS-R Produced very similar results However, PLS-R was the clear choice because it is by far the least computationally demanding (Important for real-time applications.)
28 Real-time Results Imagination tasks: Repetitive Motor & Spatial Navigation
29 Synchronization of display with data acquisition (negligible lag time) Real-time fmri Feedback Loop Mirror Headphones Projector computer Projector screen MRI Scanner Image reconstruction (negligible lag time) Transfer of controller commands and feedback data (negligible lag time) Continuous, real-time image transfer (1-2 seconds) Controller GUI fmri Processing (<0.5 seconds)
30 Real-time Results 19 of 19 subjects were able to control the feedback cursor using only of their thoughts. Feedback was provided on the basis of the whole-brain (PLS) classifier.
31 Real-time Results: SVM vs. PLS PLS outperforms default SVM
32 Time needed for Machine-Learning with PLS
33 Strategies for Providing Feedback METHOD 1: Regional BOLD Feedback METHOD 2: Whole Brain State Feedback METHOD 3: Spatio-temporally resolved activity in real time (STAR). Idea: (Local) classifier is obtained at each spatial location (neighborhood of each pixel). Principal component analysis is used to remove noise. Robustness of whole-brain approach is combined with regional specificity. Whole Brain Regional STAR Regional BOLD Magland et al. NeuroImage
36 STAR Method: Results (PLS) (PLS) Study Protocol 19 Subjects were scanned, 13 controls, 6 cocaine patients Classifier training period (~5 minutes) followed by a feedback period (8-24 minutes). Subjects were instructed to alternate between two sets of thoughts: (1) Repeatedly hitting a tennis ball to an imaginary partner (30 seconds) (2) Navigating from room to room in a familiar building (30 seconds)
37 STAR Method: Results Evidence for Regional Specificity in STAR
38 STAR: Processing Pipeline (PLS)
39 User Interface
40 Target Application: Treatment of Craving and Addiction (Anna Rose Childress): Real-time fmri pattern training for treatment of craving and addiction. Goal: To determine whether substance abuse patients can use rtfmri feedback technology to control patterns in their own motivational circuitry, with associated reductions in drug craving.
41 Cocaine Application: Initial Experiments Previously acquired fmri datasets from cocaineaddicted subjects were retrospectively analyzed for feasibility of whole-brain real-time classification. Block design: Results: Whole-brain classifier was able to quickly distinguish between cocaine and neutral videos Training duration was 3-5 minutes for all subjects. = neutral video (30 sec) = cocaine video (30 sec)
42 Cocaine Application: Initial Experiments We soon realized that direct tracking of the craving state is problematic. Although classifier could distinguish between cocaine and neutral videos, we were probably not tracking craving, but other processes triggered by the videos. Issue: when craving goes on, it does not go off easily -- could persist for many minutes. Therefore, not well-suitable for BOLD techniques (due to drift)
43 Distraction Paradigm Six seconds on each stimulus. Instructions: When you see the place pictures, imagine yourself in that place, interacting with the people, etc. More than just a visual stimulus paradigm. Cognitive control task: stay focused on the pictures as they appear Blank screens provides contrast (brain is resting) Craving is measured in terms of a breakdown in cognitive control after the distraction image appears.
47 Distraction Paradigm: Prelim. Results Same Healthy Control t-score map Spatial parametric map does not provide as much information as multi-voxel/classifier approaches.
48 Summary Real-time fmri requires special data processing considerations Classifier-based approaches can be used to provide robust real-time fmri feedback. We have explored a paradigm for quantifying cognitive control (under preliminary testing). In the presence of distractions, this paradigm could be used to quantify and/or treat various cognitive disorders.
49 Working to make data available for collaborative exploration Cloud-based software for fmri data exploration
50 Acknowledgements Treatment Research Center, University of Pennsylvania Anna Rose Childress Christopher Tjoa Laboratory for Structural NMR Imaging, University of Pennsylvania Felix W. Wehrli This work was supported by National Institutes of Health research grants K25-EB R33-DA P50-DA12756 P60-DA005186
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