RESUMO
Introduction: Various methods have been used to determine the frequency components of seizures in scalp electroencephalography (EEG) and in intracortical recordings. Most of these methods rely on subjective or trial-and-error criteria for choosing the appropriate bandwidth for filtering the EEG or local field potential (LFP) signals to establish the frequency components that contribute most to the initiation and maintenance of seizure activity. The empirical mode decomposition (EMD) with the Hilbert-Huang transform is an unbiased method to decompose a time and frequency variant signal into its component non-stationary frequencies. The resulting components, i.e., the intrinsic mode functions (IMFs) objectively reflect the various non-stationary frequencies making up the original signal. Materials and methods: We employed the EMD method to analyze the frequency components and relative power of spontaneous electrographic seizures recorded in the dentate gyri of mice during the epileptogenic period. Epilepsy was induced in mice following status epilepticus induced by suprahippocampal injection of kainic acid. The seizures were recorded as local field potentials (LFP) with electrodes implanted in the dentate gyrus. We analyzed recording segments that included a seizure (mean duration 28 s) and an equivalent time period both before and after the seizure. Each segment was divided into non-overlapping 1 s long epochs which were then analyzed to obtain their IMFs (usually 8-10), the center frequencies of the respective IMF and their spectral root-mean-squared (RMS) power. Results: Our analysis yielded unbiased identification of the spectral components of seizures, and the relative power of these components during this pathological brain activity. During seizures, the power of the mid frequency components increased while the center frequency of the first IMF (with the highest frequency) dramatically decreased, providing mechanistic insights into how local seizures are generated. Discussion: We expect this type of analysis to provide further insights into the mechanisms of seizure generation and potentially better seizure detection.
RESUMO
BACKGROUND: Current methods for quantitative assessment of cerebral small vessel disease (CSVD) ignore critical aspects of the disease, namely lesion type and regionality. We developed and tested a new scoring system for CSVD, "regional Cerebral Small Vessel Disease" (rCSVD) based on regional assessment of magnetic resonance imaging (MRI) features. METHODS: 141 patients were retrospectively included with a derivation cohort of 46 consecutive brain MRI exams and a validation cohort of 95 patients with known cerebrovascular disease. We compared the predictive value of rCSVD against existing scoring methods. We determined the predictive value of rCSVD score for all-cause mortality and recurrent strokes. RESULTS: 46 (44 male) veteran patients (age: 66-93â¯years), were included for derivation of the rCSVD score. A non-overlapping validation cohort consisted of 95 patients (89 male; age: 34-91â¯years) with known cerebrovascular disease were enrolled. Based on ROC analysis with comparison of AUC (Area Under the Curve), "rCSVD" score performed better compared to "total SVD score" and Fazekas score for predicting all-cause mortality (0.75 vs 0.68 vs 0.69; pâ¯=â¯0.046). "rCSVD" and total SVD scores were predictive of recurrent strokes in our validation cohort (p-values 0.004 and 0.001). At a median of 5.1â¯years (range 2-17â¯years) follow-up, Kaplan-Meier survival analysis demonstrated an rCSVD score of 2 to be a significant predictor of all-cause-mortality. CONCLUSION: "rCSVD" score can be derived from routine brain MRI, has value in risk stratification of patients at risk of CSVD, and has potential in clinical trials once fully validated in a larger patient cohort.
