EEG-VLM Toolbox: Extending voxel-based lesion mapping to multi-dimensional EEG data

Focal brain lesions (such as with stroke) cause functional changes in local and distributed neural systems. While there is a long history of post-stroke neurophysiological assessment using electroencephalography (EEG), the observed neurophysiological changes have rarely been related to specific lesion locations. Therefore, the relationships between anatomical injury and physiological changes after stroke remain unclear. Voxel-based lesion symptom mapping (VLSM) is a tool for statistically relating stroke lesion locations to “symptoms”, but current VLSM methods are restricted to symptoms that can be defined by a single value. Therefore, current VLSM techniques are unable to map the relationships between anatomical injury and multidimensional neurophysiological data such as EEG, which contains rich spatio-temporal information across different channels and frequency bands.

Here we present a novel algorithm, EEG Voxel-based Lesion Mapping (EEG-VLM), that produces the set of significant relationships between precise neuroanatomical injury locations and neurophysiology (defined by a cluster of adjacent EEG channels and frequency bands). Further, the algorithm provides statistical analyses to define the overall significance of each neural structure-function relationship by correcting for multiple comparisons using a permutation test. Applying EEG-VLM to a dataset of recordings from chronic stroke patients performing a cued upper extremity movement task, we found that subjects with lesions in frontal subcortical white matter have reduced ipsilesional parietal cue-evoked EEG responses. These results are consistent with damage to a frontal-parietal network that has been associated with impairments in attention. EEG-VLM is a novel and unbiased method for relating neurophysiologic changes after stroke with neuroanatomic lesions. In the context of focal brain lesions associated with neurological impairments, we propose that this method will enable improved mechanistic understanding, facilitate biomarker development, and guide neurorehabilitation strategies.