Ictal EEG: Etiology and Mortality in Older Adults With Nonconvulsive Status Epilepticus.

Clinical-electroencephalogram (EEG), as well as etiological and prognostic data on subtypes of nonconvulsive status epilepticus (NCSE) are yet to be established. Objective: Evaluate the clinical semiology and EEG findings and prognostic data of older adults with NCSE. Methodology: Characterize the clinical-EEG and prognostic data in the subtypes of NCSE in older adults consecutively admitted to the emergency room of the Pontifícia Universidade Católica de Campinas (PUC-Campinas) University Hospital. Results: When evaluating 105 older adults with altered consciousness, it was possible to diagnose NCSE in 50 (47.6%) older adults, with a mean age of 72.8 ± 8.8 years. NCSE-coma occurred in 6 cases, with NCSE-without coma in 44 cases. The etiology was structural in 41(82%) cases, metabolic in 5 cases, and unknown etiology in 4 cases. Twelve cases had a history of epileptic seizures. On the EEG, epileptiform discharges (EDs > 2.5 Hz) were present in 34(68%) cases and rhythmic delta activity /lateralized periodic patterns occurred in 35(70%) cases. There was clinical improvement after the initial pharmacological treatment in 36 cases and, within 30 days, 18 cases died. The better prognosis was associated with a good response to initial pharmacological treatment (n = 14) and with EDs > 2.5 Hz on EEG (Fisher's exact test; 26 vs 8; P = .012). Conclusion: Focal NCSE with impaired consciousness was the most frequent subtype. The most frequent finding on the EEG was the recording of focal/regional seizures. A high number of cases showed initial clinical improvement, but mortality was high. The favorable prognosis was associated with initial clinical improvement and the presence of EDs > 2.5 Hz. There was no relationship between EEG patterns and the etiology and subtypes of NCSE in older adults.

Family support in adults with epilepsy.

BACKGROUND: The perception of family support in chronic disease can be relevant. OBJECTIVE: To assess the perception of family support in adult patients with epilepsy (PWEs) and relate it to quality of life (QoL) and clinical aspects. METHODS: Data from the Perceived Family Support Inventory (IPFS) of 130 PWEs were related to the clinical variables, QOLIE-31 scores, and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) with statistical tests, with p < 0.05. RESULTS: The mean age was 49.9 ± 17.2 years, and the duration of epilepsy was 20.8 ± 15.4 years. The presence of depression (scores ≥ 15) was associated with lower family support. Being married and non-occurrence of depression were the variables associated with a higher IPFS score (R = 0.2112), in the multiple linear regression. CONCLUSION: The perception of greater family support was associated with demographic aspects, the absence of depression, and better QoL. Family relationships may play an essential role in health adjustment behaviors and QoL in epilepsy.

ANTECEDENTES: A percepção do suporte familiar nas doenças crônicas pode ser relevante. OBJETIVO: Avaliar em pacientes adultos com epilepsia (PCE) a percepção do suporte familiar e relacioná-la com os aspectos clínicos e com a qualidade de vida (QV). MéTODOS: Os dados do Inventário de Percepção de Suporte Familiar (IPSF) de 130 PCE foram relacionados com as variáveis clínicas, os escores do QOLIE-31 e com o Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), com testes estatísticos, com p < 0.05. RESULTADOS: A idade média foi 49.9 ± 17.2 anos e o tempo de epilepsia foi de 20.8 ± 15.4 anos. Escores ≥ 15 no NDDI-E (presença de depressão) associaram-se a menor suporte familiar. Ser casado e não ter depressão são as variáveis associadas a maiores escores no IPSF (R = 0.2112), na regressão linear múltipla. CONCLUSãO: A percepção de maior suporte familiar associou-se à aspectos demográficos, a ausência de depressão e a melhor QV. As relações familiares podem ter papel essencial nos comportamentos de ajustamento na saúde e na QV na epilepsia.

Family support in adults with epilepsy / Percepção do suporte familiar em adultos com epilepsia

Abstract Background The perception of family support in chronic disease can be relevant. Objective To assess the perception of family support in adult patients with epilepsy (PWEs) and relate it to quality of life (QoL) and clinical aspects. Methods Data from the Perceived Family Support Inventory (IPFS) of 130 PWEs were related to the clinical variables, QOLIE-31 scores, and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) with statistical tests, with p < 0.05. Results The mean age was 49.9 ± 17.2 years, and the duration of epilepsy was 20.8 ± 15.4 years. The presence of depression (scores ≥ 15) was associated with lower family support. Being married and non-occurrence of depression were the variables associated with a higher IPFS score (R = 0.2112), in the multiple linear regression. Conclusion The perception of greater family support was associated with demographic aspects, the absence of depression, and better QoL. Family relationships may play an essential role in health adjustment behaviors and QoL in epilepsy.

Resumo Antecedentes A percepção do suporte familiar nas doenças crônicas pode ser relevante. Objetivo Avaliar em pacientes adultos com epilepsia (PCE) a percepção do suporte familiar e relacioná-la com os aspectos clínicos e com a qualidade de vida (QV). Métodos Os dados do Inventário de Percepção de Suporte Familiar (IPSF) de 130 PCE foram relacionados com as variáveis clínicas, os escores do QOLIE-31 e com o Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), com testes estatísticos, com p < 0.05. Resultados A idade média foi 49.9 ± 17.2 anos e o tempo de epilepsia foi de 20.8 ± 15.4 anos. Escores ≥ 15 no NDDI-E (presença de depressão) associaram-se a menor suporte familiar. Ser casado e não ter depressão são as variáveis associadas a maiores escores no IPSF (R = 0.2112), na regressão linear múltipla. Conclusão A percepção de maior suporte familiar associou-se à aspectos demográficos, a ausência de depressão e a melhor QV. As relações familiares podem ter papel essencial nos comportamentos de ajustamento na saúde e na QV na epilepsia.

Risk of suicide and religious or spiritual beliefs in Brazilian adult patients with epilepsy.

In epilepsy, suicidal behavior is higher compared with the general population. OBJECTIVE: To assess the relationship between suicide risk, religiosity or spirituality, and clinical variables in adult patients with epilepsy (PWE). METHODOLOGY: The data from the suicide module of the Mini International Neuropsychiatric Interview (MINI) were related to scores on the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS-P) and the Hospital Anxiety and Depression Scale (HADS), as well as clinical variables in 96 adults PWE, with a significance level of p < 0.05. RESULTS: The study included 49 patients with temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) and 47 cases of other epilepsies. The presence of suicide risk in the MINI was observed in 43 (44.7%) cases. Suicide risk was associated with an earlier age of epilepsy onset, higher seizure frequency, neurological abnormalities, and higher scores on the HADS-A and HADS-D scales. Suicide risk was low in 33 (76.7%) cases and moderate or high in 10 (23.2%) cases. Higher suicide risk was associated with higher education levels, focal structural epilepsy, use of ≥2 antiseizure medications, neurological abnormalities, anxiety, and dimensions such as daily spiritual experiences, religious or spiritual coping, organizational religiousness, and total score in the BMMRS-P. DISCUSSION: A high number of patients with epilepsy exhibited suicide risk, with epilepsy-related variables, the presence of anxiety, and perceived lower belongingness and social support from religiosity or spirituality anxiety being associated with a higher risk. The social support provided by religiosity/spirituality may be a non-clinical factor associated with suicidal behavior. Suicide in epilepsy is associated with a complex interaction of multidimensional factors.

Cognition and obesity in adults with epilepsy.

Introduction: Objective: to assess the occurrence of overweight/obesity in patient with epilepsy (PWEs) and to relate it to cognitive aspects and clinical variables. Methodology: the measurements of waist circumference, calf circumference, arm circumference, and the body mass index were related to the scores of the Mini-Mental State Examination and the Brief Cognitive Battery-Edu, as well as to the clinical variables of 164 PWEs, with a significance level of p < 0.05. Data were compared to a similar control group (CG) comprising 71 cases. Linear and multiple logistic regression models were used to assess factors related to cognitive aspects. Results: the mean age of the PWEs was 49.8 ± 16.6 years with a mean length of epilepsy of 22 ± 15.9 years. Overweight/obesity occurred in 106 (64.6 %) PWEs and in 42 (59.1 %) CG subjects. The PWEs had a worse performance in several cognitive functions when compared to CG subjects. In the PWEs, overweight/obesity was associated with lower educational level, older age, and cognitive impairment. Greater waist circumference, overweight, age at the first seizure, and use of polytherapy with antiseizure medications were predictive factors of memory impairment in multiple linear regression. Greater arm and calf circumference values were associated with better performance in several cognitive areas. Conclusion: the occurrence of overweight/obesity in PWEs and CG subjects was high. Cognitive impairment occurred in a high number of PWEs and was associated with overweight, greater waist circumference values, and clinical aspects of epilepsy. Better cognitive performance was associated with greater arm and calf circumference.

Introducción: Objetivo: evaluar la ocurrencia de sobrepeso/obesidad en pacientes con epilepsia y relacionarla con aspectos cognitivos y variables clínicas. Metodología: las medidas de circunferencia de cintura, circunferencia de pantorrilla, circunferencia de brazo e índice de masa corporal se relacionaron con los puntajes del Mini-Mental State Exam y de la Batería Cognitiva Breve-Edu, así como con las variables clínicas de 164 pacientes con epilepsia, con un nivel de significación de p < 0,05. Los datos se compararon con un grupo de control similar (GC) compuesto por 71 casos. Se utilizaron modelos de regresión logística lineal y múltiple para evaluar factores relacionados con aspectos cognitivos. Resultados: la edad media de las pacientes con epilepsia fue de 49,8 ± 16,6 años con una duración media de la epilepsia de 22 ± 15,9 años. Presentaron sobrepeso/obesidad 106 (64,6 %) pacientes con epilepsia y 42 (59,1 %) sujetos del GC. Los pacientes con epilepsia tuvieron un peor desempeño en varias funciones cognitivas en comparación con los sujetos del GC. En las pacientes con epilepsia, el sobrepeso/obesidad se asoció con menor nivel educativo, mayor edad y deterioro cognitivo. La mayor circunferencia de la cintura, el sobrepeso, la edad de la primera convulsión y el uso de politerapia con medicamentos anticonvulsivos fueron factores predictivos del deterioro de la memoria en la regresión lineal múltiple. Los valores mayores de circunferencia del brazo y la pantorrilla se asociaron con un mejor rendimiento en varias áreas cognitivas. Conclusión: la incidencia de sobrepeso/obesidad en sujetos pacientes con epilepsia y GC fue alta. El deterioro cognitivo ocurrió en un alto número de pacientes con epilepsia y se asoció con sobrepeso, mayores valores de circunferencia de la cintura y aspectos clínicos de la epilepsia. Un mejor rendimiento cognitivo se asoció con una mayor circunferencia del brazo y la pantorrilla.

Focal nonconvulsive status epilepticus with impaired consciousness in older adults: Prognosis-related variables.

OBJECTIVE: To assess the prognosis-related clinical-EEG characteristics in older adults with focal nonconvulsive status epilepticus with impaired consciousness (focal NCSE). METHODOLOGY: We prospectively assessed clinical variables and EEG data at diagnosis and after an initial pharmacological protocol (within 24 hours) and their relationship with prognosis in older adults with focal NCSE treated at the emergency room. RESULTS: The clinical presentation of focal NCSE in 45 adults (mean age 73.5 ±â€¯9.1 years) was characterized by decreased consciousness and the presence of subtle ictal phenomena in 24 cases. On the initial EEG, there were lateralized periodic discharges (LPDs) and lateralized rhythmic delta activity (RDA) in 25 cases and epileptiform discharges (EDs > 2.5 Hz) in 32 cases. After the drug protocol, 33 (73.3%) cases had effective clinical improvement. Death after 30 days occurred in 10 (22.2%) cases. In simple and multiple logistic regression, it was observed that older adults with a history of epilepsy/seizures have a greater chance of clinical improvement. The occurrence of death was associated with the presence of RDA in the initial EEG and its subsequent disappearance (OR 6.93, 95% CI 1.20-46.01, p = 0.033). Higher mortality was associated with the presence of LPDs in the initial EEG and with the presence of LPDs/EDs > 2.5 Hz in the EEG after treatment. CONCLUSION: The presence of ED > 2.5 Hz in the initial EEG was the most frequent pattern at focal NCSE. Clinical improvement was associated with a history of epilepsy/seizures. Mortality in the focal NCSE was high and was associated with the presence of RDA in the initial EEG and the occurrence of LPDs/ED > 2.5 Hz after treatment.

Religious Experience and Clinical-EEG Aspects in Adult People with Epilepsy.

Spirituality and religiosity are complex cognitive phenomena; however, the relationship between spiritual experiences and epilepsy continues to be debated. Methods. Data from the daily spiritual experience scale (DSES) were related to EEG data and clinical variables of 100 adult people with epilepsy (PWEs). DSES scores were compared to 51 normal individuals (control group [CG]), with a significance level of P < .05. Results. The total score in the DSES was 36.1 ± 14 and 37.6 ± 13.2, respectively, in the PWEs and in the CG. In the PWEs, there was a correlation between DSES and age (Pearson's correlation; -0.22; P = .027) and educational level (0.207; P = .039). PWEs with ≥one seizure/month have a lower frequency of daily spiritual experiences than those with better controlled seizures (T-test; 39.2 ± 16.2 vs 31.7 ± 7.6; P = .038). EEG epileptiform activity (EA) in the right hemisphere was associated with a higher frequency of spiritual experiences than those with left-hemisphere EA (29.8 ± 9.0 vs 38.5 ± 17.5; P = .010). Conclusion. Demographic aspects, EA in the right hemisphere, and lower seizure frequency are associated with daily spiritual experiences in epilepsy, suggesting an association between aspects of spirituality, epilepsy, and neurobiological correlates.

Seizure-related injuries in adults: A prospective case-controlled study on risk factors, seizure severity and quality of life.

OBJECTIVE: The current study was conducted to understand the occurrence of seizure-related injuries in people with epilepsy. The relationship between injuries and clinical variables, the perception of seizure severity and quality of life (QoL) and the practice of risky activities were also assessed. The characteristics of the injuries from the onset of epilepsy and in the previous year were assessed. METHODOLOGY: This is a prospective study to assess the occurrence of seizures-related injuries of 72 adult patients with epilepsy. Injury-related data were related to clinical variables and scores of the quality of life in epilepsy inventory (QOLIE-31) and the Seizure Severity Questionnaire (SSQ) with p < 0.05. RESULTS: The mean age of the people with epilepsy was 45.8 ± 15.2 years and the mean length of seizure disorder was 24.0 ± 18.7 years. Seizure-related injuries occurred since the onset of epilepsy in 55 (76.4%) cases and in the previous year in 17 (23.6%) cases. Throughout the lifespan, there was a greater occurrence of injuries in younger patients, with younger age at the onset of epilepsy, using various antiseizure medications and with higher SSQ scores (T test; 54.5 ± 27.7 vs 36.1 ± 23.4, p = 0.011). Injuries in the previous year were associated with a high occurrence of previous injuries, lower scores on the QOLIE-31 (56.7 ± 18.6 vs 66.6 ± 16.1; p = 0.048), higher frequency of seizures and the perception of greater severity of seizures. Seizure-related injuries during risky activities occurred in 11 (20%) cases, associated with a longer length of epilepsy disorder (34.9 ± 15.6 years vs 22.1 ± 17.4 years; p = 0.03) and the need for surgical procedures. CONCLUSION: The occurrence of seizure-related injuries suffered throughout the lifespan and recurrent injuries in the previous year were high. Injuries were significantly associated with epilepsy variables, the perception of greater severity of seizures and risky activities. Seizure-related injuries in the previous year have compromised QoL but not in individuals who suffered injuries throughout their lifespan.

Acupuncture, seizure frequency, and quality of life in temporal lobe epilepsy.

OBJECTIVE: To assess seizure frequency and quality of life (QOL) in a group of adults with temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) before and after 10 weeks of systemic acupuncture sessions and compare the results with a group of patients with TLE-HS not undergoing acupuncture. METHODS: The Quality of Life in Epilepsy Inventory (QOLIE-31) and the initial and final seizure frequency of 26 adult patients with TLE-HS who underwent acupuncture sessions for 10 consecutive weeks were assessed. The data were compared to those of 26 patients with TLE-HS not submitted to acupuncture, with p < 0.05. RESULTS: There was a clinically significant effect in reducing the mean number of seizures per month in the follow-up period of patients submitted or not to acupuncture (no intervention group and intervention group, effect size: -0.94 and -1.01, respectively). In the last four weeks of follow-up, there was a significant difference between the no intervention and intervention groups (0.5 [0-2] and 0 [0-4]; p = 0.018). When using minimally important change (MIC) threshold data for the QOLIE-31 between the final and initial scores, with the Cantril Ladder Scale as anchoring, it was observed that, in the intervention group, large clinically significant effects were seen for all dimensions, except for cognitive function, medication effect, and social function, which presented medium effects. In the follow-up, the variation of the QOLIE-31 scores was positive for both groups; however, it was higher in all dimensions in the intervention group, indicating a better QOL. CONCLUSION: There was a reduction in the mean number of seizures per month in all patients during the follow-up period. Acupuncture significantly reduced the number of seizures in the intervention group in the final phase of the study. QOL improvements occurred in all patients, however, more significantly in the intervention group.

Stigma, emotional aspects, and psychological symptoms in individuals with epilepsy.

The relationship between stigma and psychological aspects in adults with epilepsy is poorly studied. The Stigma Scale of Epilepsy (SSE) was related to the Factorial Neuroticism Scale (FNS), Symptoms Assessment Scale-40 (SAS-40), and clinical aspects of 71 individuals with epilepsy, at a significance level of p < 0.05. Clinical and sociodemographic aspects are associated with the presence of psychological symptoms and emotional maladjustment. The occurrence of psychological symptoms in the SAS-40 was associated with uncontrolled seizures, longer illness duration, and perception of greater stigma. There was a relationship between perceived stigma, age, and epilepsy duration. In the linear regression for determining the factors that potentially affected perception of stigma, the symptom dimensions 'somatization' in the SAS-40 (p < 0.001) and the 'psychosocial maladjustment' in the FNS (p = 0.012) were included, and the clinical aspects were excluded. Psychological symptoms were associated with uncontrolled seizures and perceived stigma. Perception of stigma was associated with somatization and psychosocial maladjustment.

Alzheimer's disease: nutritional status and cognitive aspects associated with disease severity.

INTRODUCTION: Alzheimer's pathology is a neurodegenerative disease characterized by cognitive impairment and functional disability that causesprogressive restrictions in daily activities. The present study associates nutritional status with cognitive and clinical aspects of the elderly withmild, moderate and severe Alzheimer's disease (AD). METHODS: data from the Mini Nutritional Assessment (MNA), bioelectrical impedance (BIA), anthropometric measurements, and physical activityindicators were associated with clinical and cognitive aspects of 43 elderly patients with AD. The data were compared to a paired control group (NC) (n = 51) at a significance level of p < 0.05. RESULTS: elderly patients with AD presented lower cognitive performance, higher risk of malnutrition (p = 0.001), lower weight (t-test, p = 0.017) and body mass index (BMI) (p = 0.006), and higher sedentarity (Chi-square, p = 0.040) when compared with the NC. The elderly with AD presented significant reduction in lean body mass (LM) and increased fat mass (FM). As dementia progresses, significant impairment of nutritional indicators is observed. Elderly patients with severe AD present lower weight, BMI, MNA scores and increased body fat mass index and fat mass when compared with those with mild/moderate AD. A correlation was observed between better cognitive performance and weight, BMI, calf circumference and triceps skinfold thickness. CONCLUSION: elderly patients with AD present high sedentarity, risk of malnutrition, lower weight, BMI and LM, and increased FM. There was progressive impairment of nutritional status and cognition as the disease progressed. There is an association between the nutritional variables and cognitive aspects.

Coherence of brain electrical activity: a quality of life indicator in Alzheimer's disease?

OBJECTIVE: To investigate the relationships between quality of life (QOL) and clinical and electroencephalogram (EEG) aspects in patients with Alzheimer's disease (AD). METHOD: Twenty-eight patients with mild or moderate AD, 31 with Parkinson's disease (PD), and 27 normal controls (NC) were submitted to: CERAD neuropsychological battery, Hamilton Depression and Anxiety Rating Scales, Functional Activities Questionnaire, QOL scale for patients with AD, and quantitative EEG measures. RESULTS: AD and PD patients had similar QOL (31.0 ± 5.8; 31.7 ± 4.8, respectively), worse than that of NC (37.5 ± 6.3). AD patients had lower global interhemispheric theta coherence (0.49 ± 0.04; 0.52 ± 0.05; 0.52 ± 0.05; respectively) than PD and NC. Multiple linear regression for QOL of AD patients revealed that global interhemispheric theta coherence, and Hamilton depression scores were significant factors (coefficients; 58.2 and -0.27, respectively; R2, 0.377). CONCLUSION: Interhemispheric coherence correlates with QOL regardless of cognitive and functional variables and seems to be a neurophysiological indicator of QOL in AD patients.

Coherence of brain electrical activity: a quality of life indicator in Alzheimer’s disease?Coerência da atividade elétrica cerebral: indicador da qualidade de vida na doença de Alzheimer?

Objective To investigate the relationships between quality of life (QOL) and clinical and electroencephalogram (EEG) aspects in patients with Alzheimer’s disease (AD). Method Twenty-eight patients with mild or moderate AD, 31 with Parkinson’s disease (PD), and 27 normal controls (NC) were submitted to: CERAD neuropsychological battery, Hamilton Depression and Anxiety Rating Scales, Functional Activities Questionnaire, QOL scale for patients with AD, and quantitative EEG measures. Results AD and PD patients had similar QOL (31.0 ± 5.8; 31.7 ± 4.8, respectively), worse than that of NC (37.5 ± 6.3). AD patients had lower global interhemispheric theta coherence (0.49 ± 0.04; 0.52 ± 0.05; 0.52 ± 0.05; respectively) than PD and NC. Multiple linear regression for QOL of AD patients revealed that global interhemispheric theta coherence, and Hamilton depression scores were significant factors (coefficients; 58.2 and -0.27, respectively; R2, 0.377). Conclusion Interhemispheric coherence correlates with QOL regardless of cognitive and functional variables and seems to be a neurophysiological indicator of QOL in AD patients. .

Objetivo Investigar relações entre qualidade de vida (QV) e aspectos clínico-eletrencefalográficos (EEG) em pacientes com doença de Alzheimer (DA). Método Vinte e oito pacientes com DA, 31 com doença de Parkinson (DP) e 27 controles normais (CN) foram submetidos a avaliações neurocognitivas, escala de depressão de Hamilton e de qualidade de vida para pacientes com DA, questionário de atividades funcionais e medidas do EEG. Resultados A QV foi similar nos grupos DA e DP (31,0 ± 5,8; 31,7 ± 4,8, respectivamente), mas inferior ao CN (37,5 ± 6,3). No grupo DA houve menor coerência inter-hemisférica global teta (CIGT) do que em DP e CN (p < 0,05). Regressão múltipla linear para QV no grupo DA revelou a CIGT e a escala de Hamilton como fatores significativos (coeficientes; 58,2; -0,27, respectivamente; R2, 0,377). Conclusão A CIGT correlaciona-se com a QV independentemente de variáveis cognitivas e funcionais e parece ser um indicador neurofisológico da QV em pacientes com DA. .

Comparison of quantitative EEG between patients with Alzheimer's disease and those with Parkinson's disease dementia.

OBJECTIVE: Dementia frequently occurs in Parkinson's disease (PD) but its pathophysiological basis is little known. Comparative EEG studies of Alzheimer's disease (AD) and Parkinson's disease dementia (PDD) are still rare, but could provide knowledge on the different pathophysiological mechanisms involved. The objective of the present study was to comparatively evaluate the absolute power and coherence on the EEG for patients with AD and PDD. METHODS: This study assessed 38 adults with AD, 12 with PDD, 31 with Parkinson's disease without dementia, and 37 controls (CG) by a neurological evaluation, CERAD neuropsychological battery, executive functions tests and qEEG, calculating global absolute powers for the delta, theta, alpha and beta bands and inter- and intra-hemispheric coherences. RESULTS: The delta and theta powers were highest in PDD and lowest in CG (p<0.05). The beta frontal-occipital inter-hemispheric coherence was highest in PDD (p<0.05). Whereas, alpha and beta frontal inter-hemispheric coherence was highest in PDD and lowest in AD (p<0.05). CONCLUSION: These results suggest that qEEG power and coherence measures are different in AD and PDD. SIGNIFICANCE: These qEEG differences must be related to the distinct mechanisms of cortical neural connections in AD and PDD.

Electroencephalographic alpha reactivity on opening the eyes in children with attention-deficit hyperactivity disorder.

The quantification of differences in alpha electroencephalograph (EEG) activity between the eyes-closed and eyes-open resting conditions could be used as a measure of resting state arousal. The objective of this study was to evaluate the contribution of EEG alpha reactivity on opening the eyes, to the neurophysiology of children with attention-deficit hyperactivity disorder (ADHD). Thirty-eight children with ADHD were assessed using quantitative EEG (qEEG) analysis of absolute band power at rest, with eyes open and closed. Alpha reactivity index was calculated on opening the eyes, defined from the relationship between the absolute powers in the respective bands in the periods with the eyes open and closed. EEG data of 38 sex- and age-matched controls, with no neurological or psychiatric problems, were collected for comparison. There was a significant reduction in absolute alpha power at all electrodes for both ADHD and control groups with eyes open, indicating an increase in the arousal level. However, the alpha reactivity index was greater, corresponding to less reactivity, in the frontal regions of the children with ADHD (P < .01). Such a finding suggests alterations in arousal mechanisms in ADHD. This research suggests that alpha reactivity on opening the eyes, allied with other variables from the qEEG, may improve diagnostic accuracy in ADHD.

Somatosensory-evoked spikes on electroencephalography (EEG): longitudinal clinical and EEG aspects in 313 children.

Somatosensory-evoked spikes (ESp) are high-voltage potentials registered on the EEG, which accompany each of the percussions on the feet or hands. The objective of this research was to study the longitudinal clinical and EEG aspects of children with ESp. A total of 313 children, 53.7% male, showing ESp on the EEG and with an average initial age of 6.82 (range from 2 to 14 years) were followed for a mean period of 35.7 months. In the initial evaluation, 118 (37.7%) had a history of nonfebrile epileptic seizures (ES). Epileptiform activity (EA) was observed on the EEG in 61% and showed a significantly greater occurrence in children with ES than in those without (P = .000). Of the 118 showing seizures from the start, 53 (44.9%) continued to have seizures; of the 195 without seizures at the start, only 13 (6.67%) developed them. Thus, only 66 (21.1%) children showed ES during the follow-up. ESp disappeared in 237 (75.7%) cases and EA in 221 (70.6%). In the children with ES, it was found that the presence of EA on the first EEG did not indicate continuation of the ES throughout the remaining period, while the 13 children who presented their first ES in a later period showed a greater occurrence of EA on the initial EEG than those who did not develop ES (P = .001). Evidence of brain injury was observed in 43 (13.7%) children and was associated with a greater continuity of the ES during the study (P = .018). ESp, EA, and ES tend to disappear, suggesting an age-dependent phenomenon. The finding of ESp, particularly in the absence of any evidence of brain injury, indicates a low association with ES and benign outcome.

Alzheimer's disease: relationship between cognitive aspects and power and coherence EEG measures / Doença de Alzheimer: relação entre aspectos cognitivos e medidas de potência e coerência no eletrencefalograma

OBJECTIVE: To evaluate the relationship between specific cognitive aspects and quantitative EEG measures, in patients with mild or moderate Alzheimer's disease (AD). METHOD: Thirty-eight AD patients and 31 controls were assessed by CERAD neuropsychological battery (Consortium to Establish a Registry for AD) and the electroencephalogram (EEG). The absolute power and coherences EEG measures were calculated at rest. The correlations between the cognitive variables and the EEG were evaluated. RESULTS: In the AD group there were significant correlations between different coherence EEG measures and Mini-Mental State Examination, verbal fluency, modified Boston naming, word list memory with repetition, word list recall and recognition, and constructional praxis (p<0.01). These correlations were all negative for the delta and theta bands and positive for alpha and beta. There were no correlations between cognitive aspects and absolute EEG power. CONCLUSION: The coherence EEG measures reflect different forms in the relationship between regions related to various cognitive dysfunctions.

OBJETIVO: Avaliar as relações entre aspectos cognitivos específicos e medidas quantitativas do EEG em pacientes com doença de Alzheimer (DA) leve e moderado. MÉTODO: Trinta e oito pacientes com DA e 31 controles foram avaliados com a bateria neuropsicológica CERAD (Consortium to Establish a Registry for AD) e o eletroencefalograma. Foram realizadas medidas de potência absoluta e coerência do EEG, durante repouso, e avaliadas suas relações com variáveis do CERAD. RESULTADOS: No grupo DA houve correlações significativas entre diferentes medidas de coerência e o mini-exame do estado mental, fluência verbal, teste de nomeação de Boston modificado, memória de lista de palavras com repetição, recordação e reconhecimento de lista de palavras e praxia construtiva (p<0,01). Essas correlações foram negativas para as faixas delta e teta e positivas para alfa e beta. CONCLUSÃO: As medidas de coerência do EEG em repouso refletem diferentes formas de organização nas relações entre regiões, relacionadas a várias disfunções cognitivas.

EEG theta and alpha reactivity on opening the eyes in the diagnosis of Alzheimer's disease.

The objective of this study was to evaluate the contribution of EEG theta and alpha reactivity on opening the eyes, in the diagnosis of slight and moderate Alzheimer's disease (AD). Thirty four patients with AD and a control group of 30 individuals were studied, all being assessed using a neurological evaluation, CERAD neuropsychological battery (consortium to establish a registry for Alzheimer's disease), incorporating the Mini Mental State Examination (MMSE), Clinical Dementia Rating (CDR) and a qEEG analysis of the absolute band power at rest, with the eyes both open and closed. The theta and alpha reactivity indices were calculated on opening the eyes, defined from the relationship between the absolute powers in the respective bands in the periods with the eyes open and with them closed, the quotient of the relationship between the alpha and theta indices, the alpha/theta ratio, was also calculated. Multiple regression models were used to determine the accuracy in discriminating between the AD and control groups. A regression model using only cognitive data provided an accuracy of 92.2%, whereas a regression model combining cognitive data and qEEG measurements provided an accuracy of 95.3% in the classification between AD and the controls. The variable for the qEEG was the left hemisphere alpha/theta index, since the other parameters were shown to be inferior with respect to the clinical data in the regression analysis. The integrated study of the theta and alpha reactivity indices on opening the eyes and the alpha/theta index, was shown to be a useful approach in qEEG in the evaluation of AD and should be evaluated with larger samples and with other data analysis methods, with the aim of increasing the accuracy.

Alzheimer's disease: relationship between cognitive aspects and power and coherence EEG measures.

OBJECTIVE: To evaluate the relationship between specific cognitive aspects and quantitative EEG measures, in patients with mild or moderate Alzheimer's disease (AD). METHOD: Thirty-eight AD patients and 31 controls were assessed by CERAD neuropsychological battery (Consortium to Establish a Registry for AD) and the electroencephalogram (EEG). The absolute power and coherences EEG measures were calculated at rest. The correlations between the cognitive variables and the EEG were evaluated. RESULTS: In the AD group there were significant correlations between different coherence EEG measures and Mini-Mental State Examination, verbal fluency, modified Boston naming, word list memory with repetition, word list recall and recognition, and constructional praxis (p<0.01). These correlations were all negative for the delta and theta bands and positive for alpha and beta. There were no correlations between cognitive aspects and absolute EEG power. CONCLUSION: The coherence EEG measures reflect different forms in the relationship between regions related to various cognitive dysfunctions.

Benign childhood epilepsy with centro-temporal spikes: evolutive clinical, cognitive and EEG aspects.

Thirty-two children with benign childhood epilepsy with centrotemporal spikes (BECTS) were studied for a mean period of 27.6 months. The characteristics of the seizures, electroencephalogram (EEG), WISC-III and School Performance Test were compared at the start and end of the study. Nine (28.1%) children continued having seizures. Epileptiform activity (EA) on the EEG reduced in number and was no longer recorded in 6 (18.7%) children. There was a significant improvement in the performance and perceptual organization IQ values. The improvement in reading performance failed to reach statistical significance. The performance in arithmetic worsened in 43.7% of the children, and this was associated with the persistence of epileptic seizures. There were no significant correlations between changes in cognitive aspects and characteristics of EA. There is a need to continue this study, and also search for other factors influencing the evolution of cognitive abilities in children with BECTS.