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1.
Rev. cuba. pediatr ; 93(3): e1018, 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1347542

ABSTRACT

Introducción: El síndrome de Lowe o síndrome oculocerebrorenal es un trastorno multisistémico. Es una enfermedad rara e infrecuente. Objetivo: Exponer un caso clínico típico, con fracaso renal controlado sin método dialítico y que de manera tardía en su adolescencia se diagnostica con síndrome de Lennox-Gastaut. Presentación caso: Adolescente masculino de 18 años nacido de un embarazo sin riesgo y parto por cesárea, macrofeto. Desde el nacimiento, con diagnóstico perinatal de catarata congénita y evolutivamente glaucoma bilateral con tratamiento conservador. A partir del primer año de vida padece de acidosis tubular y síndrome de Fanconi con evolución a una enfermedad renal crónica. Relacionado todo con retraso del desarrollo psicomotor, discapacidad intelectual, estereotipias, síntomas obsesivos compulsivos y depresión. De manera tardía, a los 10 años tuvo inicio de crisis epilépticas de varios tipos con predominio de las tónicas durante el sueño y en vigilia, frecuentes, con electroencefalograma característico de síndrome Lennox-Gastaut. Tuvo atención interdisciplinaria y evolución clínica estable hasta la edad adulta cumplida. El estudio molecular de ADN materno y del niño confirmaron la mutación c2224_2226 del GTA (exón 19), delección de valina en la posición 742 del cromosoma X del OCRL 1, que ratifica el síndrome de Lowe. Conclusiones: El Síndrome de Lowe, es un trastorno multisitémico, ligado al cromosoma X y frecuente en varones. Clínicamente se caracteriza por alteraciones oftalmológicas, renales y neurológicas(AU)


Introduction: Lowe syndrome or oculocerebrorenal syndrome is a multisystemic disorder. It's a rare and uncommon disease. Objective: Show a typical clinical case, with controlled renal failure without dialytic method and that late in the adolescence is diagnosed with Lennox-Gastaut syndrome. Case presentation: 18-year-old male adolescent born of a risk-free pregnancy and cesarean delivery, with macrosomia. From birth, he had a perinatal diagnosis of congenital cataract and evolutionarily bilateral glaucoma with conservative treatment. From the first year of life he suffers from tubular acidosis and Fanconi syndrome with an evolution to chronic kidney disease. All of these were related to delayed psychomotor development, intellectual disability, stereotypies, obsessive-compulsive symptoms and depression. Lately, at 10 years old, epileptic seizures of various types with predominance of tonic ones during sleep and wakefulness began; they were frequent, with characteristic electroencephalogram of Lennox-Gastaut syndrome. He had interdisciplinary care and stable clinical evolution into adulthood. The molecular study of the mother and child DNA confirmed the c2224_2226 mutation of GTA (exon 19), valine deletion at position 742 of the X chromosome of OCRL 1, which ratifies Lowe syndrome. Conclusion: Lowe Syndrome is a multisystemic disorder, linked to the X chromosome and common in males. Clinically, it is characterized by ophthalmological, renal and neurological alterations(AU)


Subject(s)
Humans , Male , Adolescent , Cataract/therapy , Rare Diseases/etiology , Renal Insufficiency, Chronic/therapy , Lennox Gastaut Syndrome/diagnosis , Oculocerebrorenal Syndrome/diagnosis , Electroencephalography/methods
2.
Arq. neuropsiquiatr ; 78(6): 356-360, June 2020. tab, graf
Article in English | LILACS | ID: biblio-1131711

ABSTRACT

ABSTRACT Background: Generalized periodic discharges (GPDs) are rare patterns that can be found in long-term electroencephalographic monitoring in critical patients. These patterns have been correlated with non-seizure crisis and non-convulsive status epilepticus, associated with poor prognosis. Objective: To compare the outcome between patients who developed GPDs and patients with other abnormalities in long-term electroencephalographic monitoring. Methods: A retrospective study was performed by analyzing the medical records of 112 patients over 18 years who developed GPDs during long-term electroencephalographic monitoring (12‒16 hours of monitoring) in the intensive care unit of a general hospital, compared with a group that had only nonspecific abnormalities in the monitoring. Results: Age and cardiorespiratory arrest (CA) were risk factors for death - OR 1.04 (95% CI 1,02 - 1,07) and p<0.001; OR 3.00 (95% CI 1,01 - 8,92) and p=0.046, respectively. It was not possible to evaluate if GPDs alone were associated with an unfavorable outcome or would be a bias for the development of CA in these patients. However, of the six isolated GPDs cases, 2/3 evolved to death, showing a tendency to worse prognosis. A significant difference (p=0.031) was observed for a worse outcome when comparing the group of 28 patients who presented GPD or CA with the other group which did not present any of these variables; of these 28 patients, 20 (71.4%) died. Conclusions: The presence of post-CA GPDs was associated with worse prognosis, but it was not clear whether these patterns are independent factors of an unfavorable evolution.


RESUMO Introdução: As descargas periódicas generalizadas (DPG) são padrões raros que podem ser encontrados durante monitorização eletroencefalográfica prolongada (MEP) em pacientes críticos. Esses padrões têm sido correlacionados com crises não convulsivas e estado de mal epiléptico não convulsivo, associados a um pior prognóstico. Objetivo: Comparar o desfecho entre pacientes que desenvolveram DPG e pacientes com anormalidades inespecíficas na MEP. Métodos: Foi realizado um estudo retrospectivo através da análise dos prontuários de 112 pacientes acima de 18 anos que desenvolveram DPG durante MEP (de 12‒16 horas de monitorização) na unidade de terapia intensiva de um hospital geral, comparando com um grupo que apresentou apenas anormalidades inespecíficas na MEP. Resultados: As variáveis idade e parada cardiorrespiratória (PCR) se mostraram como fatores de risco estatisticamente significativos para óbito - OR 1,04 (IC 95% 1,02 - 1,07) e p<0,001; OR 3,00 (IC 95% 1,01 - 8,92) e p=0,046, respectivamente. Não foi possível avaliar se DPG isoladamente se associaram a um desfecho desfavorável ou seriam um viés para o desenvolvimento de PCR nesses pacientes. Porém, dos seis casos de DPG isoladas, 2/3 evoluíram para óbito, o que revela uma tendência a pior prognóstico. Foi observada diferença significativa (p=0,031) para pior desfecho ao comparar o grupo de 28 pacientes que apresentou DPG ou PCR com o outro grupo que não apresentou nenhuma dessas variáveis, sendo que desses 28 pacientes, 20 (71,4%) foram a óbito. Conclusões: A presença de DPG pós-PCR está associada a pior prognóstico, porém não ficou claro se esses padrões são fatores independentes de evolução desfavorável.


Subject(s)
Humans , Patient Discharge , Status Epilepticus , Retrospective Studies , Hospital Mortality , Electroencephalography/methods
3.
Medicina (B.Aires) ; 80(supl.2): 63-66, mar. 2020. tab
Article in Spanish | LILACS | ID: biblio-1125109

ABSTRACT

El cociente Theta-Beta (T/B) del electroencefalograma cuantificado (EEGQ) de los pacientes con trastorno por déficit de atención e hiperactividad (TDAH) constituye una variable del EEG característica del trastorno primario con una precisión global del 89%. El objetivo de este estudio es medir el cociente T/B de una población de con TDAH y los efectos del tratamiento farmacológico con psicoestimulantes y no psicoestimulantes sobre el cociente T/B. La muestra estaba formada por 85 sujetos de entre 6 y los 18 años (68 niños y 17 niñas) con el diagnóstico de TDAH de subtipo inatento y combinado, según los criterios del DSM-V. Se les realizó un EEGQ con medición del cociente T/B antes y después de 6 meses de tratamiento con fármacos psicoestimulantes y no psicoestimulantes. Se compararon ambos grupos mediante la prueba de rangos con signo de Wilcoxon para muestras relacionadas. En el 86% de los casos el cociente T/B fue elevado respecto de los valores normales para la edad. La reducción en el cociente T/B fue significativa en el grupo tratado con psicoestimulantes aunque la reducción con los no psicoestimulantes no fue significativa. En conclusión, se confirma la elevación del cociente T/B en los pacientes con TDAH. Los fármacos psicoestimulantes disminuyen de forma significativa el cociente T/B elevado en los pacientes con TDAH tras 6 meses de tratamiento.


Theta-Beta (T / B) ratio of the quantified electroencephalogram (EEGQ) in patients with attention deficit hyperactivity disorder (ADHD) constitutes a characteristic EEG variable of the primary disorder with an overall accuracy of 89%. The objective of this study was to measure the T/B ratio in a sample of patients with ADHD and the effects of the treatment with psychostimulants and non-psychostimulants on the T/B ratio. The sample consisted of 85 children between 6 and 18 years (68 males and 17 females) with the diagnosis of the inattentive and combined subtype of ADHD, according to the criteria of the DSM-V. An EEGQ was performed with measurement of the T/B ratio before and after 6 months of treatment with psychostimulant and non-psychostimulant drugs. Both groups were compared using the Wilcoxon signed range test for related samples. The results showed that 86% of the cases had a T/B ratio above the normal values for the age of them. The reduction in the T/B ratio was statistically significant in the group of patients treated with psychostimulants. The reduction of non-psychostimulants was not significant. In conclusion, we confirmed the high T/B ratio in patients with ADHD. Psychostimulant drugs decrease the elevated T/B ratio in patients with ADHD after 6 months of treatment.


Subject(s)
Humans , Male , Female , Child , Adolescent , Attention Deficit Disorder with Hyperactivity/physiopathology , Attention Deficit Disorder with Hyperactivity/drug therapy , Theta Rhythm/physiology , Beta Rhythm/physiology , Electroencephalography/methods , Central Nervous System Stimulants/therapeutic use , Reference Values , Age Factors , Treatment Outcome , Statistics, Nonparametric
4.
Einstein (Säo Paulo) ; 18: eAO5442, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133738

ABSTRACT

ABSTRACT Objective: To verify if, by three distinct quantifiers, the measured electroencephalographic signal at rest is different from the signal measured during a word reading situation, especially considering the faster rhythms, gamma and high-gamma, as it occurs in clinical rhythms (delta to beta). Methods: A total of 96 electroencephalographic signals measured from neurologically healthy volunteers were evaluated at two moments: resting and word reading. Each signal segment was measured by three quantifiers that separately assess normalized power, percent power, and right and left hemisphere coherence. The Mann-Whitney test was used to compare the results of the quantifiers in each brain range. Results: The gamma and high-gamma rhythms presented a more distinct behavior when comparing the analyzed moments (resting and reading) than the clinical rhythms. Conclusion: This finding contributes to the scarce literature on faster rhythms, which can contain information that is normally disregarded in neurological clinical practice.


RESUMO Objetivo: Verificar se, por meio de três quantificadores distintos, o sinal eletroencefalográfico medido em repouso é diferente do sinal medido durante o processo de leitura, especialmente considerando os ritmos rápidos, gama e supergama, assim como ocorre nos ritmos clínicos delta a beta. Métodos: Foram avaliados 96 sinais eletroencefalográficos medidos em voluntários neurologicamente saudáveis, em dois momentos: repouso e leitura de palavras. Cada trecho do sinal foi mensurado por três quantificadores que medem, de maneira isolada, a potência normalizada e a potência percentual, bem como a coerência entre os hemisférios direito e esquerdo. O teste estatístico de Mann-Whitney foi usado para comparar os resultados dos quantificadores em cada faixa cerebral. Resultados: Os ritmos gama e supergama apresentaram comportamento mais distinto entre os momentos analisados (repouso e leitura) que os ritmos clinicamente analisados. Conclusão: Esse achado contribui com a escassa literatura segundo a qual os ritmos rápidos podem conter informações que normalmente são descartadas na neurologia clínica.


Subject(s)
Reading , Brain/diagnostic imaging , Electroencephalography/methods , Gamma Rhythm , Beta Rhythm , Delta Rhythm
5.
Rev. cuba. inform. méd ; 11(1)ene.-jun. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093305

ABSTRACT

La anestesia general proporciona al paciente estados de inconciencia, amnesia y analgesia, sin embargo, se reportan casos de despertar intraoperatorio. Debido a la incidencia de este fenómeno y sus efectos psicosomáticos, el Centro de Estudios de Neurociencias, Procesamiento de Imágenes y Señales en la Universidad de Oriente, y el Hospital General Juan Bruno Zayas Alfonso ambos en Santiago de Cuba, Cuba, implementan una metodología que permita detectar automáticamente estados de sedación anestésica aplicando Inteligencia Artificial. Para esto se emplearon las señales registradas por el canal electroencefalográfico F4, nueve parámetros espectrales, las Máquinas de Soporte Vectorial y los Sistemas Neuro-Difusos. En el reconocimiento automático de los estados de Sedación Profunda, Moderada y Ligera se logró una Exactitud de 96.12 por ciento, 90.06 por ciento y 90.24 por ciento respectivamente con las Máquinas de Soporte Vectorial, por lo que se propone el uso del canal electroencefalográfico F4 en la detección de estados anestésicos(AU)


General anesthesia provide the patient states of unconsciousness, amnesia and analgesia, however, cases of intraoperative awareness are reported. Due to the incidence of this phenomenon and the psychosomatic effects it causes, the Neuroscience Studies Center, Images and Signals Processing at the University of Oriente, and the General Hospital Juan Bruno Zayas Alfonso both in Santiago de Cuba, Cuba, implement a methodology that allows the automatic detection of anesthetic sedation states applying Artificial Intelligence. For this, the signals recorded by the electroencephalographic channel F4, nine spectral parameters, the Support Vector Machines and the Neuro-Fuzzy Systems were used. In the automatic recognition of the Sedation States: Profound, Moderate and Mild an Accuracy of 96.12 percent, 90.06 percent and 90.24 percent respectively was achieved with the Support Vector Machines, so the use of the electroencephalographic channel F4 is proposed in the detection of anesthetic states(AU)


Subject(s)
Cerebrovascular Disorders/diagnostic imaging , Electroencephalography/methods , Deep Sedation , Intraoperative Awareness
6.
Arq. neuropsiquiatr ; 77(4): 260-267, Apr. 2019.
Article in English | LILACS | ID: biblio-1001357

ABSTRACT

ABSTRACT The use of methods to evaluate cortical activity in neonates has great importance in modern medicine, as it allows the observation and evaluation of several clinical aspects, which guarantees that the health team has knowledge about possible intervention measures that may be necessary in the treatment of newborns. Objective: This systematic review aimed to compare the main technologies available for the evaluation of brain functions in neonates, among them: the conventional electroencephalogram (EEG), the amplitude-integrated electroencephalogram (aEEG) and the geodesic sensor net EEG. Methods: A search was conducted forarticles from national and international periodicals included in the Web of Science, LILACS, SciELO and Medline electronic databases. Results: The search found 39 among 155 articles of interest and the analyses indicated that, in the clinical environment, the use of both conventional EEG and aEEG is highly recommended, as the combination of their functions allows, for example, a greater number of subclinical seizures to be detected. Conversely, the use of a geodesic sensor net EEG could be of great value, as it allows a large amount of data to be analyzed. Conclusion: This analysis may be useful in studies and research related to diseases and symptoms, such as seizures, a current challenge for neonatal neuromonitoring, as well as aspects of neurological development and functional studies. However, despite many advances in technology, electroencephalography in preterm neonates remains a challenge worldwide and still requires more robust research and efforts towards the best clinical assistance in this extremely early stage of life.


RESUMO Métodos para avaliar a atividade cortical em neonatos têm grande importância na Medicina moderna, pois permitem a observação e avaliação de diversos aspectos clínicos, garantindo que a equipe de saúde tenha conhecimento sobre possíveis medidas de intervenção que possam ser necessárias no tratamento de recém-nascidos. Objetivo: Esta revisão sistemática tem como objetivo comparar as principais tecnologias disponíveis para a avaliação das funções cerebrais em neonatos: eletroencefalograma convencional (EEG), eletroencefalograma de amplitude integrada (aEEG) e eletroencefalograma da rede do sensor geodésico. Métodos: Os artigos foram selecionados em periódicos nacionais e internacionais, incluídos nas bases de dados eletrônicas Web of Science, LILACS, SciELO e Medline. Resultados: Foram encontrados 39 artigos de interesse entre 155 artigos. As análises indicaram que, em relação ao ambiente clínico, o uso associativo de EEG convencional e aEEG é altamente recomendado, pois permite a combinação de funções, facilitando, por exemplo, que um maior número de convulsões sub-clínicas seja detectado. Por outro lado, o uso do eletroencefalograma da rede do sensor geodésico seria de grande valor, uma vez que permite que uma grande quantidade de dados seja analisada. Conclusão: Essa análise pode ser útil em estudos e pesquisas relacionados a doenças e sintomas, como convulsões, um desafio atual para a neuromonitorização neonatal, bem como aspectos de desenvolvimento neurológico e estudos funcionais. No entanto, apesar de muitos avanços tecnológicos, a eletroencefalografia em recém-nascidos prematuros ainda é um desafio em todo o mundo e requer pesquisas e esforços mais robustos para a melhor assistência clínica neste estágio extremamente precoce da vida.


Subject(s)
Humans , Infant, Newborn , Infant, Premature , Cerebral Cortex/diagnostic imaging , Electroencephalography/methods , Seizures/diagnostic imaging , Intensive Care Units, Neonatal
7.
Arq. neuropsiquiatr ; 77(2): 122-130, Feb. 2019. graf
Article in English | LILACS | ID: biblio-983884

ABSTRACT

ABSTRACT Seizures in the newborn are associated with high morbidity and mortality, making their detection and treatment critical. Seizure activity in neonates is often clinically obscured, such that detection of seizures is particularly challenging. Amplitude-integrated EEG is a technique for simplified EEG monitoring that has found an increasing clinical application in neonatal intensive care. Its main value lies in the relative simplicity of interpretation, allowing nonspecialist members of the care team to engage in real-time detection of electrographic seizures. Nevertheless, to avoiding misdiagnosing rhythmic artifacts as seizures, it is necessary to recognize the electrophysiological ictal pattern in the conventional EEG trace available in current devices. The aim of this paper is to discuss the electrophysiological basis of the differentiation of epileptic seizures and extracranial artifacts to avoid misdiagnosis with amplitude-integrated EEG devices.


RESUMO Las convulsiones neonatales están asociadas a una alta morbi-mortalidad por lo que su correcto diagnóstico y tratamiento es fundamental. Las convulsiones en los recién nacidos son frecuentemente subclínicas lo que hace que su detección sea dificultosa. La electroencefalografía integrada por amplitud es una técnica de monitoreo electroencefalográfico simplificado que ha encontrado una creciente aplicación clínica en las unidades de terapia intensiva neonatales. Su principal ventaja es la relativa simplicidad de su interpretación lo que permite a personal no especializado del equipo neonatal diagnosticar convulsiones electrográficas en tiempo real. Sin embargo, para evitar diagnosticar erróneamente artefactos rítmicos como crisis epilépticas es necesario reconocer los patrones electrofisiológicos ictales en el EEG convencional disponible en los dispositivos actuales. El objetivo de este artículo es describir las bases electrofisiológicas para la diferenciación de convulsiones neonatales y artefactos extracraneanos para evitar errores diagnósticos con el uso de EEG integrado por amplitud.


Subject(s)
Humans , Infant, Newborn , Seizures/diagnosis , Seizures/physiopathology , Electroencephalography/methods , Infant, Newborn, Diseases/diagnosis , Intensive Care, Neonatal , Diagnostic Errors , Infant, Newborn, Diseases/physiopathology
8.
Braz. j. med. biol. res ; 52(3): e8059, 2019. tab, graf
Article in English | LILACS | ID: biblio-984037

ABSTRACT

Cyclic alternating pattern (CAP) is a neurophysiological pattern that can be visually scored by international criteria. The aim of this study was to verify the feasibility of visual CAP scoring using only one channel of sleep electroencephalogram (EEG) to evaluate the inter-scorer agreement in a variety of recordings, and to compare agreement between visual scoring and automatic scoring systems. Sixteen hours of single-channel European data format recordings from four different sleep laboratories with either C4-A1 or C3-A2 channels and with different sampling frequencies were used in this study. Seven independent scorers applied visual scoring according to international criteria. Two automatic blind scorings were also evaluated. Event-based inter-scorer agreement analysis was performed. The pairwise inter-scorer agreement (PWISA) was between 55.5 and 84.3%. The average PWISA was above 60% for all scorers and the global average was 69.9%. Automatic scoring systems showed similar results to those of visual scoring. The study showed that CAP could be scored using only one EEG channel. Therefore, CAP scoring might also be integrated in sleep scoring features and automatic scoring systems having similar performances to visual sleep scoring systems.


Subject(s)
Humans , Male , Female , Sleep Stages/physiology , Electronic Data Processing , Polysomnography/methods , Electroencephalography/methods , Observer Variation , Reproducibility of Results , Sensitivity and Specificity , Polysomnography/instrumentation , Electroencephalography/instrumentation
9.
Clinics ; 74: e908, 2019. tab, graf
Article in English | LILACS | ID: biblio-1011907

ABSTRACT

OBJECTIVES: Approximately one-third of candidates for epilepsy surgery have no visible abnormalities on conventional magnetic resonance imaging. This is extremely discouraging, as these patients have a less favorable prognosis. We aimed to evaluate the utility of quantitative magnetic resonance imaging in patients with drug-resistant neocortical focal epilepsy and negative imaging. METHODS: A prospective study including 46 patients evaluated through individualized postprocessing of five quantitative measures: cortical thickness, white and gray matter junction signal, relaxation rate, magnetization transfer ratio, and mean diffusivity. Scalp video-electroencephalography was used to suggest the epileptogenic zone. A volumetric fluid-attenuated inversion recovery sequence was performed to aid visual inspection. A critical assessment of follow-up was also conducted throughout the study. RESULTS: In the subgroup classified as having an epileptogenic zone, individualized postprocessing detected abnormalities within the region of electroclinical origin in 9.7% to 31.0% of patients. Abnormalities outside the epileptogenic zone were more frequent, up to 51.7%. In five patients initially included with negative imaging, an epileptogenic structural abnormality was identified when a new visual magnetic resonance imaging inspection was guided by information gleaned from postprocessing. In three patients, epileptogenic lesions were detected after visual evaluation with volumetric fluid-attenuated sequence guided by video electroencephalography. CONCLUSION: Although quantitative magnetic resonance imaging analyses may suggest hidden structural lesions, caution is warranted because of the apparent low specificity of these findings for the epileptogenic zone. Conversely, these methods can be used to prevent visible lesions from being ignored, even in referral centers. In parallel, we need to highlight the positive contribution of the volumetric fluid-attenuated sequence.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Magnetic Resonance Imaging/methods , Drug Resistant Epilepsy/diagnostic imaging , Brain Mapping , Prospective Studies , Diagnosis, Computer-Assisted/methods , Electroencephalography/methods , Multimodal Imaging
10.
Dement. neuropsychol ; 12(3): 264-271, July-Sept. 2018. tab, graf
Article in English | LILACS | ID: biblio-952971

ABSTRACT

ABSTRACT: Stress is a response in which an individual wants to have more control over a situation. A constant state of stress is called anxiety. Some patients deny symptoms. An instrument can help arrive at a diagnosis. Objective: Using TQ-7 QEEG, this study aimed to evaluate the association of symptoms of anxiety, insecurity, fear, panic and phobia with hot temporals defined as Beta (15-23 Hz) >17% and High-Beta waves (23-38 Hz) >10% at T3 and T4. Methods: Five hundred and forty-three patients of both genders with ages ranging from 16-59 years were evaluated, divided into two groups: Control (without hot temporals: n=274) and Case Group (with hot temporals: n=269). The Chi-square test was used (p-values ≤0.05). Results: There was a significant association (p-value <0.001) between the symptoms related to amygdala activation, expressed in the temporals (Beta >17% and High-Beta >10%). (Anxiety, T3=89.6% - T4=88.8%; T3=92.6% - T4=93.3%), (Fear, T3=80.7% - T4=84.4%; T3=82.9% - T4=95.9%), (Insecurity, T3=82.2% - T4=81.4%; T3=69.5% - T4=97.8%), (Panic, T3=52.4 - T4=72.5%; T3=90.3% - T4=74.0%), (Phobia, T3=17.5% - T4=22.7%; T3=19.7% - T4=27.1%), when compared to the respective controls (Beta control, T3=8.4%, 10.2%, 21.2%, 1.1%, 0.4% and T4=11.3%, 4.4%, 23.0%, 2.6%, 1.1%) (High-Beta control, T3=4.0%, 6.9%, 6.2%, 0.4%, 0.0% and T4=17.5%, 6.2%, 3.3%, 4.0%, 0.7%). Conclusion: Anxiety, insecurity, fear, panic and phobia are observed by QEEG when the levels of total Beta >17% and High-Beta waves >10% at T3 and T4.


RESUMO: O estresse é uma resposta a uma situação na qual, um indivíduo quer ter mais controle. Um estado de estresse constante é chamado de ansiedade. Alguns pacientes negam sintomas. Um instrumento pode auxiliar um diagnóstico. Objetivo: Utilizando o QEEG TQ-7, este estudo objetivou avaliar a associação dos sintomas de ansiedade, insegurança, medo, pânico e/ou fobia com a categoria de temporais quentes definidos como Beta (15-23 Hz) >17% e Beta-Alta (23-38 Hz) >10% em T3 e T4. Métodos: Foram avaliados 543 pacientes de ambos os gêneros na faixa etária de 16-59 anos, divididos: Controle (sem temporais quentes: n=274) Grupo estudado (com temporais quentes: n=269). Foi utilizado o teste qui-quadrado (p-valor ≤0.05). Resultados: Houve associação significativa (p-valor <0.001) entre os sintomas relacionados à ativação da amigdala, expressos nos temporais (Beta >17% e Beta-Alta >10%). (Ansiedade, T3=89,6% - T4=88,8%; T3=92,6% - T4=93,3%), (Medo, T3=80,7% - T4=84,4%; T3=82,9% - T4=95,9%), (Insegurança, T3=82,2% - T4=81,4%; T3=69,5% - T4=97,8%), (Pânico, T3=52.4% - T4=72.5%; T3=90.3% - T4=74.0%), (Fobia, T3=17,5% - T4=22,7%; T3=19,7% - T4=27,1%), quando comparados aos respectivos controles (Beta controle, T3=8,4%, 10,2%, 21,2%, 1,1%, 0,4% e T4=11,3%, 4,4%, 23,0%, 2,6%, 1,1%) e (Beta-Alta Controle, T3=4,0%, 6,9%, 6,2%, 0,4%, 0,0%; T4=17,5%, 6,2%, 3,3%, 4,0%, 0,7%). Conclusão: Ansiedade, insegurança, medo, pânico e fobia são observados no QEEG, quando Beta >17% e Beta-Alta >10% em T3 e T4.


Subject(s)
Humans , Stress, Psychological/diagnostic imaging , Anxiety , Panic , Electroencephalography/methods
11.
Rev. bras. med. esporte ; 24(5): 382-385, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-977836

ABSTRACT

INTRODUCTION: ADHD probably affects more than 50% of schoolchildren, yet although characteristics such as inattention and/or hyperactivity and impulsiveness are clear, electrophysiological brain behavior during motor activity is not fully understood. OBJECTIVE: To investigate alpha, beta, and SMR band patterns on the EEG in children with Attention Deficit Hyperactivity Disorder (ADHD) during attention-demanding motor skills tasks. METHODS: Fourteen children with a mean age of 9.64±1.74 years divided into diagnosed and undiagnosed with ADHD underwent an EEG at rest and during task performance with attentional demand. Alpha, SMR and beta waves were observed on the EEG. Data were evaluated using the Shapiro-Wilk test in order to determine data normality. ONE WAY ANOVA and Tukey's post hoc tests were used to determine intragroup and intergroup differences, and the Pearson (r) and Spearman (p) correlations were used to determine correlations. All treatments had a significance of 5%. RESULTS: The ADHD and N-ADHD groups showed no difference in cortical alpha, beta and SMR bands at rest, but there were differences in cortical behavior during activity. The cortical activity correlation coefficient (0.30) differed from undiagnosed children (0.70). CONCLUSION: The ADHD group had a low correlation coefficient between rest and activity, contrary to the N-ADHD group. In the intergroup comparison, ADHD had higher alpha, beta and SMR band output power during the same high attentional task when compared with N-ADHD. Level of Evidence III.


INTRODUÇÃO: O TDAH afeta, provavelmente, mais de 50% crianças em idade escolar, porém, embora características como falta de atenção e/ou hiperatividade e impulsividade sejam claras, o comportamento eletrofisiológico do cérebro durante atividades motoras não é bem entendido. OBJETIVO: Investigar o padrão das bandas Alfa, Beta e SMR no EEG de crianças com transtorno do déficit de atenção com hiperatividade (TDAH), durante tarefas motrizes com alta demanda de atenção. MÉTODOS: Catorze crianças com média de idade de 9,64 ± 1,74 anos, divididas nos grupos diagnosticadas e não diagnosticadas com TDAH, realizaram EEG em repouso e durante o desempenho de tarefa com demanda de atenção. As ondas Alfa, SMR e Beta foram observadas no EEG. Os dados foram avaliados pelo teste de Shapiro-Wilk para determinar a normalidade dos dados. Os teste ANOVA one-way e post hoc de Tukey foram usados para determinar as diferenças intragrupo e intergrupo, e a correlação de Pearson (r) e Spearman (p) foram usadas para determinar as correlações. Todos os tratamentos tiveram significância de 5%. RESULTADOS: Os grupos TDAH e N-TDAH não apresentaram diferença na banda cortical Alfa, Beta e SMR em repouso, porém, durante a atividade, constataram-se diferenças do comportamento cortical. O índice de correlação da atividade cortical (0,30) foi diferente nas crianças não diagnosticadas (0,70). CONCLUSÃO: O grupo TDAH apresentou baixo índice de correlação entre repouso e atividade, diferentemente do grupo N-TDAH. Na comparação intergrupos, o TDAH apresentou maior potência de saída da banda Alfa, Beta e SMR durante a mesma tarefa de alta atenção em comparação com o N-TDAH. Nível de Evidência III.


INTRODUCCIÓN: El TDAH afecta probablemente a más del 50% de los escolares, pero aunque las características como la falta de atención y/o la hiperactividad e impulsividad sean entendidas como comportamiento electrofisiológico del cerebro durante las actividades motoras, esto no es bien entendido. OBJETIVO: investigar el patrón de las franjas de Alfa, Beta y SMR en el EEG en niños con trastorno de déficit de atención y de Hiperactividad (TDAH), durante tareas motrices con altas demandas de atención. MÉTODOS: catorce niños con promedio de edad de 9,64 ± 1,74 años, divididos en diagnosticados y no diagnosticados con TDAH, realizaron EEG durante el reposo y desempeño de la tarea motriz con alta demanda de atención. Las ondas Alfa, SMR y Beta se observaron en el EEG. Los datos fueron evaluados por el test de Shapiro-Wilk para determinar la normalidad. ANOVA ONE WAY y el test de Tukey fueron utilizados para determinar las diferencias intragrupo e intergrupo, así como también la correlación de Pearson (r) y Spearman (p) fueron usadas para determinar las correlaciones. Todos los tratamientos tuvieron un nivel de significancia del 5%. RESULTADOS: El TDAH y el N-TDAH no presentaron diferencias en la Franja Cortical Alfa, Beta y SMR durante el reposo, no obstante, al estar en actividad, el comportamiento cortical presentó diferencias. El índice de correlación de la actividad cortical (0,30) fue diferente de niños no diagnosticados (0,70). CONCLUSIONES: El TDAH presentó un bajo índice de correlación entre reposo y actividad, a diferencia del N-TDAH. En la comparación intergrupos, el TDAH presentó mayor potencia de salida de la franja Alfa, Beta y SMR durante la misma tarea de alta atención, en comparación con el N-TDAH. Nivel de Evidencia III.


Subject(s)
Humans , Male , Female , Child , Psychomotor Performance , Attention/physiology , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/psychology , Electroencephalography/methods , Brain Waves , Motor Activity/physiology , Cross-Sectional Studies , Analysis of Variance
12.
Rev. cuba. pediatr ; 90(2): 262-275, abr.-jun. 2018. ilus, tab
Article in Spanish | LILACS | ID: biblio-901486

ABSTRACT

Introducción: el estatus socioeconómico puede impactar sobre la cognición y la actividad eléctrica cerebral de los niños, por la influencia que tiene sobre el desarrollo durante etapas tempranas. Objetivo: evaluar la asociación de variables socioeconómicas, con alteraciones cognitivas y electroencefalográficas, en un grupo de niños escolares con riesgo de daño cerebral. Métodos: se estudiaron 42 niños mexicanos, de 6-7 años de edad. Se realizó un estudio socioeconómico a los padres y los niños fueron evaluados mediante la Evaluación Neuropsicológica Infantil (subpruebas de lectura-escritura y escala de signos neurológicos blandos), la Escala de Inteligencia de Wechsler para Niños, la Escala de Conners para Padres-Revisada y un electroencefalograma en diferentes edades. Resultados: con las variables socioeconómicas y, mediante un análisis de conglomerados, se encontraron 3 grupos que mostraban una adecuada diferenciación académica y económica entre sí. Por el método de clasificación basado en regresiones dispersas, se identificaron las variables que diferenciaban significativamente a los 3 grupos: problemas sociales, cognitivos, síntomas inatento, índice TDAH (Trastorno por Déficit de Atención e Hiperactividad, Escala de Conners para Padres-Revisada), lectura de palabras, comprensión en lectura de oraciones, dictado de sílabas, precisión de lectura en voz alta, lectura de sílabas, dictado de no palabras, movimiento de oposición digital, agarre de lápiz (Evaluación Neuropsicológica Infantil) y primer electroencefalograma normal. Conclusiones: el grupo con más desventajas socioeconómicas tuvo un peor desempeño en la lectoescritura y mayor prevalencia de actividad paroxística no epileptiforme; mientras que, el grupo con mayores ventajas socioeconómicas, mostró mejor desempeño en estas habilidades, mayor proporción de electroencefalogramas normales y una tendencia hacia problemas de atención(AU)


Introduction: the socioeconomic status can impact on the cognition and electrical brain activity of children due to the influence it has on the development during early stages. Objective: to evaluate the association of socioeconomic variables with cognitive and electroencephalographic alterations, in a group of school children at risk of brain damage. Methods: 42 Mexican children in the ages from 6 to 7 years old were studied. A socioeconomic study was conducted on the parents, and the children were evaluated through the Child Neuropsychological Assessment (reading-writing subtests and the scale of neurological soft signs), the Wechsler´s Intelligence Scale for Children, the Conners´ Scale for Parents-Revised and an electroencephalogram in different ages. Results: with the socioeconomic variables and by means of an analysis of conglomerate, 3 groups were found that showed an adequate academic and economic differentiation among themselves. By the classification method based on scattered regressions were identified variables that significantly differentiated the 3 groups: social and cognitive problems, inattentive symptoms, ADHD (Attention Deficit and Hyperactivity Disorder, Conners Scale for Parents-Revised), reading of words, comprehension in reading of sentences, dictation of syllables, accuracy of reading aloud, reading of syllables, dictation of non words, movement of digital opposition, pencil´s grip (Neuropsychological Evaluation of Children) and first normal electroencephalogram. Conclusions: the group with more socioeconomic disadvantages had a worse performance in reading and writing and a higher prevalence of non-epileptiform paroxysmal activity; whereas, the group with the greatest socioeconomic advantages showed a better performance in these skills, a greater proportion of normal electroencephalograms and a tendency towards attention problems(AU)


Subject(s)
Humans , Child , Brain Injuries, Diffuse , Social Class , Electroencephalography/methods , Mental Status and Dementia Tests
14.
Anaesthesia, Pain and Intensive Care. 2017; 21 (1): 79-86
in English | IMEMR | ID: emr-187466

ABSTRACT

Status epilepticus [SE] represents a diagnostic and treatment challenge in comatosed patients. This clinic report represents one of the first descriptions of the use of Bilateral BIS[R] monitor to depict the changes of colour density spectral array [CDSA] from the operating room to the intensive care unit [ICU], and allowed us to hypothesize about the presence of epileptiform activity. A 45 years old man submitted to an urgent craniotomy directed to decompress a malignant middle cerebral artery infarct. Initial CDSA panel showed a pattern of asymmetry, related to the left hemisphere, where the ischemic-hemorrhagic lesion was located. A pattern of high power at frequencies under the 12Hz range was observed, resulting in a plateau formation that can imply seizure presence. This pattern responded to changing of Ce of target controlled infusion [TCI] Propofol and to a bolus of thiopental. At encephalic decompression a global reduction of activity at all frequencies was observed. The patient was transferred to the ICU where the DSA panel showed a sudden loss of alpha and then delta band frequencies. Cerebral death was afterwards clinically diagnosed. CDSA can be used as a complementary tool to detect and monitor SE. It shows good correlation with surgical events and anesthetic depth making it possible to tailor anesthesia to each patient needs in the operating room and in the ICU


Subject(s)
Humans , Male , Middle Aged , Electroencephalography/methods , Sensitivity and Specificity , Perioperative Care , Status Epilepticus , Decompressive Craniectomy , Infarction, Middle Cerebral Artery , Emergency Treatment
15.
Motriz (Online) ; 23(4): e1017138, 2017.
Article in English | LILACS | ID: biblio-895016

ABSTRACT

In the last 20 years, there was a growing interest in the study of the theoretical and applied issues surrounding psychophysiological processes underlying performance. The psychophysiological monitoring, which enables the study of these processes, consists of the assessment of the activation and functioning level of the organism using a multidimensional approach. In sport, it can be used to attain a better understanding of the processes underlying athletic performance and to improve it. The most frequently used ecological techniques include electromyography (EMG), electrocardiography (ECG), electroencephalography (EEG), and the assessment of electrodermal activity and breathing rhythm. The purpose of this paper is to offer an overview of the use of these techniques in applied interventions in sport and physical exercise and to give athletes, coaches and sport psychology experts new insights for performance improvement.(AU)


Subject(s)
Humans , Athletic Performance/physiology , Electrocardiography/methods , Electroencephalography/methods , Electromyography/methods , Exercise/physiology , Sports/physiology
16.
Rev. chil. neurocir ; 42(2): 107-110, nov. 2016. ilus
Article in English | LILACS | ID: biblio-869760

ABSTRACT

La insulectomía es una técnica microquirúrgica establecida para el tratamiento de la epilepsia refractaria al tratamiento farmacológico. El origen insular de la epilepsia es inusual, sin embargo, con la investigación a través de electrodos híbridos este tipo de epilepsia ha incrementado su diagnóstico. Los autores hacen hincapié en las funciones insulares, así como los puntos de referencia anatómicos para la cirugía. Se discuten las principales complicaciones y las bases fisiológicas para las indicaciones de cirugía.


Insulectomy is an established microsurgical technique for treatment of insular epilepsy refractory to clinical management. The insular origin of epilepsy is unusual, however with depth investigation through hybrids electrodes such kind of epilepsy is increasing its diagnosis. The authors emphasizes the insular functions as well as the anatomical landmarks for surgery. The main complications are discussed and physiological basis for indications.


Subject(s)
Humans , Cerebral Decortication , Cerebral Cortex/anatomy & histology , Cerebral Cortex/surgery , Cerebral Cortex/physiology , Electrodes , Electroencephalography/methods , Epilepsy, Temporal Lobe/surgery , Drug Resistance , Microsurgery/methods
17.
MedicalExpress (São Paulo, Online) ; 3(5)Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-829162

ABSTRACT

OBJECTIVE: To analyze changes in gamma band absolute power in motor cortical areas, before and after a condition of hand immobilization for 48 hours. METHOD: Fifteen healthy volunteers, aged between 20 and 30, were submitted to EEG assessment before and after 48 hours of immobilization of the dominant hand, while performing a motor task triggered by a visual stimulus. A two-way repeated measures ANOVA with two within-group factors (moment x condition), each one with two levels (before vs. after visual stimuli; before vs. after 48-hour HI, respectively) was used to test for changes in beta band absolute power. RESULTS: Statistical analysis revealed that hand immobilization caused changes in cortical areas. A significant increase in gamma band absolute power was found after hand immobilization at electrodes F3 (p = 0.001) at F4 (p = 0.001) and at Fz (p = 0.001), at C3 (p = 0.001), C4 (p = 0.001) and Cz (p = 0.001). CONCLUSION: These results reveal that oscillations of the gamma band can be a cortical strategy to solve the effect of less activation due to movement restriction. Knowledge of the functioning of motor cortical areas after a condition of immobilization can lead to more effective strategies in rehabilitation.


OBJETIVO: O objetivo deste estudo foi analisar mudanças na potência absoluta da banda gamma em áreas corticais motoras, antes e depois de uma condição de imobilização da mão por 48 horas. MÉTODO: Quinze voluntários saudáveis, com idades entre 20 e 30 anos, foram submetidos a avaliação eletroencefalográfica antes e depois da imobilização, durante a execução de uma tarefa motora desencadeada por um estímulo visual. Uma análise de variância com dois fatores (ANOVA two-way) foi empregada para investigar o fator momento (antes e depois do estímulo visual) e o fator condição (antes e depois da imobilização). RESULTADOS: Um aumento significativo na potencia absoluta da banda gamma foi encontrado após imobilização da mão nos elétrodos (ou derivações) F3, F4, FZ, C3, C4 e Cz. CONCLUSÃO: Estes resultados revelam que as oscilações na banda gama podem ser uma estratégia cortical para resolver o efeito de menor ativação devido à restrição de movimento. Um melhor conhecimento do funcionamento de áreas corticais motoras após uma condição de imobilização pode orientar estratégias mais eficazes na reabilitação.


Subject(s)
Electroencephalography/methods , Hand/physiopathology , Immobilization/methods , Neuronal Plasticity , Analysis of Variance
18.
MedicalExpress (São Paulo, Online) ; 3(5)Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-829160

ABSTRACT

OBJECTIVE: The purpose of this study was to analyze changes in beta band absolute power in cortical areas, before and after a condition of hand immobilization for 48 hours. METHOD: Fifteen healthy volunteers, aged between 20 and 30, were submitted to EEG assessment before and after immobilization, while performing a motor task triggered by a visual stimulus. RESULTS: Statistical analysis revealed that hand immobilization caused changes in cortical areas. Significant increases in beta band absolute power were found after hand immobilization at electrodes Fp2, C3 and P4. In contrast, at electrode C4 a decrease in beta band absolute power occurred after hand immobilization. CONCLUSION: Predominant hand immobilization, even for 48 hours, is sufficient to cause cortical changes that affect movement planning. Such changes may represent a cortical strategy to supply cortical changes in contralateral hemisphere due to immobilization. Further studies are necessary to understand cortical changes due to hand immobilization and movement planning, especially considering how much time of immobilization is necessary to promote such changes.


OBJETIVO: O objetivo deste estudo foi analisar mudanças na potencia absoluta da banda beta em áreas corticais, antes e depois de uma condição de imobilização da mão por 48 horas. MÉTODO: Quinze voluntários saudáveis, com idades entre 20 e 30 anos, foram submetidos à avaliação EEG antes e depois da imobilização, durante a execução de uma tarefa motora desencadeada por um estímulo visual. RESULTADOS: A análise estatística revelou que a imobilização da mão causou mudanças em áreas corticais. Um aumento significativo na potencia absoluta da banda beta foi encontrado após imobilização da mão nos eletrodos Fp2 (F (1,3823) = 4,147; p = 0,042), C3 (F (1,3563) = 5,005; p = 0,025) e P4 (F (1,3290) = 5,114; p = 0,024). No C4 eletrodo (F (1,3657) = 11,858; p = 0,001) uma diminuição da potencia absoluta da banda beta ocorreu após imobilização da mão. CONCLUSÃO: A imobilização da mão predominante, mesmo para 48 horas, é suficiente para causar alterações corticais que afetam o planejamento movimento. Tais mudanças podem representar uma estratégia cortical para fornecer alterações corticais em hemisfério contralateral devido à imobilização. Mais estudos são necessários para entender as mudanças corticais devido a imobilização da mão e planejamento do movimento, especialmente considerando quanto tempo de imobilização é necessário para promover essas mudanças.


Subject(s)
Humans , Electroencephalography/methods , Hand , Immobilization , Neuronal Plasticity
20.
Arq. neuropsiquiatr ; 74(7): 536-543, tab, graf
Article in English | LILACS | ID: lil-787368

ABSTRACT

ABSTRACT Cerebral hemispheres, although similar, are neither completely symmetrical in structure nor equivalent in function. EEG asymmetry studies have been directed more to frequency than to amplitude analysis. Objective Better definition of normal amplitude asymmetry values on the classical EEG frequency bands. Results EEG amplitude asymmetry index (AAI) is physiologically low in normal adults, differences usually lesser than 7%. Conclusion Persistent or intermittent amplitude asymmetry regional differences higher than 7% may be suggestive of pathology after adequate correlation with clinical data and EEG classical visual analysis.


RESUMO Os hemisférios cerebrais não são simétricos em morfologia ou funções. Tradicionalmente, os estudos de assimetria do EEG focaram mais na análise de frequências do que na de amplitudes. Objetivo Contribuir para melhor definição dos valores normais de assimetria de amplitudes nas faixas de frequência clássicas do EEG. Resultados O índice de assimetria de amplitudes é fisiologicamente baixo em adultos, usualmente menor do que 7%. Conclusão Se adequadamente correlacionadas aos dados clínicos e à análise visual do EEG, assimetrias persistentes ou intermitentes de amplitude acima de 7% podem ser sugestivas de patologia.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Brain/physiology , Electroencephalography/methods , Reference Standards , Reference Values , Brain Diseases/diagnosis , Brain Diseases/physiopathology , Brain Mapping/methods , Reproducibility of Results , Age Factors , Age Distribution , Electroencephalography/standards , Functional Laterality/physiology
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