The cortical generators of the contingent negative variation in humans: a study with subdural electrodes.

Contingent negative variations (CNVs) and Bereitschaftspotentials (BPs) were recorded from subdural electrodes implanted in 14 patients with intractable epilepsy. For recording CNVs, a Go/NoGo S2 choice reaction-time paradigm was employed. Two seconds after presentation of a low tone burst (S1), either a medium (S2m) or a high tone burst (S2h) was delivered at random. Patients were instructed to make middle finger extensions after S2m but not after S2h. For recording BPs, patients repeated self-paced middle finger extensions. BPs were recorded from the primary motor area (MI), the primary sensory area (SI) and the supplementary sensorimotor area (SSMA). CNVs showed a patchy distribution in the prefrontal area and SSMA for the early component and in the prefrontal area, MI, SI, temporal area, occipital area and SSMA for the late component. These results suggest that the CNV recorded from the scalp is the summation of multiple cortical potentials which have different origins and different functions. The cortical distribution of the late CNVs was different from that of BPs. Late CNVs are not equivalent to BPs and are not related to motor preparation alone. After S2, 3 kinds of potentials, probably related to decision making, somatosensory feedback and motor execution under specific conditions, respectively, were observed.

Subdural potentials at orbitofrontal and mesial prefrontal areas accompanying anticipation and decision making in humans: a comparison with Bereitschaftspotential.

Field potentials associated with the execution of a warned choice Go/No-Go reaction task were recorded from prefrontal supplementary (SMA) and primary motor cortex (MI) by using subdural electrodes in 5 epileptic patients during presurgical evaluation. The choice was between a Go and a No-Go imperative stimulus (S2) in the S1-S2 paradigm. Orbitofrontal and mesial prefrontal areas generated a slow preceding potential before S2 (most likely late CNV), and bilateral mesial prefrontal areas generated a transient potential, most likely related to decision making, upon S2 in both Go and No-Go conditions. In self-paced, repetitive movement, the Bereitschaftspotential was seen only at SMA and MI, but not in the prefrontal area. The present result, therefore, suggests that in humans orbitofrontal and mesial frontal areas play an important role in preparation for cognition and in decision making, whereas SMA and MI do so in motor preparation.

Movement-related potentials associated with bilateral simultaneous and unilateral movements recorded from human supplementary motor area.

To clarify the differences of movement-related potentials (MRPs) among ipsilateral, contralateral and simultaneous bilateral movements, MRPs with finger, thumb or foot movements were recorded from subdural electrodes chronically implanted on the supplementary motor area (SMA) in 3 patients, and also from the primary sensorimotor area in two of them being evaluated for epilepsy surgery. As a result: (1) SMA generated clear pre-movement potentials regardless of the type of movement. Its amplitude was almost identical between contralateral and bilateral movements except for the motor potential (MP). The pre-movement potentials associated with ipsilateral movements were relatively smaller than those with contralateral or bilateral movements. (2) The primary sensorimotor area generated clear pre-movement potentials in contralateral and bilateral movements with similar amplitude. With ipsilateral hand movements, however, only a small Bereitschaftspotential (BP) and no negative slope (NS') or MP was seen, and ipsilateral foot movements were not preceded by any BP. It is, therefore, most likely that, as far as the preparation for simple voluntary self-paced movement is concerned, the SMA plays an equally important role in unilateral and bilateral movements, whereas the primary sensorimotor area is involved predominantly in the preparation of contralateral movements.

EView--a workstation-based viewer for intensive clinical electroencephalography.

We describe a workstation-based EEG viewer that satisfies the requirements for high-volume clinical EEG review. It currently supports two 24-h four-bed epilepsy monitoring units and a network of routine, intraoperative, and intensive care monitors, providing paperless review of over 5000 pages/day by a staff of clinical neurophysiologists. The design takes advantage of the development environment, processing and graphics resources, and networking capabilities of high-performance UNIX workstations. The user interface and operational infrastructure have been tailored to the demands of clinical neurophysiologists requiring rapid access to large volumes of EEG waveform data in a large clinical neurophysiology laboratory. This paper describes the functional requirements, system architecture, and implementation details of the current system.

A data interchange standard for clinical neurophysiology.

A Standard Specification for Transferring Digital Neurophysiological Data Between Independent Computer Systems (Designation E 1467-92) has been developed. The specification defines a common representation of all of the data associated with a complete clinical study, including digitized neurophysiological waveforms, textual annotations and interpretive reports. Patterned after existing, related healthcare data interchange standards, it will facilitate data interchange between neurophysiological instruments, computer systems within the neurophysiology laboratory, other information systems in the hospital, and outside healthcare facilities or research laboratories.

Data interchange for clinical neurophysiology.

Clinical Neurophysiology is rapidly moving towards complete dependence on digital instrumentation and computer-based systems. ASTM E 1467-92 "Standard Specification for Transferring Digital Neurophysiological Data Between Independent Computer Systems" was developed to allow exchange of multichannel electrophysiological waveforms, embedded textual annotations, results of mathematical processing, and clinical interpretive reports between various instruments and systems. This will permit integration of the neurophysiology laboratory interaction with hospital and clinic informations systems, and sharing of data between institutions for clinical or research purposes.

Real-time filtering for the estimation of steady-state visual evoked brain potentials.

It is shown that EEG visual evoked potentials elicited by repetitive stimuli in the range of 2 to 20 per second can be readily estimated in real time using a simple filtering approach. This measurement takes advantage of the fact that a comb filter will pass the important Fourier harmonics of the signal to provide an estimate of the evoked activity, plus track time-variations in the signal. Results on human subjects demonstrate the effectiveness of the approach.

EEG mapping for surgery of epilepsy.

This report describes the objectives, problems, and current techniques associated with using EEG maps in the management of surgery of epilepsy. The purpose of EEG mapping in epilepsy is to precisely identify and characterize epileptogenic zones of the brain. Such zones may be single or multiple, pointlike or diffuse, and may be near or distant from the recording electrodes. The resulting measured electric fields are used to obtain information which, when analyzed in light of all the complementary clinical information, can frequently help to localize and describe the epileptic foci with more precision.