Pub Date : 2024-05-01Epub Date: 2022-12-20DOI: 10.1177/15500594221144570
Yujie Ma, Hongbin Zhang, Jijia Bai, Jinyuan Zhu
Background. Bedside electroencephalography (EEG) can monitor the changes in brain function in critical patients. Light sedation is recommended in intensive care unit (ICU) patients, but sedation might confuse the EEG readings. There are few studies on the changes of EEG in severe patients with dexmedetomidine. This study aimed to explore the EEG characteristics before and after dexmedetomidine in severe patients in the ICU. Methods. This prospective study enrolled severe patients with sepsis who needed light sedation, we sedated the patients with dexmedetomidine. EEG was recorded for at least 60 min using a quantitative EEG (qEEG) bedside monitor. Amplitude-EEG (aEEG), relative spectral energy, alpha variation, and spectral entropy were recorded and compared before/after dexmedetomidine. Results. Sixty-three participants were enrolled. The relative spectral energy and alpha variation were not different before and after the use of dexmedetomidine (P> .05). The amplitude of the upper and lower boundaries in aEEG and spectral entropy were significantly lower after light sedation with dexmedetomidine compared with before (P< .05). When grouped according to the Glasgow Coma Scale (GCS), the amplitude of qEEG in participants with moderate GCS decreased significantly(P< .05), but not in mild or severe GCS. Conclusion. Relative spectral energy and alpha variation derived from qEEG could be used to evaluate the state of brain function even under light sedation with dexmedetomidine in severe patients during their ICU stay.
{"title":"EEG Characteristics Before and After Dexmedetomidine Treatment in Severe Patients: A Prospective Study.","authors":"Yujie Ma, Hongbin Zhang, Jijia Bai, Jinyuan Zhu","doi":"10.1177/15500594221144570","DOIUrl":"10.1177/15500594221144570","url":null,"abstract":"<p><p><i>Background.</i> Bedside electroencephalography (EEG) can monitor the changes in brain function in critical patients. Light sedation is recommended in intensive care unit (ICU) patients, but sedation might confuse the EEG readings. There are few studies on the changes of EEG in severe patients with dexmedetomidine. This study aimed to explore the EEG characteristics before and after dexmedetomidine in severe patients in the ICU. <i>Methods.</i> This prospective study enrolled severe patients with sepsis who needed light sedation, we sedated the patients with dexmedetomidine. EEG was recorded for at least 60 min using a quantitative EEG (qEEG) bedside monitor. Amplitude-EEG (aEEG), relative spectral energy, alpha variation, and spectral entropy were recorded and compared before/after dexmedetomidine. <i>Results.</i> Sixty-three participants were enrolled. The relative spectral energy and alpha variation were not different before and after the use of dexmedetomidine (<i>P</i> <i>></i> .05). The amplitude of the upper and lower boundaries in aEEG and spectral entropy were significantly lower after light sedation with dexmedetomidine compared with before (<i>P</i> <i><</i> .05). When grouped according to the Glasgow Coma Scale (GCS), the amplitude of qEEG in participants with moderate GCS decreased significantly(<i>P</i> <i><</i> .05), but not in mild or severe GCS. <i>Conclusion.</i> Relative spectral energy and alpha variation derived from qEEG could be used to evaluate the state of brain function even under light sedation with dexmedetomidine in severe patients during their ICU stay.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":" ","pages":"384-390"},"PeriodicalIF":2.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10768248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2023-09-05DOI: 10.1177/15500594231197100
Jitendra Kumawat, Anuradha Yadav, Kavita Yadav, Kusum Lata Gaur
Background. Imagined motor movement is a cognitive process in which a subject imagines a movement without doing it, which activates similar brain regions as during actual motor movement. Brain gamma band activity (GBA) is linked to cognitive functions such as perception, attention, memory, awareness, synaptic plasticity, motor control, and Imagination. Motor imagery can be used in sports to improve performance, raising the possibility of using it as a rehabilitation method through brain plasticity through mirror neurons. Method. A comparative observational study was conducted on 56 healthy male subjects after obtaining clearance from the Ethics Committee. EEG recordings for GBA were taken for resting, real, and imaginary motor movements and compared. The power spectrum of gamma waves was analyzed using the Kruskal-Wallis test; a p-value <.05 was considered significant. Results. The brain gamma rhythm amplitude was statistically increased during both actual and imaginary motor movement compared to baseline (resting stage) in most of the regions of the brain except the occipital region. There was no significant difference in GBA between real and imaginary movements. Conclusions. Increased gamma rhythm amplitude during both actual and imaginary motor movement than baseline (resting stage) indicating raised brain cognitive activity during both types of movements. There was no potential difference between real and imaginary movements suggesting that the real movement can be replaced by the imaginary movement to enhance work performance through mirror therapy.
{"title":"Comparison of Spectral Analysis of Gamma Band Activity During Actual and Imagined Movements as a Cognitive Tool.","authors":"Jitendra Kumawat, Anuradha Yadav, Kavita Yadav, Kusum Lata Gaur","doi":"10.1177/15500594231197100","DOIUrl":"10.1177/15500594231197100","url":null,"abstract":"<p><p><i>Background.</i> Imagined motor movement is a cognitive process in which a subject imagines a movement without doing it, which activates similar brain regions as during actual motor movement. Brain gamma band activity (GBA) is linked to cognitive functions such as perception, attention, memory, awareness, synaptic plasticity, motor control, and Imagination. Motor imagery can be used in sports to improve performance, raising the possibility of using it as a rehabilitation method through brain plasticity through mirror neurons. <i>Method.</i> A comparative observational study was conducted on 56 healthy male subjects after obtaining clearance from the Ethics Committee. EEG recordings for GBA were taken for resting, real, and imaginary motor movements and compared. The power spectrum of gamma waves was analyzed using the Kruskal-Wallis test; a <i>p-value</i> <.05 was considered significant. <i>Results.</i> The brain gamma rhythm amplitude was statistically increased during both actual and imaginary motor movement compared to baseline (resting stage) in most of the regions of the brain except the occipital region. There was no significant difference in GBA between real and imaginary movements. <i>Conclusions.</i> Increased gamma rhythm amplitude during both actual and imaginary motor movement than baseline (resting stage) indicating raised brain cognitive activity during both types of movements. There was no potential difference between real and imaginary movements suggesting that the real movement can be replaced by the imaginary movement to enhance work performance through mirror therapy.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":" ","pages":"340-346"},"PeriodicalIF":2.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10218340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2022-12-22DOI: 10.1177/15500594221145905
Elisa Schröder, Anais Ingels, Alexandru Dumitrescu, Charles Kornreich, Salvatore Campanella
According to the Dual Mechanisms of Control (DMC) framework, cognitive control can be divided into two strategies: proactive cognitive control, which relies mainly on the active maintenance of contextual information relevant to the ongoing task; and reactive cognitive control, which is a form of transient control triggered by an external cue. Although cognitive control has been studied extensively, little is known about the specificities of inhibition within the framework of the DMC model and the influence of interindividual variables on inhibitory control.Thanks to an inhibitory version of the continuous performance task (CPT), we studied behavioral performances and Event-Related Potentials (ERPs) related to proactive and reactive inhibition, and their links to psychological profile and cognitive performances. One hundred and five young adults underwent the task, along with a short clinical and cognitive evaluation.We were able to observe ERPs related to proactive (cue-N1, cue-N2, cue-P3, and the contingent negative variation) and reactive inhibitory control (target-N2 and target-P3). Our results showed that proactive strategies appeared to be linked with impulsivity, working memory abilities, dominant response inhibition, gender, and the consumption pattern of nicotine. Reactive strategies appeared to be linked with attentional and working memories abilities.Overall, the inhibitory AX-CPT allowed a specific investigation of cognitive control within the framework of the DMC based on behavioral and ERP variables. This provided us an opportunity to investigate the principal ERP components related to proactive and reactive inhibitory control strategies as well as to link them with specific clinical and cognitive variables.
{"title":"Proactive and Reactive Inhibitory Control Strategies: Exploring the Impact of Interindividual Variables on an ERP Continuous Performance Task (AX-CPT).","authors":"Elisa Schröder, Anais Ingels, Alexandru Dumitrescu, Charles Kornreich, Salvatore Campanella","doi":"10.1177/15500594221145905","DOIUrl":"10.1177/15500594221145905","url":null,"abstract":"<p><p>According to the Dual Mechanisms of Control (DMC) framework, cognitive control can be divided into two strategies: proactive cognitive control, which relies mainly on the active maintenance of contextual information relevant to the ongoing task; and reactive cognitive control, which is a form of transient control triggered by an external cue. Although cognitive control has been studied extensively, little is known about the specificities of inhibition within the framework of the DMC model and the influence of interindividual variables on inhibitory control.Thanks to an inhibitory version of the continuous performance task (CPT), we studied behavioral performances and Event-Related Potentials (ERPs) related to proactive and reactive inhibition, and their links to psychological profile and cognitive performances. One hundred and five young adults underwent the task, along with a short clinical and cognitive evaluation.We were able to observe ERPs related to proactive (cue-N1, cue-N2, cue-P3, and the contingent negative variation) and reactive inhibitory control (target-N2 and target-P3). Our results showed that proactive strategies appeared to be linked with impulsivity, working memory abilities, dominant response inhibition, gender, and the consumption pattern of nicotine. Reactive strategies appeared to be linked with attentional and working memories abilities.Overall, the inhibitory AX-CPT allowed a specific investigation of cognitive control within the framework of the DMC based on behavioral and ERP variables. This provided us an opportunity to investigate the principal ERP components related to proactive and reactive inhibitory control strategies as well as to link them with specific clinical and cognitive variables.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":" ","pages":"317-328"},"PeriodicalIF":2.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10412154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-13DOI: 10.1177/15500594241246505
Jacqueline Crawford, Cassie McFarlane, Anita N Datta
Introduction: Frontal-predominant epileptiform discharges (EDs) include generalized spike-wave (GSW) and frontal spikes (FS). However, negative bi-frontal ED with simultaneous occipital positivity (BFOD) are rare, leading to questions regarding physiological generators. Methods: To determine the clinical significance of BFOD, electroclinical features of children with BFOD (n = 40) were compared to control patients with GSW (n = 102) and FS (n = 100). Results: Results are presented in the following order: BFOD, GSW, and FS. Epilepsy was prevalent among the groups: 95.0%, 90.2%, and 77.0%, respectively. The median age of seizure-onset did not significantly differ between groups: 3.00, 4.00, and 2.25 years, respectively. Regarding EEG background features, the BFOD group had more disorganized sleep architecture than other groups, P < .005. There was a significant difference in the proportion of developmental delay (DD) between the groups ( P < .005). BFOD had much higher odds of DD compared to GSW and FS groups: odds ratio (OR) (confidence interval [CI]) 19.44 [5.64, 64.05] and 3.98 [1.16, 13.34]. Furthermore, BFOD had much higher odds of severe DD compared to GSW and FS groups: 9.60 [2.75, 33.45] and 2.73 [1.03, 7.27]. A Gross Motor Function Classification System (GMFCS) score of ≥ 4 was more prevalent in BFOD (22.5%), than GSW (0%) and FS groups (9%). On neuroimaging, BFOD had more structural ( P < .005) and multilobar structural ( P < .05) abnormalities than control groups. Conclusion: Children with BFOD had particularly severe significant DD, considerable motor deficit (GMFCS ≥ 4), and brain structural abnormalities, often multilobar. This suggests BFOD is a marker of severe underlying brain dysfunction and not benign when encountered on routine EEG review.
{"title":"Original Research: Clinical Significance of a Unique Pediatric EEG Configuration: Bi-Frontal Spikes With Simultaneous Bi-Occipital Positivity","authors":"Jacqueline Crawford, Cassie McFarlane, Anita N Datta","doi":"10.1177/15500594241246505","DOIUrl":"https://doi.org/10.1177/15500594241246505","url":null,"abstract":"Introduction: Frontal-predominant epileptiform discharges (EDs) include generalized spike-wave (GSW) and frontal spikes (FS). However, negative bi-frontal ED with simultaneous occipital positivity (BFOD) are rare, leading to questions regarding physiological generators. Methods: To determine the clinical significance of BFOD, electroclinical features of children with BFOD (n = 40) were compared to control patients with GSW (n = 102) and FS (n = 100). Results: Results are presented in the following order: BFOD, GSW, and FS. Epilepsy was prevalent among the groups: 95.0%, 90.2%, and 77.0%, respectively. The median age of seizure-onset did not significantly differ between groups: 3.00, 4.00, and 2.25 years, respectively. Regarding EEG background features, the BFOD group had more disorganized sleep architecture than other groups, P < .005. There was a significant difference in the proportion of developmental delay (DD) between the groups ( P < .005). BFOD had much higher odds of DD compared to GSW and FS groups: odds ratio (OR) (confidence interval [CI]) 19.44 [5.64, 64.05] and 3.98 [1.16, 13.34]. Furthermore, BFOD had much higher odds of severe DD compared to GSW and FS groups: 9.60 [2.75, 33.45] and 2.73 [1.03, 7.27]. A Gross Motor Function Classification System (GMFCS) score of ≥ 4 was more prevalent in BFOD (22.5%), than GSW (0%) and FS groups (9%). On neuroimaging, BFOD had more structural ( P < .005) and multilobar structural ( P < .05) abnormalities than control groups. Conclusion: Children with BFOD had particularly severe significant DD, considerable motor deficit (GMFCS ≥ 4), and brain structural abnormalities, often multilobar. This suggests BFOD is a marker of severe underlying brain dysfunction and not benign when encountered on routine EEG review.","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":"147 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140573800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective. This study aimed to investigate age-related changes in cortical auditory evoked potentials (CAEPs) while considering three crucial factors: aging, high-frequency hearing loss and sensation level of the CAEP stimulus. Method. The electrophysiological and audiometric data of 71 elderly participants were analyzed using multiple regression analysis to investigate the association of CAEPs with the factors of aging, high-frequency hearing loss and sensation level of the CAEP test stimulus. Results. Aging was significantly associated with prolonged N1 and P2 latencies and reduced P2 amplitude. Elevated thresholds related to the sensation level of the CAEP stimulus were significantly associated with increased N1 and P2 amplitudes and decreased N1 latency. A significant relationship was detected between high-frequency hearing thresholds and the shortening of P2 latencies and the reduction of P2 amplitudes. Conclusion. The results of this study highlight the complex interplay of aging, high-frequency hearing loss and the sensation level of the CAEP stimulus on CAEP components in elderly people. These factors should be considered in future research using CAEPs to enhance overall understanding of auditory processing in the aging population.
{"title":"Central Auditory Changes Associated with Age-related Hearing Loss","authors":"Selhan Gürkan, Oğuz Başokçu, Serpil Mungan Durankaya, Yalçın İşler, Günay Kırkım","doi":"10.1177/15500594241243116","DOIUrl":"https://doi.org/10.1177/15500594241243116","url":null,"abstract":"Objective. This study aimed to investigate age-related changes in cortical auditory evoked potentials (CAEPs) while considering three crucial factors: aging, high-frequency hearing loss and sensation level of the CAEP stimulus. Method. The electrophysiological and audiometric data of 71 elderly participants were analyzed using multiple regression analysis to investigate the association of CAEPs with the factors of aging, high-frequency hearing loss and sensation level of the CAEP test stimulus. Results. Aging was significantly associated with prolonged N1 and P2 latencies and reduced P2 amplitude. Elevated thresholds related to the sensation level of the CAEP stimulus were significantly associated with increased N1 and P2 amplitudes and decreased N1 latency. A significant relationship was detected between high-frequency hearing thresholds and the shortening of P2 latencies and the reduction of P2 amplitudes. Conclusion. The results of this study highlight the complex interplay of aging, high-frequency hearing loss and the sensation level of the CAEP stimulus on CAEP components in elderly people. These factors should be considered in future research using CAEPs to enhance overall understanding of auditory processing in the aging population.","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":"4 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140573801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2022-12-14DOI: 10.1177/15500594221145265
Sonal Bhatia, Andrew Todd Ham, Ekrem Kutluay
Despite characteristic clinical and scalp EEG findings, BCECTS pathophysiology is unclear regarding involvement of large-scale neuronal networks. Higher number of scalp electrodes with HD-EEG may promote accurate localization of the cortical generators in BCECTS providing additional insight in those with neurocognitive problems. We aimed to determine the value of visual interpretation of topographical maps using 256 channels (when compared to standard 21 channel array) HD-EEG in BCECTS and attempted to source localize interictal discharges (IEDs) using Geosource 2 software. Patient records were reviewed for demographic, seizure, brain magnetic resonance imaging (MRI) details; scalp and HD-EEG findings. HD-EEG software was used to review raw EEG data (21 scalp EEG electrodes were compared to 256 HD-EEG electrodes); select, average, and source localize IEDs.Five BCECTS patients with HD-EEG were identified. Seizure onset age ranged from 5-11 years with 1-18 lifetime seizures; both focal (n = 3) and focal to bilateral tonic-clonic (n = 2). Neurocognitive co-morbidities noted in our cohort included attention deficit hyperactivity disorder, speech/developmental delay and a specific learning disorder. Scalp EEG showed typical findings with IEDs over the centrotemporal regions (bilateral n = 3; unilateral n = 2). Visualization and inspection of expanded coverage topographic maps with HD-EEG showed well-defined islands of maximum negativity and positivity of a dipole compared to conventional channels where boundary delineation was obscured. Further, HD-EEG localized IEDs/"spike-generator" to areas such as the pre-and post-central, middle-frontal and temporal gyrus, and the inferior parietal lobule. In BCECTS, HD-EEG may show affection for a broader neural network and may provide a better insight into the associated neurocognitive morbidities.
{"title":"High-Density (HD) Scalp EEG Findings in \"Benign\" Childhood Epilepsy with Centrotemporal Spikes (BCECTS).","authors":"Sonal Bhatia, Andrew Todd Ham, Ekrem Kutluay","doi":"10.1177/15500594221145265","DOIUrl":"10.1177/15500594221145265","url":null,"abstract":"<p><p>Despite characteristic clinical and scalp EEG findings, BCECTS pathophysiology is unclear regarding involvement of large-scale neuronal networks. Higher number of scalp electrodes with HD-EEG may promote accurate localization of the cortical generators in BCECTS providing additional insight in those with neurocognitive problems. We aimed to determine the value of visual interpretation of topographical maps using 256 channels (when compared to standard 21 channel array) HD-EEG in BCECTS and attempted to source localize interictal discharges (IEDs) using Geosource 2 software. Patient records were reviewed for demographic, seizure, brain magnetic resonance imaging (MRI) details; scalp and HD-EEG findings. HD-EEG software was used to review raw EEG data (21 scalp EEG electrodes were compared to 256 HD-EEG electrodes); select, average, and source localize IEDs.Five BCECTS patients with HD-EEG were identified. Seizure onset age ranged from 5-11 years with 1-18 lifetime seizures; both focal (<i>n</i> = 3) and focal to bilateral tonic-clonic (<i>n</i> = 2). Neurocognitive co-morbidities noted in our cohort included attention deficit hyperactivity disorder, speech/developmental delay and a specific learning disorder. Scalp EEG showed typical findings with IEDs over the centrotemporal regions (bilateral <i>n</i> = 3; unilateral <i>n</i> = 2). Visualization and inspection of expanded coverage topographic maps with HD-EEG showed well-defined islands of maximum negativity and positivity of a dipole compared to conventional channels where boundary delineation was obscured. Further, HD-EEG localized IEDs/\"spike-generator\" to areas such as the pre-and post-central, middle-frontal and temporal gyrus, and the inferior parietal lobule. In BCECTS, HD-EEG may show affection for a broader neural network and may provide a better insight into the associated neurocognitive morbidities.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":" ","pages":"248-251"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10338255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although the remission of self-limited epilepsy with centrotemporal spikes (SeLECTS) usually occurs by adolescence, deficits in cognition and behavior are not uncommon. Several functional magnetic resonance imaging (fMRI) studies have revealed connectivity disturbances in patients with SeLECTS associated with cognitive impairment. However, the disadvantages of fMRI are expensive, time-consuming, and motion sensitive. In the current study, we used a partial directed coherence (PDC) method to analyze electroencephalogram (EEG) for exploring brain connectivity in patients with SeLECTS. This study enrolled 38 participants (19 patients with SeLECTS and 19 healthy controls) for PDC analysis. Our results demonstrated that the controls had significantly higher PDC inflow connectivity in the F7, T3, FP1, and F8 channels than patients with SeLECTS. By contrast, the patients with SeLECTS demonstrated significantly higher PDC inflow connectivity than did the controls in the T5, Pz, and P4 channels. We also compared the PDC connectivity in different Brodmann areas between the patients with SeLECTS and the controls. The results revealed that the inflow connectivity in the BA9_46_L area was significantly higher in the controls than in the patients with SeLECTS, whereas the inflow connectivity in the MIF_L area 4 was significantly higher in the patients with SeLECTS than in the controls. Our proposed approach of combining EEG with PDC provides a convenient and useful tool for investigating functional connectivity in patients with SeLECTS. This approach is time-saving and inexpensive compared with fMRI, but it achieves similar results to fMRI.
{"title":"Connectivity Disturbances in Self-Limited Epilepsy with Centrotemporal Spikes: A Partial Directed Coherence Analysis of Electroencephalogram.","authors":"Ching-Tai Chiang, Rei-Cheng Yang, Yu-Chia Kao, Rong-Ching Wu, Chen-Sen Ouyang, Lung-Chang Lin","doi":"10.1177/15500594231177979","DOIUrl":"10.1177/15500594231177979","url":null,"abstract":"<p><p>Although the remission of self-limited epilepsy with centrotemporal spikes (SeLECTS) usually occurs by adolescence, deficits in cognition and behavior are not uncommon. Several functional magnetic resonance imaging (fMRI) studies have revealed connectivity disturbances in patients with SeLECTS associated with cognitive impairment. However, the disadvantages of fMRI are expensive, time-consuming, and motion sensitive. In the current study, we used a partial directed coherence (PDC) method to analyze electroencephalogram (EEG) for exploring brain connectivity in patients with SeLECTS. This study enrolled 38 participants (19 patients with SeLECTS and 19 healthy controls) for PDC analysis. Our results demonstrated that the controls had significantly higher PDC inflow connectivity in the F7, T3, FP1, and F8 channels than patients with SeLECTS. By contrast, the patients with SeLECTS demonstrated significantly higher PDC inflow connectivity than did the controls in the T5, Pz, and P4 channels. We also compared the PDC connectivity in different Brodmann areas between the patients with SeLECTS and the controls. The results revealed that the inflow connectivity in the BA9_46_L area was significantly higher in the controls than in the patients with SeLECTS, whereas the inflow connectivity in the MIF_L area 4 was significantly higher in the patients with SeLECTS than in the controls. Our proposed approach of combining EEG with PDC provides a convenient and useful tool for investigating functional connectivity in patients with SeLECTS. This approach is time-saving and inexpensive compared with fMRI, but it achieves similar results to fMRI.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":" ","pages":"257-264"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9526707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-06-18DOI: 10.1177/15500594231182758
Guangshuang Lu, Yun Cheng, Yun Wang, Jie Hu, Fan Zhang, Wenbo Li, Minnong Xia, Xiaoyan Lu, Wu Yang
Objective. To investigate the prevalence and risk factors for electrical status epilepticus during slow-wave sleep (ESES) in patients with self-limited epilepsy with centrotemporal spikes (SeLECTS). Methods. The clinical and follow-up data of children with SeLECTS were collected between 2017 and 2021. Patients were divided into typical ESES, atypical ESES, and non-ESES groups according to spike-wave indices (SWI). Clinical and electroencephalography characteristics were retrospectively analyzed. Logistic regression was used to identify risk factors for ESES. Results. A total of 95 patients with SeLECTS were enrolled. Seven patients (7.4%) developed typical ESES, 30 (31.6%) developed atypical ESES, 25 (26.3%) developed ESES at the first visit, and 12 (12.6%) developed ESES during treatment and follow-up. Multivariate logistic regression analysis showed that the risk factors for SeLECTS combined with ESES were Rolandic double or multiple spikes (OR = 8.626, 95% CI: 2.644-28.147, P < .001) and Rolandic slow waves (OR = 53.550, 95% CI: 6.339-452.368, P < .001). There were no significant differences in seizure characteristics, electroencephalogram (EEG) findings, or cognitive impairment between the atypical and typical ESES groups. Conclusion. More than one-third of the SeLECTS patients combined with ESES. Both atypical and typical ESES scores can affect cognitive function. On electroencephalography, interictal Rolandic double/multiple spikes and slow-wave abnormalities may indicate SeLECTS with ESES.
{"title":"The Prevalence and Risk Factors of Electrical Status Epilepticus During Slow-Wave Sleep in Self-Limited Epilepsy With Centrotemporal Spikes.","authors":"Guangshuang Lu, Yun Cheng, Yun Wang, Jie Hu, Fan Zhang, Wenbo Li, Minnong Xia, Xiaoyan Lu, Wu Yang","doi":"10.1177/15500594231182758","DOIUrl":"10.1177/15500594231182758","url":null,"abstract":"<p><p><b>Objective</b><i>.</i> To investigate the prevalence and risk factors for electrical status epilepticus during slow-wave sleep (ESES) in patients with self-limited epilepsy with centrotemporal spikes (SeLECTS). <b>Methods.</b> The clinical and follow-up data of children with SeLECTS were collected between 2017 and 2021. Patients were divided into typical ESES, atypical ESES, and non-ESES groups according to spike-wave indices (SWI). Clinical and electroencephalography characteristics were retrospectively analyzed. Logistic regression was used to identify risk factors for ESES. <b>Results.</b> A total of 95 patients with SeLECTS were enrolled. Seven patients (7.4%) developed typical ESES, 30 (31.6%) developed atypical ESES, 25 (26.3%) developed ESES at the first visit, and 12 (12.6%) developed ESES during treatment and follow-up. Multivariate logistic regression analysis showed that the risk factors for SeLECTS combined with ESES were Rolandic double or multiple spikes (OR = 8.626, 95% CI: 2.644-28.147, <i>P</i> < .001) and Rolandic slow waves (OR = 53.550, 95% CI: 6.339-452.368, <i>P</i> < .001). There were no significant differences in seizure characteristics, electroencephalogram (EEG) findings, or cognitive impairment between the atypical and typical ESES groups. <b>Conclusion.</b> More than one-third of the SeLECTS patients combined with ESES. Both atypical and typical ESES scores can affect cognitive function. On electroencephalography, interictal Rolandic double/multiple spikes and slow-wave abnormalities may indicate SeLECTS with ESES.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":" ","pages":"265-271"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9655669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2022-10-25DOI: 10.1177/15500594221134920
Prashant A Natteru, Shoba Jayaram, Oriana Sanchez, Kyla Leon, Aditi Mishra, Christa O'Hana Nobleza
Refractory status epilepticus is commonly defined as status epilepticus that fails to respond to two or more appropriately dosed intravenous anti-seizure medications including at least one non-benzodiazepine drug. Super-refractory status epilepticus (SRSE) is when status epilepticus continues for ≥24 h despite anesthetic treatment or recurs on an attempted wean of the anesthetic drugs. There is little evidence to guide the management of SRSE. Of late, unconventional therapies have been described in the literature regarding the management of SRSE, with ketamine leading the pack. Studies have noted ketamine's therapeutic efficacy up to 91% in SRSE cessation. Common side effects of ketamine include nausea, vomiting, headache, and hallucinations; but to our knowledge, ketamine has not been implicated in the pathogenesis of abdominal compartment syndrome. We describe a 74-year-old male who developed severe abdominal compartment syndrome in the setting of ketamine infusion for new-onset SRSE to increase awareness about this potential complication.
{"title":"Abdominal Compartment Syndrome with Super-K (Ketamine) for Super-R(efractory) Status Epilepticus: A Case Report.","authors":"Prashant A Natteru, Shoba Jayaram, Oriana Sanchez, Kyla Leon, Aditi Mishra, Christa O'Hana Nobleza","doi":"10.1177/15500594221134920","DOIUrl":"10.1177/15500594221134920","url":null,"abstract":"<p><p>Refractory status epilepticus is commonly defined as status epilepticus that fails to respond to two or more appropriately dosed intravenous anti-seizure medications including at least one non-benzodiazepine drug. Super-refractory status epilepticus (SRSE) is when status epilepticus continues for ≥24 h despite anesthetic treatment or recurs on an attempted wean of the anesthetic drugs. There is little evidence to guide the management of SRSE. Of late, unconventional therapies have been described in the literature regarding the management of SRSE, with ketamine leading the pack. Studies have noted ketamine's therapeutic efficacy up to 91% in SRSE cessation. Common side effects of ketamine include nausea, vomiting, headache, and hallucinations; but to our knowledge, ketamine has not been implicated in the pathogenesis of abdominal compartment syndrome. We describe a 74-year-old male who developed severe abdominal compartment syndrome in the setting of ketamine infusion for new-onset SRSE to increase awareness about this potential complication.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":"1 1","pages":"230-234"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47103450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-07-27DOI: 10.1177/15500594231183554
Glória M A S Tedrus
Clinical-electroencephalogram (EEG), as well as etiological and prognostic data on subtypes of nonconvulsive status epilepticus (NCSE) are yet to be established. Objective: Evaluate the clinical semiology and EEG findings and prognostic data of older adults with NCSE. Methodology: Characterize the clinical-EEG and prognostic data in the subtypes of NCSE in older adults consecutively admitted to the emergency room of the Pontifícia Universidade Católica de Campinas (PUC-Campinas) University Hospital. Results: When evaluating 105 older adults with altered consciousness, it was possible to diagnose NCSE in 50 (47.6%) older adults, with a mean age of 72.8 ± 8.8 years. NCSE-coma occurred in 6 cases, with NCSE-without coma in 44 cases. The etiology was structural in 41(82%) cases, metabolic in 5 cases, and unknown etiology in 4 cases. Twelve cases had a history of epileptic seizures. On the EEG, epileptiform discharges (EDs > 2.5 Hz) were present in 34(68%) cases and rhythmic delta activity /lateralized periodic patterns occurred in 35(70%) cases. There was clinical improvement after the initial pharmacological treatment in 36 cases and, within 30 days, 18 cases died. The better prognosis was associated with a good response to initial pharmacological treatment (n = 14) and with EDs > 2.5 Hz on EEG (Fisher's exact test; 26 vs 8; P = .012). Conclusion: Focal NCSE with impaired consciousness was the most frequent subtype. The most frequent finding on the EEG was the recording of focal/regional seizures. A high number of cases showed initial clinical improvement, but mortality was high. The favorable prognosis was associated with initial clinical improvement and the presence of EDs > 2.5 Hz. There was no relationship between EEG patterns and the etiology and subtypes of NCSE in older adults.
{"title":"Ictal EEG: Etiology and Mortality in Older Adults With Nonconvulsive Status Epilepticus.","authors":"Glória M A S Tedrus","doi":"10.1177/15500594231183554","DOIUrl":"10.1177/15500594231183554","url":null,"abstract":"<p><p>Clinical-electroencephalogram (EEG), as well as etiological and prognostic data on subtypes of nonconvulsive status epilepticus (NCSE) are yet to be established. <b>Objective:</b> Evaluate the clinical semiology and EEG findings and prognostic data of older adults with NCSE. <b>Methodology:</b> Characterize the clinical-EEG and prognostic data in the subtypes of NCSE in older adults consecutively admitted to the emergency room of the Pontifícia Universidade Católica de Campinas (PUC-Campinas) University Hospital. <b>Results:</b> When evaluating 105 older adults with altered consciousness, it was possible to diagnose NCSE in 50 (47.6%) older adults, with a mean age of 72.8 ± 8.8 years. NCSE-coma occurred in 6 cases, with NCSE-without coma in 44 cases. The etiology was structural in 41(82%) cases, metabolic in 5 cases, and unknown etiology in 4 cases. Twelve cases had a history of epileptic seizures. On the EEG, epileptiform discharges (EDs > 2.5 Hz) were present in 34(68%) cases and rhythmic delta activity /lateralized periodic patterns occurred in 35(70%) cases. There was clinical improvement after the initial pharmacological treatment in 36 cases and, within 30 days, 18 cases died. The better prognosis was associated with a good response to initial pharmacological treatment (n = 14) and with EDs > 2.5 Hz on EEG (Fisher's exact test; 26 vs 8; <i>P </i>= .012). <b>Conclusion:</b> Focal NCSE with impaired consciousness was the most frequent subtype. The most frequent finding on the EEG was the recording of focal/regional seizures. A high number of cases showed initial clinical improvement, but mortality was high. The favorable prognosis was associated with initial clinical improvement and the presence of EDs > 2.5 Hz. There was no relationship between EEG patterns and the etiology and subtypes of NCSE in older adults.</p>","PeriodicalId":10682,"journal":{"name":"Clinical EEG and Neuroscience","volume":" ","pages":"278-282"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10241494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}