Adrian G GuggisbergHôpitaux Universitaires de Genève | HUG · Département des neurosciences cliniques
Adrian G Guggisberg
MD
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133
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Introduction
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October 2011 - present
Publications
Publications (133)
Since Libet's seminal observation that a brain potential related to movement preparation occurs before participants report to be aware of their movement intention, it has been debated whether consciousness has causal influence on movement decisions. Here we review recent advances that provide new insights into the dynamics of human decision-making...
Continuous theta-burst stimulation (cTBS) can modify behavior, but effects are inconsistent and their mechanisms insufficiently understood. As coherence in resting-state networks influences human behavior, we hypothesized that cTBS may act via modulation of neural oscillation coherence. This study used electroencephalography (EEG) to investigate wh...
The spatial distribution of functional connectivity between brain areas and the disturbance introduced by focal brain lesions are poorly understood. Based on the rationale that damaged brain tissue is disconnected from the physiological interactions among healthy areas, this study aimed to map the functionality of brain areas according to their con...
Learning new motor skills through training, also termed motor learning, is central for everyday life. Current training strategies recommend intensive task-repetitions aimed at inducing local activation of motor areas, associated with changes in oscillation amplitudes ("event-related power") during training. More recently, another neural mechanism w...
Background
State-of-the-art stroke treatment significantly reduces lesion size and stroke severity, but it remains unclear whether these therapeutic advances have diminished the burden of post-stroke cognitive impairment (PSCI).
Aims
In a cohort of patients receiving modern state-of-the-art stroke care including endovascular therapy, we assessed t...
Objective:
Recent research suggests that patients with neurological disorders without overt seizures may also experience accelerated long-term forgetting (ALF). This term describes unimpaired learning and memory performance after standard retention intervals, but an excessive rate of forgetting over delays of days or weeks. The objective of this r...
Zusammenfassung: In der neu überarbeiteten Leitlinie wurde das bewährte Explorationstraining bei der Behandlung des Neglects durch Vorschläge zum therapeutischen Vorgehen für verschiedene Schweregrade des Neglects und eine damit einhergehende zeitliche Reduktion ergänzt. Darüber hinaus erfährt es derzeit interessante Erweiterungen durch den Einsatz...
Severe traumatic brain injury (TBI) may cause disorders of consciousness (DoC) in the form of coma, unresponsive wakefulness syndrome (UWS), or minimally conscious state (MCS). Despite significant advancements made over the last two decades in detecting, predicting, and promoting the recovery of consciousness in TBI patients with DoC, the available...
Background:
Around 25% of patients who have had a stroke suffer from severe upper-limb impairment and lack effective rehabilitation strategies. The AVANCER proof-of-concept clinical trial (NCT04448483) tackles this issue through an intensive and personalized-dosage cumulative intervention that combines multiple non-invasive neurotechnologies.
Met...
Following a stroke in regions of the brain responsible for motor activity, patients can lose their ability to control parts of their body. Over time, some patients recover almost completely, while others barely recover at all. It is known that lesion volume, initial motor impairment and cortico-spinal tract asymmetry significantly impact motor chan...
Fibromyalgia (FM) is a major chronic pain disease with prominent affective disturbances, and pain-associated changes in neurotransmitters activity and in brain connectivity. However, correlates of affective pain dimension lack. The primary goal of this correlational cross-sectional case-control pilot study was to find electrophysiological correlate...
Impairment of hand motor function is a frequent consequence after a stroke and strongly determines the ability to regain a self-determined life. An influential research strategy for improving motor deficits is the combined application of behavioral training and non-invasive brain stimulation of the motor cortex (M1). However, a convincing clinical...
Background: Following an acute ischemic stroke, some patients recover almost completely, while others barely recover. It is known that lesion volume, initial motor impairment, and cortico-spinal tract asymmetry (benchmark features) significantly impact motor changes over time. However, accurate prediction models of patients’ recovery are still miss...
Objective:
Return-to-work is often the most important objective of working-age patients with acquired brain injury, but is often difficult to achieve. There is a lack of evidence for effective treatment. This study aimed to assess the benefit of a multidisciplinary neurorehabilitation in a daytime hospital on return-to-work after an acquired brain...
Introduction
Stroke causes different levels of impairment and the degree of recovery varies greatly between patients. The majority of recovery studies are biased towards patients with mild-to-moderate impairments, challenging a unified recovery process framework. Our aim was to develop a statistical framework to analyse recovery patterns in patient...
Objectives
Functional connectivity (FC) is increasingly used as target for neuromodulation and enhancement of performance. A reliable assessment of FC with electroencephalography (EEG) currently requires a laboratory environment with high-density montages and a long preparation time. This study investigated the feasibility of reconstructing source...
Stroke patients vary considerably in terms of outcomes: some patients present 'natural' recovery proportional to their initial impairment (fitters), while others do not (non-fitters). Thus, a key challenge in stroke rehabilitation is to identify individual recovery potential to make personalized decisions for neuro-rehabilitation, obviating the 'on...
Objective
Homonymous visual field deficits (HFVDs) are frequent following brain lesions. Current restoration treatments aim at activating areas of residual vision through numerous stimuli, but show limited effect. Recent findings suggest that spontaneous neural α-band coupling is more efficient for enabling visual perception in healthy humans than...
Background and purpose:
Structural brain networks possess a few hubs, which are not only highly connected to the rest of the brain but are also highly connected to each other. These hubs, which form a rich-club, play a central role in global brain organization. To investigate whether the concept of rich-club sheds new light on poststroke recovery,...
These authors contributed equally to this work. All other authors are listed in reverse alphabetical order. Neurofeedback has begun to attract the attention and scrutiny of the scientific and medical mainstream. Here, neurofeedback researchers present a consensus-derived checklist that aims to improve the reporting and experimental design standards...
Neurobehavioral studies in humans have long concentrated on changes in local activity levels during repetitive executions of a task. Spontaneous neural coupling within extended networks has latterly been found to also influence performance. Here, we intend to uncover the underlying mechanisms, the relative importance, and the interaction between sp...
The serial reaction time task (SRTT) has been widely used to induce learning of a repeated motor sequence without the participants’ awareness. The task has also been of major influence for defining current concepts of offline consolidation after motor learning. The present study intended to replicate previous findings in a larger population of 53 h...
Accurate predictions of motor impairment after stroke are of cardinal importance for the patient, clinician, and healthcare system. More than 10 years ago, the proportional recovery rule was introduced by promising that high-fidelity predictions of recovery following stroke were based only on the initially lost motor function, at least for a specif...
Objective:
Several training programs have been developed in the past to restore motor functions after stroke. Their efficacy strongly relies on the possibility to assess individual levels of impairment and recovery rate. However, commonly used clinical scales rely mainly on subjective functional assessments and are not able to provide a complete d...
Background:
In the past years, robotic systems have become increasingly popular in upper limb rehabilitation. Nevertheless, clinical studies have so far not been able to confirm superior efficacy of robotic therapy over conventional methods. The personalization of robot-aided therapy according to the patients' individual motor deficits has been su...
Patients with acquired brain injury often suffer from pathological fatigue that differs from "normal" fatigue in that it appears more quickly and during non-demanding tasks, and recovery is not complete despite rest. It limits physical and cognitive activities, interferes with rehabilitation and return to work. The underlying mechanisms are poorly...
Neurobehavioral studies in humans have long concentrated on changes in local activity levels during repetitive executions of a task. Spontaneous neural coupling within extended networks has latterly been found to also influence performance. Here, we intend to uncover the underlying mechanisms and the interaction with task-induced activations. We de...
Neurofeedback has begun to attract the attention and scrutiny of the scientific and medical mainstream. Here, neurofeedback researchers present a consensus-derived checklist that aims to improve the reporting and experimental design standards in the field.
Accurate predictions of motor performance after stroke are of cardinal importance for the patient, clinician, and health care system. More than ten years ago, the proportional recovery rule was introduced by promising just that: high-fidelity predictions of recovery following stroke based only on the initially lost motor performance, at least for a...
Upper limb motor deficits in severe stroke survivors often remain unresolved over extended time periods. Novel neurotechnologies
have the potential to significantly support upper limb motor restoration in severely impaired stroke individuals. Here, we review
recent controlled clinical studies and reviews focusing on the mechanisms of action and eff...
Background
In the past years, robotic systems have become increasingly popular in both upper and lower limb rehabilitation. Nevertheless, clinical studies have so far not been able to confirm superior efficacy of robotic therapy over conventional methods. The personalization of robot-aided therapy according to the patients’ individual motor deficit...
Stroke has long been regarded as focal disease with circumscribed damage leading to neurological deficits. However, advances in methods for assessing the human brain and in statistics have enabled new tools for the examination of the consequences of stroke on brain structure and function. Thereby, it has become evident that stroke has impact on the...
This checklist is intended to encourage robust experimental design and clear reporting for clinical and cognitive-behavioural neurofeedback experiments.
This checklist is intended to encourage robust experimental design and clear reporting for clinical and cognitive-behavioural neurofeedback experiments. Available at https://psyarxiv.com/nyx84
In our paper entitled ‘Resting-state connectivity predicts visuo-motor skill learning’ we have become aware that the Fig. 1 A, B and C is incorrect. [Figure presented] The incorrect Fig.1 does not affect any of the results or conclusions, as the results stated in the article in the ‘results’ section are correct. The Fig. 1 has now been corrected. T...
The integrity of muscle synergies patterns has been proposed as a physiological marker of cortical damage but how to modify and train muscle synergies to relearn movement is still an open question. Here we present our recent results about the modifications that the forces induced by robots can cause on upper limb muscle synergies after stroke. Our...
The lesions induced by unilateral strokes perturb the complex and critical interhemispheric balance. While a high asymmetry measured in the acute phase is known to be a predictor for poor motor recovery, the evolution of this imbalance along motor recovery has not been studied. Here, we evaluated the evolution of the cortical power asymmetry during...
Understanding motor learning mechanisms could help find new approaches in motor neurorehabilitation. We used the classical Serial Reaction Time Task (SRTT) to study motor learning in healthy subjects. The aim was to investigate its neural basis by asking whether neural interactions, i.e., functional connectivity (FC), during a task-free resting-sta...
Stroke is a devastating neurological condition, often causing severe functional and cognitive deficits, sharply diminishing the patient’s quality of life. Among others, robot-assisted rehabilitation has been widely proposed to enhance the rehabilitation outcome. However, clinical scores and robotic parameters often used to inform rehabilitative-dec...
Clinical studies have so far not been able to show if robotic therapy is superior to conventional methods. The personalization of robot-assisted therapy according to the individual motor deficits might contribute to reach this goal. Here we present a statistical approach to automatically personalize robotic rehabilitation. Our method uses different...
Motor deficit is a prominent feature among stroke survivors. Robot-assisted therapies have been proposed as a strategy to boost rehabilitation, by allowing therapy to be provided in a more reproducible and intense manner, while quantitatively monitoring patient’s improvement. However, those approaches have so far not shown superiority over conventi...
Recent studies demonstrated that stroke patients with large lesion to the cortico-spinal tract (CST) show secondary degradation of ipsilesional white matter tracts and poor motor recovery (POOR) in the subacute period. This suggests that white matter preservation might be an interesting target for this group of patients and might help improve motor...
Warum Menschen und fast alle Wirbeltiere zuweilen herzhaft den Mund aufreißen, wenn sie die Müdigkeit übermannt, ist Forschern noch immer ein Rätsel. Der Neurologe Adrian G. Guggisberg stellt die konkurrierenden Erklärungsansätze auf den Prüfstand.
Objectives:
To develop and test a new immersive digital technology for complex regional pain syndrome (CRPS) that combines principles from mirror therapy and immersive virtual reality and the latest research from multisensory body processing.
Methods:
In this crossover double-blind study, 24 patients with CRPS and 24 age- and sex-matched healthy...
Background:
A false sense of reality is a characteristic of schizophrenia spectrum disorders (SSD). Reality confusion may also emanate from posterior orbitofrontal cortex (OFC) lesions, as evident in confabulations that patients act upon and disorientation. This confusion can be measured by repeated runs of a continuous recognition task (CRT): pat...
Synchronization of neural activity as measured with functional connectivity (FC) is increasingly used to study the neural basis of brain disease and to develop new treatment targets. However, solid evidence for a causal role of FC in disease and therapy is lacking. Here, we manipulated FC of the ipsilesional primary motor cortex in ten chronic huma...
Brain-computer interfaces (BCI) are used in stroke rehabilitation to translate brain signals into intended movements of the paralyzed limb. However, the efficacy and mechanisms of BCI-based therapies remain unclear. Here we show that BCI coupled to functional electrical stimulation (FES) elicits significant, clinically relevant, and lasting motor r...
Significance
When listening to speech, phonemes are represented in a distributed fashion in our temporal and prefrontal cortices. How these representations are selected in a phonemic decision context, and in particular whether distributed or focal neural information is required for explicit phoneme recognition, is unclear. We hypothesized that foca...
Objective:
To investigate the effects of cathodal transcranial direct current stimulation (tDCS) and continuous theta burst stimulation (cTBS) on neural network connectivity and motor recovery in individuals with subacute stroke.
Design:
Double-blinded, randomized, placebo-controlled study.
Setting:
Stroke subjects recruited through a universi...
Background:
Evolution of motor function during the first months after stroke is stereotypically bifurcated, consisting of either recovery to about 70% of maximum possible improvement ("proportional recovery, PROP") or in little to no improvement ("poor recovery, POOR"). There is currently no evidence that any rehabilitation treatment will prevent...
Any thought, whether it refers to the present moment or reflects an imagination, is again encoded as a new memory trace. Orbitofrontal reality filtering (ORFi) denotes an on-line mechanism which verifies whether upcoming thoughts relate to ongoing reality or not. Its failure induces reality confusion with confabulations and disorientation. If the r...
Background and purpose:
Motor recovery after stroke can be characterized into two different patterns. A majority of patients recover about 70% of initial impairment, whereas some patients with severe initial deficits show little or no improvement. Here, we investigated whether recovery from visuospatial neglect and aphasia is also separated into t...
Percepts and words can be decoded from largely distributed neural activity measures. The existence of widespread representations might, however, conflict with the fundamental notions of hierarchical processing and efficient coding. Using fMRI and MEG during syllable identification, we first show that sensory and decisional activity co-localize to a...
Repetitive transcranial magnetic stimulation (rTMS) has demonstrated beneficial effects on motor learning. It would be important to obtain a similar enhancement for verbal learning. However, previous studies have mostly assessed short-term effects of rTMS on language performance and the effect on learning is largely unknown. This study examined whe...
Repetitive transcranial magnetic stimulation (rTMS) has demonstrated beneficial effects on motor learning. It would be important to obtain a similar enhancement for verbal learning. However, previous studies have mostly assessed short-term effects of rTMS on language performance and the effect on learning is largely unknown. This study examined whe...
Functional imaging studies have identified a dorsal fronto-parietal network whose activity reflects shifts of attention in space and is sensitive to the behavioural relevance of stimuli. In patients with severe deficits of spatial attention this network is often structurally preserved. Here, we show that resting-state EEG functional connectivity in...
Orbitofrontal reality filtering is a mechanism that allows us to keep thought and behavior in phase with reality. Its failure induces reality confusion with confabulation and disorientation. Confabulations have been claimed to have a positive emotional bias, suggesting that they emanate from a tendency to embellish the situation of a handicap. Here...
Reliable predictors of motor improvement in individual patients after stroke are scarce. Acute determination of upper limb Fugl-Meyer assessment (FMA) appears to have predictive value.1,2 This approach predicts that patients will improve approximately 70% of the difference between the maximum upper extremity FMA score and the score first tested for...
Binaural beats (BBs) are an auditory illusion occurring when two tones of slightly different frequency are presented separately to each ear. BBs have been suggested to alter physiological and cognitive processes through synchronization of the brain hemispheres. To test this, we recorded electroencephalograms (EEG) at rest and while participants lis...