Mnemotecnias para la aplicación e interpretación del electroencefalograma de amplitud integrada en recién nacidos / Mnemonics for the use and interpretation of amplitude-integrated electroencephalography in newborn infants

La electroencefalografía (EEG) siempre ha sido considerada una materia especializada, que amerita de entrenamiento para su aplicación e interpretación; esto ha provocado que el acceso a estos estudios quedara confinado a neurólogos y neurofisiólogos. El recién nacido ingresado en la unidad de cuidados intensivos neonatales (UCIN) amerita de monitorización neurológica para establecer diagnóstico y pronóstico, por lo que se necesita una herramienta sencilla y accesible para el personal de la UCIN. Estas características han sido cubiertas por el electroencefalograma de amplitud integrada (aEEG) que, a través de patrones visuales simples de la actividad cerebral, permite el abordaje de la condición neurológica. El objetivo de este ensayo se orienta al manejo de mnemotecnias que faciliten la identificación de patrones visuales normales y patológicos en el aEEG. La nomenclatura empleada, aunque puede parecer simple, pretende crear una idea fácilmente asimilable de los conceptos básicos para la aplicación e interpretación de la neuromonitorización con aEEG.

An electroencephalography (EEG) has always been considered a specialized field, whose use and interpretation requires training. For this reason, access to these monitoring studies has been restricted to neurologists and neurophysiologists. Newborn infants admitted to the neonatal intensive care unit (NICU) require neurophysiological monitoring to establish their diagnosis and prognosis, so a simple and accessible tool is required for NICU staff. Such features have been covered by amplitude-integrated electroencephalography (aEEG), which, through simple visual patterns of brain activity, allows to approach neurological conditions. The objective of this study is to help with the management of mnemonics that facilitate the identification of normal and pathological visual patterns in an aEEG. Although simple in appearance, this nomenclature is intended to create an easy-to-understand idea of basic concepts for the use and interpretation of neurophysiological monitoring with aEEG.

Application of a mental imagery protocol for the promotion of implicit learning in university students / Aplicación de un protocolo de imaginería mental para la promoción del aprendizaje implícito en estudiantes universitarios

Abstract Objective. The improvement of cognitive skills has become an issue of particular interest nowadays. It is still being determined if techniques like mental imagery (MI) could generate cognitive enhancement via modulation of neural brain activity. The purpose of this study was to provide information on the impact of mental imagery on implicit motor learning. Method. To test this hypothesis, an MI protocol was applied to an experimental group before performing an implicit learning (IL) task, while a control group received a sham feedback protocol. In addition, to have empirical evidence of cortical activation during MI, we made an electroencephalographic (EEG) record of motor cortex activity during baseline and during the task associated with IL. Results. The ANCOVA models all together show how the MI protocol does impact the IL process, but not as clearly as expected.

Resumen Objetivo. La mejora de las habilidades cognitivas es un tema de especial interés en la actualidad. Todavía se está determinando si técnicas como la imaginería mental (IM) podrían generar una mejora cognitiva a través de la modulación de la actividad cerebral. El propósito de este estudio fue aportar información sobre el impacto de la imaginería mental en el aprendizaje motor implícito. Método. Se aplicó un protocolo de IM a un grupo experimental antes de realizar una tarea de aprendizaje motor implícito, mientras que un grupo de control recibió realimentación simulada. Además, para tener evidencia empírica de la activación cortical durante la IM, se registró, mediante electroencefalografía, la actividad de la corteza motora durante el inicio y durante la tarea de aprendizaje motor implícito. Resultados. Los modelos ANCOVA muestran cómo el protocolo de IM impacta el proceso de aprendizaje motor implícito, pero no tan claramente como se esperaba.

Estimulación luminosa intermitente durante el electroencefalograma en epilepsia. Necesidad de homogeneizar su práctica en Hispanoamérica / Intermittent photic stimulation during electroencephalogram in epilepsy. Need to homogenize its practice in Hispanic America

RESUMEN La estimulación luminosa intermitente (ELI) es una de las maniobras más comunes y conocidas utilizadas durante los registros de electroencefalograma (EEG). A pesar de ser la de más fácil estandarización, presenta una gran variabilidad metodológica y la interpretación y clasificación de la respuesta fotoparoxística (RFP) sigue siendo, en gran medida, subjetiva. Objetivo: La presente revisión intenta ofrecer un marco de referencia actualizado acerca de la metodología estandarizada para la ejecución de la ELI y para interpretar/clasificar la RFP. Se formula un análisis crítico de los retos prácticos actuales en el ámbito clínico y se proponen algunos criterios operativos que pueden contribuir a mejorar el acuerdo entre evaluadores. Conclusiones: Los criterios operativos propuestos abarcan -pero no se limitan- a la morfología, la amplitud, la duración, el desfase y la redundancia. La generalización del uso de una metodología estandarizada de ELI, aunada a criterios operativos para confirmar la presencia de RFP, puede ayudar a mejorar el diagnóstico de epilepsia y de fotosensibilidad. De esta forma, la práctica clínica del EEG no solo mantendría su vigencia, sino que incluso mejoraría la atención a pacientes con epilepsia. La presente revisión en idioma español puede contribuir a homogeneizar esta práctica clínica en países hispanohablantes.

ABSTRACT Intermittent photic stimulation (IPS) is one of the most common and well-known activation methods used during routine EEG recordings. However, although it is the most straightforwardly standardized activation technique, its methodology still has significant variability, and the interpretation and classification of photoparoxysmal response (PPR) remain largely subjective. Objective: This review aims to provide an updated reference about the standardized methodology to perform the IPS procedure. Additionally, it intends to provide an update on the interpretation and classification of the PPR. A critical analysis about current practical/clinical challenges is formulated, and some potential operational criteria to improve the interrater agreement for the confirmation of PPR are proposed. Conclusions: Proposed operational criteria include, but are not limited to morphology, amplitude, duration, lag, and redundancy. The generalization of using a standardized IPS methodology and defined operational criteria to confirm the presence of PPR can help improve the diagnosis of epilepsy and photosensitivity. Thus, the clinical practice of EEG would maintain its validity, and enhance the care of patients with epilepsy. This review in Spanish can contribute to standardize this clinical practice in Spanish-speaking countries.

Biomarcadores electrofisiológicos en patología dual / Electrophysiological Biomarkers in Dual Pathology

resumen Introducción: Se denomina patología dual a la coocurrencia del trastorno por consumo de sustancias con al menos otro trastorno mental, que a su vez se caracteriza por una clínica heterogénea difícil de diagnosticar y de pobre respuesta al tratamiento. Por esto es necesario la identificación y validación de biomarcadores. Dentro de este grupo, se han reportado posibles biomarcadores electroencefalográficos útiles en el diagnóstico, el tratamiento y el seguimiento, tanto en condiciones neuropsiquiátricas como en trastornos por consumo de sustancias. Este artículo tiene como objetivo revisar la literatura existente acerca de biomarcadores electroencefalográficos en patología dual. Métodos: Revisión narrativa de la literatura. Se realizó una búsqueda bibliográfica en las bases de datos PubMed, Science Direct, OVID, BIREME y Scielo, con las palabras clave: biomarcador electrofisiológico y trastorno por uso de sustancias, biomarcador electrofisiológico y trastornos mentales, biomarcador y patología dual, biomarcador y trastorno por uso de sustancias, electroencefalografía y trastorno por uso de sustancias o trastorno mental comórbido. Resultados: Dado que se ha hallado mayor cantidad de literatura en relación con la electroencefalografía como biomarcador de enfermedades mentales y trastornos por consumo de sustancias y pocos artículos sobre patología dual, se organiza la evidencia como biomarcador en psiquiatría para el diagnóstico y la predicción del riesgo y como biomarcador para patología dual. Conclusiones: Aunque la evidencia no es concluyente, indica la existencia de subconjunto de sitios y mecanismos donde los efectos de las sustancias psicoactivas y la neurobiología de algunos trastornos mentales podrían traslaparse o interactuar.

abstract Introduction: The co-occurrence of substance use disorder with at least one other mental disorder is called dual pathology, which in turn is characterised by heterogeneous symptoms that are difficult to diagnose and have a poor response to treatment. For this reason, the identification and validation of biomarkers is necessary. Within this group, possible electroencephalographic biomarkers have been reported to be useful in diagnosis, treatment and follow-up, both in neuropsychiatric conditions and in substance use disorders. This article aims to review the existing literature on electroencephalographic biomarkers in dual pathology. Methods: A narrative review of the literature. A bibliographic search was performed on the PubMed, Science Direct, OVID, BIREME and Scielo databases, with the key**words: electrophysiological biomarker and substance use disorder, electrophysiological biomarker and mental disorders, biomarker and dual pathology, biomarker and substance use disorder, electroencephalography, and substance use disorder or comorbid mental disorder. Results: Given the greater amount of literature found in relation to electroencephalography as a biomarker of mental illness and substance use disorders, and the few articles found on dual pathology, the evidence is organised as a biomarker in psychiatry for the diagnosis and prediction of risk and as a biomarker for dual pathology. Conclusions: Although the evidence is not conclusive, it suggests the existence of a subset of sites and mechanisms where the effects of psychoactive substances and the neurobiology of some mental disorders could overlap or interact.

Application of Acoustoelectric Imaging in Biological Current Detection / 生物化学与生物物理进展

The conventional noninvasive biological current detection such as electrocardiogram, electroencephalography and surface electromyography can provide electrical reference for diseases diagnosis. Because the bioelectrical signals are the mixed result of the common discharge of sell populations, the spatial resolution of the above bioelectrical detection is relatively limited. In recent years, the acoustoelectric imaging (AEI) has been introduced to spatially code biological current through noninvasive focused ultrasound. Then the electrical signal with precise focus position can be obtained. It can achieve noninvasive detection of biological electrical signals with millimeter-level spatial resolution and millisecond-level temporal resolution which is expected to develop into a new imaging technology for accurately detecting deep electrical activities of living organisms. We firstly describe AEI principle, including acoustoelectric effect and the derivation of acoustoelectric signal equation. Then we briefly introduce characteristics of acoustoelectric signal. It can be seen from the equation of acoustoelectric signal that the acoustoelectric signal depends on the current field and the ultrasonic field. Furtherly, the typical studies of AEI are introduced including acoustoelectric coupling mechanism, AEI methods, acoustoelectric brain imaging (ABI) and acoustoelectric cardiac imaging (ACI). In terms of the acoustoelectric coupling mechanism, the researchers found that the acoustoelectric effect of electrolyte solution is caused by the change of ion molar concentration, ion migration rate and ion viscosity with pressure and temperature, and the acoustoelectric effect coefficient of normal saline is accurate to (0.034±0.003)% MPa–1. In terms of AEI methods, researchers improved the detection sensitivity, spatial resolution, signal to noise ratio and other performance indicators by improving AEI methods and optimizing AEI systems. In terms of ABI, it can utilize the acoustoelectric coupling mechanism to endow the target area with spatial features of ultrasound, and achieve noninvasive high resolution EEG detection. We review the important research achievements and significance layer by layer from the perspectives of feasibility verification, method system optimization, and clinical application exploration in acoustoelectric imaging. In terms of ACI, it can be used to quantitatively evaluate the spatial distribution and dynamic changes of cardiac current field, providing a new idea for real-time monitoring of cardiac electrophysiological state before and after surgery. We summarize and review the important research achievements and significance of ACI at each stage: in phantom, in vitro and in vivo. Finally, we discuss the future research direction by focusing on the challenges faced by key technical links such as focused ultrasound targeting, ultrasonic spatial coding and decoding, acoustoelectric sensing detection, and imaging system integration, in order to provide basis and inspiration for AEI technology system and clinical transformation.

Characteristics of event-related potential and frequency on working memory of post-stroke aphasia / 中国康复理论与实践

Objective To explore the task-state electroencephalogram(EEG)characteristics of working memory in patients with post-stroke aphasia(PSA). Methods From September,2020 to February,2021,a total of eight patients with PSA(PSA group)and eight healthy adults(HC group)were recruited to collect EEG and memory scale data.The EEG data of working memory task-states were used to analyze the characteristics of the EEG frequency band indicators in time domain event-related potentials(ERP)and frequency;and the correlation with the items in the memory scale. Results Finally,five patients and five controls were included.N1 and P2 components were induced in the frontal area,and P300 components were induced in the parieto-occipital area.Compared with HC group,the activation of N1 and P2 increased in central prefrontal region,while the activity of P300 decreased in the right parieto-occipital re-gion in PSA group(|t|>2.193,P<0.05).The energy of theta band decreased in the right prefrontal region and the central parieto-occipital region,the energy of alpha1 band decreased in the left parieto-occipital region,and the energy of gamma band increased in the left central region(t>2.398,P<0.05).The energy of gamma band correlated with immediate recall(r = 0.914,P = 0.030)and correct recognition(r = 0.931,P = 0.022)of Auditory Verbal Learning Test,and inverting(r = 0.924,P = 0.025)and anterograde(r = 0.889,P = 0.044)of Digit Span Test. Conclusion Visual working memory task can activate the compensatory processing activity of memory related brain re-gions after PSA,which can be used as an objective indication for the evaluation of PSA working memory related research.There is close relationship between language impairment and working memory.

Predictive value of quantitative EEG parameters on prognosis of patients with severe aneurysmal subarachnoid hemorrhage / 中国脑血管病杂志

Objective To explore the feasibility of quantitative EEG parameters for prognostic prediction of patients with severe aneurysmal subarachnoid hemorrhage(SaSAH)90 d after the onset of the disease.Methods Patients with SaSAH admitted to the Neurosurgical Intensive Care Unit(NSICU)of Henan Provincial People's Hospital from September 2022 to September 2023 were prospectively consecutively enrolled,and baseline data were collected,including age,gender,medical history(hypertension,diabetes mellitus,coronary artery disease,and stroke),history of smoking,history of drinking,location of aneurysm(anterior circulation,posterior circulation),surgical modality(craniotomy,interventional surgery,hybrid surgery),Hunt-Hess classification,Glasgow coma scale(GCS)score,acute physiology and chronic health status scoring system Ⅱ(APACHE Ⅱ)score,subarachnoid hemorrhage early brain edema score(SEBES),first randomized blood glucose level after admission to NSICU,lactate level,and duration of NSICU stay.Quantitative EEG monitoring was performed in all patients within 48 h after admission to the NSICU,and amplitude-integrated electroencephalogram(aEEG)upper and lower boundaries,95％spectral edge frequency(SEF95),α change,(δ+θ)to(α+β)power ratio(DTABR),brain symmetry index(BSI),and spectral entropy were collected.Based on modified Rankin scale(mRS)scores 90 d after onset,patients were categorized into good prognosis(mRS score 2 points)and poor prognosis(mRS score 3-6 points)groups.Spearman rank correlation was used to analyze the correlation between quantitative EEG parameters and mRS scores in SaSAH patients.Multifactorial Logistic regression analysis was used to screen for correlates of poor prognosis,and receiver operating characteristic(ROC)curves were plotted to evaluate the efficacy of each index in predicting patients'poor prognosis.Results(1)A total of 72 patients with SaSAH were included,with 47 in the poor prognosis group and 25 in the good prognosis group,and the poor prognosis rate at 90 d after the onset was 65.3％.There was no statistically significant difference between the two groups in terms of gender,age,hypertension,diabetes mellitus,coronary artery disease,history of stroke,history of smoking,history of drinking,location of aneurysm,surgical modality,lactate level,and length of hospitalization in the NSICU(all P＞0.05);the differences between the Hunt-Hess grading,SEBES,and random blood glucose were statistically significant upon comparison(all P＜0.05).Compared with the good prognosis group,the changes of aEEG upper and lower boundary,SEF95,α change and spectral entropy were lower in the poor prognosis group,but DTABR and BSI were higher(all P＜0.05).(2)Spearman rank correlation analysis showed that the upper border of aEEG(r=-0.41,P＜0.01),lower border of aEEG(r=-0.54,P＜0.01),SEF95(r=-0.46,P＜0.01),α change(r=-0.53,P＜0.01)and spectral entropy(r=-0.39,P＜0.01)were negatively correlated with the mRS scores of SaSAH patients,and DTABR(r=0.52,P＜0.01)and BSI(r=0.33,P＜0.01)were positively correlated with poor prognosis of SaSAH patients.(3)The results of multifactorial Logistic regression analysis showed that Hunt-Hess grading(level Ⅳ vs.Ⅲ:OR,1.203,95％CI 1.005-1.441,P=0.044;level V vs.Ⅲ:OR,1.661,95％CI 1.109-2.487,P=0.014),SEBES(OR,1.647,95％CI 1.050-2.586;P=0.030),aEEG lower border(OR,0.687,95％CI 0.496-0.953l;P=0.024),SEF95(OR,0.436,95％CI0.202-0.937;P=0.034),α change(OR,0.368,95％CI0.189-0.717;P=0.003),DTABR(OR,1.324,95％CI 1.064-1.649;P=0.012),and BSI(OR,1.513,95％CI 1.026-2.231;P=0.036)were influencing factors of poor prognosis in SaSAH patients.ROC curve analysis showed that all of the above seven indicators had a certain predictive value for poor prognosis in SaSAH patients,among which the area under the curve of DTABR was the highest as 0.862(95％CI 0.761-0.932),with sensitivity 85.11％and specificity 80.00％.Conclusion Quantitative EEG parameters aEEG lower border,SEF95,α change,DTABR,and BSI may have certain predictive value for the short-term prognosis of SaSAH patients,which needs to be further confirmed in future multi-center large-sample studies.

Electroencephalography applied in autism spectrum disorder research in decade: a bibliometrics analysis / 中国康复理论与实践

ObjectiveTo analyze the current state, research hotspots, and development trends of electroencephalography (EEG) applied in the field of autism spectrum disorder (ASD). MethodsRelevant literature from the Web of Science core collection database from January, 2014 to January, 2024 were retrieved and analyzed using CiteSpace 6.2.R4. ResultsA total of 1 509 articles were included, with an increasing trend in publication volume over the years. The United States ranked highest in both publication volume and node centrality. The primary journals in this field were concentrated in clinical medicine, immunology and psychology. Keyword co-occurrence and clustering indicated that research primarily focused on the correlation between core symptoms of ASD and EEG indicators, differential diagnosis of ASD and its comorbidities, brain functional connectivity, and assessment of rehabilitation efficacy. Keywords bursted in the past three years mainly included artificial intelligence and machine learning. ConclusionThe researches in EEG technology in the field of ASD is generally increasing. Future researches may focus on exploring the brain network mechanisms of ASD using EEG combined with multimodal neuroimaging, and machine learning technologies.

Value of brain 18F-FDG PET/CT in the preoperative localization of epileptogenic foci in refractory epilepsy patients with negative MRI / 中华核医学与分子影像杂志

Objective:To evaluate the value of 18F-FDG PET/CT for preoperative localization of epileptogenic foci in refractory epilepsy patients with negative MRI. Methods:Clinical data (550 lobes) of 55 epilepsy patients (38 males, 17 females, age (20.0±8.1) years) with negative MRI who underwent preoperative 18F-FDG PET/CT-MRI between January 2014 and June 2020 at the First Affiliated Hospital of Jinan University were retrospectively analyzed. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of 18F-FDG PET/CT, video electroencephalogram (VEEG), PET/CT+ VEEG and PET/CT-VEEG for localizing epileptogenic foci were calculated using stereoelectroencephalography (SEEG) and the outcomes of at least 1 year of postoperative follow-up as reference standards. χ2 test was used to compare the efficiencies of different examination modalities for unilobar, multilobar and all patients. Results:The correct lateralization rate of epileptogenic foci was 92.6%(25/27) using PET/CT. The sensitivity, specificity, accuracy, PPV and NPV of PET/CT for localization of epileptogenic foci were 65.1%(54/83), 77.9%(364/467), 76.0%(418/550), 34.4%(54/157) and 92.6%(364/393), respectively. The sensitivities of PET/CT-VEEG for localization of epileptogenic foci in all patients and patients with multilobar epilepsy were higher than those of VEEG alone (75.9%(63/83) vs 45.8%(38/83), 68.6%(35/51) vs 31.4%(16/51); χ2 values: 15.80, 14.16, both P<0.001). The specificities of PET/CT+ VEEG for localization of epileptogenic foci in all patients and patients with unilobar epilepsy were higher than those of VEEG alone (97.6%(456/467) vs 94.6%(442/467), 97.9%(282/288) vs 94.1%(271/288); χ2 values: 5.66, 5.48; P values: 0.017, 0.019). The sensitivity of PET/CT-VEEG (PET/CT and VEEG concordance) for localization of epileptogenic foci was higher than that of PET/CT+ VEEG (PET/CT and VEEG discordance) (8/9 vs 28.4%(21/74); χ2=10.40, P=0.001), and its specificity and accuracy were higher than those of PET/CT-VEEG (PET/CT and VEEG discordance) (93.4%(57/61) vs 71.7%(291/406), 92.9%(65/70) vs 72.1%(346/480); χ2 values: 13.23, 13.96; both P<0.001). Conclusions:18F-FDG PET/CT can localize and lateralize epileptogenic foci in patients with negative MRI. The combination of 18F-FDG PET/CT and VEEG improves the sensitivity, specificity, and accuracy for epileptogenic foci detection. 18F-FDG PET/CT is more accurate in detecting epileptogenic foci when it is concordant with VEEG.

Clinical value of 18F-FDG PET/MR in localizing epileptogenic foci in refractory epilepsy / 中华核医学与分子影像杂志

Objective:To analyze the clinical value of 18F-FDG PET/MR for precise localization of epileptogenic foci in patients with refractory epilepsy. Methods:From February 2019 to December 2021, 81 patients (52 males, 29 females; age (30.0±10.9) years) with refractory epilepsy confirmed in Ruijin Hospital Shanghai Jiao Tong University School of Medicine were retrospectively enrolled. All patients underwent preoperative PET/MR exam, and the possible position of the epileptogenic foci were determined by PET/MR imaging and pre-surgical evaluation, then the stereoelectroencephalography (SEEG) electrodes were implanted. Surgery was performed, and outcome was assessed by using a modified Engel classification two years after surgery. χ2 test was used to compare the detection rates of MRI and PET/MR fusion imaging in localizing epileptogenic foci and the detection rates of epileptogenic foci in temporal lobe epilepsy (TLE) and extratemporal lobe epilepsy (ETLE) by PET/MR. Results:MRI correctly localized seizure foci in 38 patients, with the detection rate of 46.91%(38/81), while PET/MR detected seizure foci in 73 patients, with the detection rate of 90.12%(73/81; χ2=35.05, P<0.001). There were 63 TLE and 18 ETLE patients. The detection rate of PET/MR in localizing seizure foci in TLE patients was 95.24%(60/63), which was significantly higher than that in ETLE patients (13/18; χ2=5.94, P=0.015). After 2 years follow-up, the postoperative efficacy rate of TLE patients with Engel grades Ⅰ-Ⅱ was 76.19%(48/63), which was 13/18 of ETLE patients ( χ2=0.12, P=0.731). Conclusion:Hybrid PET/MR imaging can accurately locate epileptogenic foci, especially for MRI negative lesions, which provides precision imaging information for surgical planning and improves surgical success rate.

Role of 18F-FDG PET in the preoperative evaluation of extratemporal lobe epilepsy / 中华核医学与分子影像杂志

Objective:To analyze the application value of 18F-FDG PET in the preoperative evaluation of patients with extratemporal lobe epilepsy (ETLE) and explore improved methods to enhance its localization accuracy. Methods:A total of 41 patients (25 males, 16 females, age (22.7±7.5) years) who underwent surgery and ultimately confirmed ETLE in Peking Union Medical College Hospital between January 2006 and November 2022 were enrolled. The accuracy of preoperative independent 18F-FDG PET imaging and the combined application of 18F-FDG PET and MRI in detecting epileptogenic foci and their impacts on treatment decisions were retrospectively analyzed by using visual and semi-quantitative methods. Fisher′s exact test was used to analyze the data. Results:In all 41 patients, 40 cases were found metabolic abnormalities in extratemporal lobe by independent 18F-FDG PET based on visual analysis. Among them, 26 showed unifocal metabolic abnormalities, which were localized as epileptogenic foci. Fourteen patients showed multifocal metabolic abnormalities, and the epileptogenic foci were further verified in 8 cases through semi-quantitative analysis. In 1 case with negative PET visual analysis, a micro-metabolism focus was found at the abnormal MRI signal area. Among 13 patients with negative independent MRI, 9 were found microstructures abnormalities in brain regions with hypometabolism. 18F-FDG PET improved clinical decision-making in 18 patients (43.9%, 18/41). There were 30 patients (73.2%, 30/41) with seizure-free postsurgery, and the prognosis was not significantly different between patients with unifocal 18F-FDG PET metabolic pattern and those with multifocal ones (73.1%(19/26) vs 10/14, P=1.000). Conclusions:18F-FDG PET can be a useful diagnostic tool for patients with ETLE. Semi-quantitative analysis helps to detect more epileptogenic foci with multifocal metabolic abnormalities. The combined evaluation of 18F-FDG PET and MRI can improve the accuracy in localizing epileptogenic foci outside the temporal lobe.

Clinical and neurophysiological characteristics of epilepsy with blink inducing / 中华神经科杂志

Objective:To summarize the clinical and neurophysiological characteristics of epilepsy with blink inducing.Methods:The patients with epilepsy with blink test positive who received 24 h-video-electroencephalography (24 h-VEEG) monitoring from May 2017 to May 2022 in the Xijing Hospital, the Air Force Military Medical University were enrolled. Their clinical and electrophysiological characteristics were studied and they were followed up to observe their prognosis.Results:A total of 42 patients with epilepsy with blink test positive were collected, 1 of whom was lost to follow-up. The remaining 41 patients included 18 males (44%) and 23 females (56%), whose age was 3 to 12 (8.1±2.6) years. Self-limited epilepsy with centrotemporal spikes (SeLECTS) was diagnosed in 35 patients, self-limited epilepsy with autonomic seizures in 3, and developmental epileptic encephalopathy with spike-and-wave activation in sleep in 3, respectively. The electrical status epilepticus during sleep (ESES) was found in 31 patients (76%), whereas 10 (24%) without ESES. Thirty-two patients experienced 24 h-VEEG monitoring more than twice, and 23 of them were seizure free, of whom blink inducing disappeared in 14 patients and existed in 9 in the last 24 h-VEEG monitoring. Among the 9 patients who were not seizure free, blink inducing disappeared in 3 patients and remained in 6. There was no statistically significant difference between the two groups ( P>0.05). The age of the patients whose blink inducing disappeared in the last 24 h-VEEG monitoring after treatment was (11.3±3.1) years. Meanwhile the age of the patients whose blink inducing remained was (9.1±2.3) years, and the difference between the two groups was statistically significant ( t=2.254, P=0.030). Conclusions:Blink inducing is highly age-dependent and common in self-limited focal epilepsy and developmental epileptic encephalopathy, especially in SeLECTS. Moreover, patients with ESES are more likely to be blink test positive. There was no correlation between blink inducing and seizure outcome.

The progress of the application of machine learning in epilepsy / 中华神经科杂志

Epilepsy is an episodic, transient, stereotypic brain dysfunction caused by highly synchronized abnormal neuronal discharges in the brain, with unpredictable timing of seizures, for which the main treatment modalities are antiepileptic drugs and surgery. Its diagnosis and treatment require a large number of aids and clinical experience. For multiple clinical aspects of epilepsy, such as seizure prediction, drug therapy prognosis, and surgical treatment evaluation, machine learning can incorporate multiple clinical and imaging factors through deep mining of data, establish corresponding learning models, improve the efficiency and accuracy of epilepsy diagnosis, realize individualized application of antiepileptic drugs, and improve the preoperative evaluation and prognosis of epilepsy patients.

The effect of selective attention on electroencephalography responses to high-level hierarchical linguistic structures / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the neural mechanisms underlying the speech perception in individuals with normal hearing under the influence of selective attention.METHODS There were 32 individuals with normal hearing who were recruited.By manipulating the participants'selective attention,two simultaneous speech streams were differentiated into target and interfering speech.Participants were guided to complete an auditory perception electroencephalogram(EEG)experiment.Fourier spectrum analysis was used to calculate the spectrum responses induced by the two types of speech,and the differences in EEG energy values at the levels of character,word,and phrase were compared.RESULTS This study observed significant differences in the EEG responses between target and ignored speech at the word level(2 Hz),while no significant differences were observed at the character level(4 Hz)and phrase level(1 Hz).CONCLUSION In environments with multiple speech streams,selective attention primarily processes and encodes the interested speech at the word level rapidly and effectively.This study preliminarily reveals how the brain represents auditory language and constructs different language hierarchy units under the modulation of selective attention,providing a theoretical model for hearing aid algorithms in hearing-impaired patients.

Research progress on the electroencephalogram characteristics of nociception / 临床麻醉学杂志

The effective analysis of electroencephalography(EEG)data to objectively reflect the changes of nociception has been a hot topic of research in recent years.The incidence of moderate to severe postoperative acute pain remains high.Postoperative acute pain seriously affects patients'physical and psy-chological health,yet there is no objective gold standard for measuring perioperative nociception to guide perioperative analgesia.The results of current studies on the characteristics of EEG changes during nociception are contradictory.This paper presents the EEG characteristics of nociception in order to provide a reference for future research design.

Absolute beta power in exercisers and nonexercisers in preparation for the oddball task / Potência absoluta de beta em praticantes e não praticantes de exercício físico na preparação da tarefa oddball

Abstract Background High levels of physical conditioning are associated with improvements in cognitive performance. In this sense, electroencephalographic (ECG) correlates are used to investigate the enhancing role of physical exercise on executive functions. Oscillations in the β frequency range are proposed to be evident during sensorimotor activity. Objective To investigate the ECG changes influenced by aerobic and resistance exercises performed in an attention task by analyzing the differences in absolute β power in the prefrontal and frontal regions before, during, and after the oddball paradigm in practitioners and nonpractitioners of physical exercise. Methods There were 15 physical activity practitioners (aged 27 ± 4.71) and 15 nonpractitioners (age 28 ± 1.50) recruited. A two-way analysis of variance (ANOVA) was implemented to observe the main effect and the interaction between groups and moments (rest 1, pre-stimulus, and rest 2). Results An interaction between group and moment factors was observed for Fp1 (p < 0.001); Fp2 (p = 0.001); F7 (p < 0.001); F8 (p < 0.001); F3 (p < 0.001); Fz (p < 0.001); and F4 (p < 0.001). Electrophysiological findings clarified exercisers' specificity and neural efficiency in each prefrontal and frontal subarea. Conclusion Our findings lend support to the current understanding of the cognitive processes underlying physical exercise and provide new evidence on the relationship between exercise and cortical activity.

Resumo Antecedentes Níveis elevados de condicionamento físico estão associados a melhorias no desempenho cognitivo. Nesse sentido, correlatos eletroencefalográficos são utilizados na investigação do papel aprimorador do exercício físico sobre as funções executivas. Tem sido proposto que as oscilações na faixa de frequência β são evidenciadas durante a atividade sensório-motora. Objetivo Investigar as alterações eletroencefalográficas influenciadas por exercícios aeróbio e resistido realizados em uma tarefa atencional analisando as diferenças da potência absoluta de β nas regiões pré-frontal e frontal antes, na preparação e depois do paradigma oddball em praticantes e não praticantes de exercício físico. Métodos Foram recrutados 15 praticantes de atividade física (idade 27 ± 4.71) e 15 não praticantes (idade 28 ± 1.50). Uma análise de variância (ANOVA) de duas vias foi implementada para observação do efeito principal e a interação entre os grupos e os momentos (repouso 1, pré-estímulo e repouso 2). Resultados Uma interação entre os fatores grupo e momento para Fp1 (p < 0,001); Fp2 (p = 0,001); F7 (p < 0,001); F8 (p < 0,001); F3 (p < 0,001); Fz (p < 0,001); e F4 (p < 0,001) foi observada. Os achados eletrofisiológicos esclareceram a especificidade e a eficiência neural dos praticantes de exercício físico em cada subárea pré-frontal e frontal. Conclusão Nossos achados promovem o entendimento atual dos processos cognitivos subjacentes ao exercício físico e acrescentam novas evidências sobre a relação exercício e atividade cortical.

Testing an online screening tool for epilepsy surgery evaluation / Testando uma ferramenta de triagem online para a avaliação de cirurgia de epilepsia

Abstract Background Epilepsy surgery is recognized for its effectiveness in controlling seizures in a significant number of patients with drug-resistant epilepsy. Despite this, there remains a notable deficiency in referring these patients for video-electroencephalogram (EEG) monitoring and surgical evaluation. Addressing this gap, the Canadian Appropriateness of Epilepsy Surgery (CASES), an online tool for epilepsy surgery evaluation (www.epilepsycases.com), was developed to aid physicians in the referral process of patients with refractory epilepsy to surgical assessments. Objective The present study aimed to evaluate the utility of CASES in identifying candidates for epilepsy surgery, thereby facilitating clinical decision-making for patients with drug-resistant epilepsy. Methods A cross-sectional analysis was conducted using the CASES platform to assess surgical candidacy among individuals with epilepsy. Participants were selected among those receiving care at the Epilepsy Clinic of the Neurology Service, Hospital de Clínicas de Porto Alegre, Brazil, over a 3-month period. The study cohort included 211 patients. Data were systematically extracted from patient medical records or collected during clinical appointments. Results Of the evaluated cohort, 59.6% were identified as potential candidates for video-EEG monitoring and subsequent surgical evaluation. Factors significantly associated with recommendations for video-EEG and surgical assessment included seizure frequency, the number of antiseizure medications (ASMs) trialed, and the occurrence of drug-related adverse effects. Conclusion The CASES showed significant potential in guiding recommendations for video-EEG monitoring and facilitating referrals for epilepsy surgery. This tool may not only enhance patient treatments and outcomes but also contribute to cost savings in epilepsy management in both the short and long term.

Resumo Antecedentes A cirurgia de epilepsia é reconhecida por sua eficácia no controle de crises em um número significativo de pacientes com epilepsia resistente a medicamentos. Apesar disso, persiste uma deficiência notável na referência desses pacientes para monitoramento por vídeo-eletroencefalograma (EEG) e avaliação cirúrgica. Para avaliar essa lacuna, a Adequação Canadense da Cirurgia de Epilepsia (Canadian Appropriateness of Epilepsy Surgery CASES, na sigla em inglês), uma ferramenta online para avaliação de cirurgia de epilepsia (www.epilepsycases.com), foi desenvolvida para auxiliar médicos no processo de selecionar pacientes com epilepsia refratária para avaliações cirúrgicas. Objetivo Avaliar a utilidade da CASES na identificação de candidatos para cirurgia de epilepsia, facilitando assim os processos de decisão terapêutica para pacientes com epilepsia resistente a medicamentos. Métodos Foi realizada uma análise transversal usando a plataforma CASES para estimar a necessidade de avaliação cirúrgica entre indivíduos com epilepsia. Os participantes foram selecionados dentre aqueles em atendimento na Clínica de Epilepsia do Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, durante um período de 3 meses. O estudo incluiu uma coorte de 211 pacientes. Os dados foram sistematicamente extraídos dos prontuários médicos dos pacientes ou coletados durante consultas clínicas. Resultados Da coorte avaliada, 59,6% foram identificados como potenciais candidatos para monitoramento por vídeo-EEG e subsequente avaliação cirúrgica. Fatores significativamente associados com recomendações para vídeo-EEG e avaliação cirúrgica incluíram a frequência de crises, o número de drogas anticrise (DACs) testadas e a ocorrência de efeitos adversos relacionados aos medicamentos. Conclusão A CASES mostrou um potencial significativo em orientar as recomendações para monitoramento por vídeo-EEG e facilitar o encaminhamento de pacientes para avaliação cirúrgica. Ferramentas como essas podem não apenas melhorar os tratamentos e resultados dos pacientes, mas também contribuir para economias de custo no manejo da epilepsia a curto e longo prazo.

A rare case of Sporadic Creutzfeldt-Jakob disease at a remote mountain hospital in the Indian Himalayan Region

ABSTRACT Sporadic Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative spongiform encephalopathy that causes neuronal derangement secondary to prion protein. Its initial diagnosis is often complex and challenging due to non-specific clinical presentation, lack of awareness, and low clinical suspicion. This disease is invariably fatal, and most patients die within 12 months of presentation. Definite diagnosis of prion disease requires neuropathological analysis, usually done at autopsy. Here, we present the autopsy findings of a 57-year-old male patient, illustrating the complexity of diagnosing this disease early in the clinical course and the need for a broad differential diagnosis at the onset.

An appraisal to Hans Berger by the time of his 150th birthday: the human EEG and tales of blood flow, heat and brain waves / Um ensaio sobre o aniversário de 150 anos de Hans Berger: uma história de sangue, calor e ondas cerebrais

Abstract More than 100 years of research have passed by and still the human electroencephalogram (EEG) remains a puzzle to be solved. Starting from his studies on plethysmography until his theories on brain thermodynamics, Hans Berger was able to refine his method of recording cortical signs with the apparatus at his disposal in an ordinary neuropsychiatric yard towards an early account of human EEG. This review is an appraisal of his contribution to the field of modern neurophysiology.

Resumo Mais de 100 anos se passaram e o eletroencefalograma humano (EEG) continua sendo um enigma a ser desvendado. A partir de seus estudos sobre pletismografia até suas teorias sobre termodinâmica cerebral, Hans Berger conseguiu refinar seu método de registro da atividade elétrica cortical com os equipamentos a sua disposição em uma ala psiquiátrica comum produzindo uma descrição acurada do EEG humano. Esta revisão é um breve resumo de sua contribuição para o campo da neurofisiologia moderna.

Diseño de la tarjeta de habilidades prácticas de electroencefalografía para el técnico en Neurofisiología Clínica

Introducción: El programa de formación del Técnico Superior de Ciclo Corto en Neurofisiología Clínica incorpora en la educación en el trabajo la rotación por electroencefalografía. En ella el estudiante adquiere habilidades esenciales, desarrolla su pensamiento creador e independiente. No obstante, las habilidades prácticas desarrolladas en la misma no están establecidas. Objetivo: Diseñar la tarjeta de habilidades prácticas de electroencefalografía para el técnico en Neurofisiología Clínica. Materiales y métodos: Se realizó un estudio descriptivo transversal entre enero y julio de 2022. Fueron entrevistados seis profesores que impartieron la asignatura Electroencefalografía en el Técnico Superior de Ciclo Corto en Neurofisiología Clínica, cuatro de la Facultad de Ciencias Médicas Juan Guiteras Gener, de Matanzas, y dos de la Facultad de Ciencias Médicas Victoria de Girón, de La Habana. Resultados: Los profesores entrevistados, de modo general, apuntaron habilidades prácticas muy similares para el diseño de la tarjeta. La misma fue validada por el criterio de especialistas. Conclusiones: El diseño de la tarjeta de habilidades prácticas contiene los elementos fundamentales para la rotación de electroencefalografía aplicada en la educación al trabajo. Esta organiza y orienta en el estudiante su aprendizaje.

Introduction: The training program of the Short Cycle High Education Technician in Clinical Neurophysiology includes electroencephalography rotation into on-the-job education. In it, the student acquires essential skills, develops his creative and independent thinking. However, the practical skills developed in it are not established. Objective: To design the practical skills card of electroencephalography for the Technician in Clinical Neurophysiology. Materials and methods: A cross sectional, descriptive study was carried out in the period from January to July 2022. Six professors who taught the subject Electroencephalography in the Short Cycle course High Education Technician in Clinical Neurophysiology were interviewed; four from the Faculty of Medical Sciences Juan Guiteras Gener, from Matanzas, and two from the Faculty of Medical Sciences Victoria de Giron, from Havana. Results: The teachers interviewed, in general, pointed out very similar practical skills for the design of the card. It was validated by the criteria of specialists. Conclusions: The design of the practical skills card contains the fundamental elements for the electroencephalography rotation applied in on-the-job education. It organizes and guides the student's learning.