Turner's syndrome: a qualitative and quantitative analysis of EEG background activity

Summary A qualitative and quantitative analysis was performed on the EEG background activity in 62 Danish girls and women with Turner's syndrome (30 with karyotype 45,X and 32 with other karyotypes) whose ages ranged from 6 to 47 years (87% were aged 15 years or more) and age-matched controls. The pooled data and a case-control study showed characteristic features in Turner subjects, including: (1) more rapid frequency, larger amplitude and lower amount of alpha waves, (2) higher amount of theta waves, (3) larger amplitude and higher amount of delta waves and (4) larger amplitude and higher amount of beta waves than in controls. These findings in Turner subjects were more pronounced in the left hemisphere, and more typical, except for the amplitude in alpha waves, in Turner subjects with 45,X than in those with other karyotypes. The effects of advancing age on the EEG background activity observed in controls — including more rapid frequency, decreased amplitude and amount of alpha waves, increased amount of theta and delta waves, and increased amount of beta waves, particularly after 35 years of age — were found in some Turner subjects. Hemispheric differences with higher activity (i.e. more rapid frequency, larger amplitude and higher amount of alpha waves, particularly at Fp₁ and F₃, and, inversely, lower amount of theta or delta waves) at P₃, T₃, T₅ and O₂ than at the opposite side were found in many Turner subjects. However, these findings were not specific for Turner subiects, since the same hemispheric differences were also observed much more markedly in controls. These topographic distributions with hemispheric differences did not provide evidence for hypofunction in the temporo-parieto-occipital tertiary area of the right hemisphere in Turner subjects, though this had been expected on the basis of neuropsychological examinations. Our findings, including transiently appearing brain hypofunction at the parietal, temporal and occipital areas, most often in the right hemisphere, indicate a relationship between the chromosomal constitution 45,X and EEG background activity. They suggest the presence of functional brain disturbance in the thalamus and in the ascending reticular activating system, which tends to disturb the thalamo-cortical circuit. Further studies, including topographic and sequential power spectrum analysis of EEG background activity, 24-h continuous EEG recording, blood flow studies (positron computerized tomography) and neuropathological examination, may be needed.Tables I-VI are available on request     

Improved Diagnosis in Children with Partial Epilepsy Using a Multivariable Prediction Model Based on EEG Network Characteristics

Background

Electroencephalogram (EEG) acquisition is routinely performed to support an epileptic origin of paroxysmal events in patients referred with a possible diagnosis of epilepsy. However, in children with partial epilepsies the interictal EEGs are often normal. We aimed to develop a multivariable diagnostic prediction model based on electroencephalogram functional network characteristics.

Methodology/Principal Findings

Routinely performed interictal EEG recordings at first presentation of 35 children diagnosed with partial epilepsies, and of 35 children in whom the diagnosis epilepsy was excluded (control group), were used to develop the prediction model. Children with partial epilepsy were individually matched on age and gender with children from the control group. Periods of resting-state EEG, free of abnormal slowing or epileptiform activity, were selected to construct functional networks of correlated activity. We calculated multiple network characteristics previously used in functional network epilepsy studies and used these measures to build a robust, decision tree based, prediction model. Based on epileptiform EEG activity only, EEG results supported the diagnosis of with a sensitivity and specificity of 0.77 and 0.91 respectively. In contrast, the prediction model had a sensitivity of 0.96 [95% confidence interval: 0.78–1.00] and specificity of 0.95 [95% confidence interval: 0.76–1.00] in correctly differentiating patients from controls. The overall discriminative power, quantified as the area under the receiver operating characteristic curve, was 0.89, defined as an excellent model performance. The need of a multivariable network analysis to improve diagnostic accuracy was emphasized by the lack of discriminatory power using single network characteristics or EEG''s power spectral density.

Conclusions/Significance

Diagnostic accuracy in children with partial epilepsy is substantially improved with a model combining functional network characteristics derived from multi-channel electroencephalogram recordings. Early and accurate diagnosis is important to start necessary treatment as soon as possible and inform patients and parents on possible risks and psychosocial aspects in relation to the diagnosis.     

Transient global amnesia after mild head injury in childhood

In seven entirely healthy children in the age group of 6.5 to 14.5 years, mild head injury produced transient global amnesia (TGA) of median duration of 4.5 hours. None of the patients had convincing signs of brain concussion or clinical focal symptomatology. In four cases CT examination of the brain showed normal findings. Four children had a transient abnormal EEG (intermittent delta rhythms, slowed background activity inconstant local finding (of slow waves). During the period monitored (2-34 months) there was no recurrent attack and the children have had no difficulties. Pathologically, the authors assume ischemia of temporobasal structures induced by mild trauma with a relationship to migraine diathesis and rank the child group among so called benign posttraumatic encephalopathy with a noncomplicated course and good outcome.     

ICA Extracts Epileptic Sources from fMRI in EEG-Negative Patients: A Retrospective Validation Study

Simultaneous EEG-fMRI has proven to be useful in localizing interictal epileptic activity. However, the applicability of traditional GLM-based analysis is limited as interictal spikes are often not seen on the EEG inside the scanner. Therefore, we aim at extracting epileptic activity purely from the fMRI time series using independent component analysis (ICA). To our knowledge, we show for the first time that ICA can find sources related to epileptic activity in patients where no interictal spikes were recorded in the EEG. The epileptic components were identified retrospectively based on the known localization of the ictal onset zone (IOZ). We demonstrate that the selected components truly correspond to epileptic activity, as sources extracted from patients resemble significantly better the IOZ than sources found in healthy controls. Furthermore, we show that the epileptic components in patients with and without spikes recorded inside the scanner resemble the IOZ in the same degree. We conclude that ICA of fMRI has the potential to extend the applicability of EEG-fMRI for presurgical evaluation in epilepsy.     

Functional microsurgical partial callosotomy in patients with secondary generalized epilepsies. II. Mesial surface electrocorticography

Eight patients with secondary generalized epilepsy not alleviated by medical treatment underwent partial callosotomy. During the surgical procedure, they had mesial surface ECoG recordings taken from both frontal and parietal lobes, using large flat multilead platinum electrodes, and simultaneously recordings from a number of scalp positions, using needle electrodes. In all cases studied, this approach demonstrated one or, more commonly, several focal areas of epileptiform activity discharging independently over the mesial aspects of one or both hemispheres. The findings were correlated with the pre- and postoperative EEG patterns, in the light of current concepts of generalized epilepsies.     

术中皮质脑电图监测癫痫病灶切除13例分析

目的:探讨继发性癫痫术中运用皮质脑电图监测切除癫痫病灶的疗效。方法:对13例继发性癫痫患者术前经多次常规脑电图、24h动态脑电图检查定位并联合CT、MRI等检查结果,确定癫痫病灶的准确位置。在皮质脑电图精确定位监测下手术切除致痫灶。结果:13例癫痫患者均通过皮质脑电图监测,准确定位,切除致痫灶,切除病灶后的棘波、尖波,棘、尖慢复合波减少或完全消失。结论:利用皮质脑电图监测手术切除痫灶是治疗继发性癫痫最有效的方法之一。     

EEG in Children: Periodometric Analysis,Typology, and Age Peculiarities

We carried out a computer analysis of the EEG of 169 healthy schoolchildren (6 to 17 years old) with the use of a periodometric approach allowing us to obtain a number of quantitative indices that characterize the temporal structure of the analyzed EEG segment (histogram of distribution of the frequencies of EEG oscillations within the analyzed time period, indices of the different rhythms, and matrix of the probabilities of conversion from waves of one frequency range to waves of other ranges). We demonstrated that data of the periodometric analysis can be used for objective classification of EEG patterns. In children of different age groups, five types of background EEG activity were classified and described; we also demonstrated that the intragroup frequencies of these EEG types vary in healthy children with age. We discuss the advantages and disadvantages of the periodometric analysis of EEG, as well as the prospects and expediency of use of this analysis in physiological studies and in clinics.     

An avian model of genetic reflex epilepsy

The Fayoumi strain of chickens (Fepi) carries a recessive autosomal gene mutation in which homozygotes are afflicted with a photogenic and audiogenic reflex epilepsy. Seizures consist of stimulus-locked motor symptoms followed by generalized self sustained convulsions. EEG recordings show spikes and spike and waves patterns at rest which are suppressed during seizures and replaced by a desynchronized pattern of activity. Neurones of the prosencephalon discharge in bursts at rest, while neurones of the mesencephalon are bursting during seizures. Living neural chimeras were obtained by replacing specific embryonic brain vesicles in a normal chicken embryo with equivalent vesicles from a Fepi donor. These chimeras show that the epileptic phenotype can be totally or partially transferred from the Fepi to the normal chickens. Total transfer of photogenic and audiogenic seizures was obtained by substitution of both the prosencephalon and mesencephalon, while substitution of the prosencephalon alone resulted in transfer of interictal paroxysmal activity and substitution of the mesencephalon alone resulted principally in transfer of ictal motor symptoms. Increased expression of the c-fos protooncogene, as revealed by the western blot technique, confirmed the distinct encephalic localizations of the symptoms of the photogenic and audiogenic reflex epilepsy of the Fepi shown with the methods of electrophysiology and brain chimeras. We conclude that the Fepi is a good model of brain stem reflex epilepsy and suggest that the brain stem is a generator of some other animal and human genetic reflex "epileptic syndromes".     

Epileptiform K-complexes in Adult Patients with Idiopathic Generalized Epilepsy

Human Physiology - Typical EEG features of idiopathic generalized epilepsy are generalized spikes, polyspikes and spike-and-wave discharges. Occasionally epileptiform discharges (ED) overlap with...     

Synchronized oscillations at alpha and theta frequencies in the lateral geniculate nucleus

In relaxed wakefulness, the EEG exhibits robust rhythms in the alpha band (8-13 Hz), which decelerate to theta (approximately 2-7 Hz) frequencies during early sleep. In animal models, these rhythms occur coherently with synchronized activity in the thalamus. However, the mechanisms of this thalamic activity are unknown. Here we show that, in slices of the lateral geniculate nucleus maintained in vitro, activation of the metabotropic glutamate receptor (mGluR) mGluR1a induces synchronized oscillations at alpha and theta frequencies that share similarities with thalamic alpha and theta rhythms recorded in vivo. These in vitro oscillations are driven by an unusual form of burst firing that is present in a subset of thalamocortical neurons and are synchronized by gap junctions. We propose that mGluR1a-induced oscillations are a potential mechanism whereby the thalamus promotes EEG alpha and theta rhythms in the intact brain.     

Increase of slow periodic modulation of EEG in a patient with Alzheimer's disease.

The recently described slow oscillations of amplitude of theta and alpha waves of the EEG (with a frequency below 0.08 Hz) in healthy subjects are attributed to the autonomic nervous system with control at the brain stem level. In the present pilot study, the slow brain rhythms were analyzed in a patient with Alzheimer's disease and were compared to a healthy subject. Dynamic analysis of the EEG was performed using time-frequency mapping which gives simultaneous time and frequency representation of the brain signal. This method comprises a transform of the filtered EEG signal into its analytic form and application of the Wigner distribution modified by time and frequency smoothing. It has been shown that the envelope of both theta and alpha activities oscillates at 0.04 Hz and 0.07 Hz in the healthy subject and at 0.03 Hz and 0.06 Hz in a patient with Alzheimer's disease. The amplitude of the slow oscillations of theta activity was substantially higher in the patient with Alzheimer's disease as compared with the healthy subject. It is being proposed that the increase of slow brain rhythms in the patient with Alzheimer's disease reflects an abnormal activity of the autonomic nervous system. However, the underlying pathophysiological mechanisms need to be further studied.     

Dynamics on Networks: The Role of Local Dynamics and Global Networks on the Emergence of Hypersynchronous Neural Activity

Graph theory has evolved into a useful tool for studying complex brain networks inferred from a variety of measures of neural activity, including fMRI, DTI, MEG and EEG. In the study of neurological disorders, recent work has discovered differences in the structure of graphs inferred from patient and control cohorts. However, most of these studies pursue a purely observational approach; identifying correlations between properties of graphs and the cohort which they describe, without consideration of the underlying mechanisms. To move beyond this necessitates the development of computational modeling approaches to appropriately interpret network interactions and the alterations in brain dynamics they permit, which in the field of complexity sciences is known as dynamics on networks. In this study we describe the development and application of this framework using modular networks of Kuramoto oscillators. We use this framework to understand functional networks inferred from resting state EEG recordings of a cohort of 35 adults with heterogeneous idiopathic generalized epilepsies and 40 healthy adult controls. Taking emergent synchrony across the global network as a proxy for seizures, our study finds that the critical strength of coupling required to synchronize the global network is significantly decreased for the epilepsy cohort for functional networks inferred from both theta (3–6 Hz) and low-alpha (6–9 Hz) bands. We further identify left frontal regions as a potential driver of seizure activity within these networks. We also explore the ability of our method to identify individuals with epilepsy, observing up to 80 predictive power through use of receiver operating characteristic analysis. Collectively these findings demonstrate that a computer model based analysis of routine clinical EEG provides significant additional information beyond standard clinical interpretation, which should ultimately enable a more appropriate mechanistic stratification of people with epilepsy leading to improved diagnostics and therapeutics.     

Endogenous cortical rhythms determine cerebral specialization for speech perception and production

Across multiple timescales, acoustic regularities of speech match rhythmic properties of both the auditory and motor systems. Syllabic rate corresponds to natural jaw-associated oscillatory rhythms, and phonemic length could reflect endogenous oscillatory auditory cortical properties. Hemispheric lateralization for speech could result from an asymmetry of cortical tuning, with left and right auditory areas differentially sensitive to spectro-temporal features of speech. Using simultaneous electroencephalographic (EEG) and functional magnetic resonance imaging (fMRI) recordings from humans, we show that spontaneous EEG power variations within the gamma range (phonemic rate) correlate best with left auditory cortical synaptic activity, while fluctuations within the theta range correlate best with that in the right. Power fluctuations in both ranges correlate with activity in the mouth premotor region, indicating coupling between temporal properties of speech perception and production. These data show that endogenous cortical rhythms provide temporal and spatial constraints on the neuronal mechanisms underlying speech perception and production.     

Rhythmic background thalamic neuronal activity in patients with extrapyramidal motor disorders

The background activity of 123 thalamic neurons was recorded in 30 patients with motor extrapyramidal disorders applying microelectrode techniques to neurosurgical practice. Recordings were taken from the ventro-oral anterior and posterior thalamic nuclei and the adjacent reticular nucleus. A computer analysis was performed of neuronal activity in 44 units and plots produced of autocorrelation and spectral density functions. In patients with parkinsonism and double athetosis, rhythmic activity was found in 48% of cells. A wide variety of regular fluctuations in background neuronal discharges was noted: in the range of theta and delta rhythms (5–7 and 1–4 Hz respectively) with a periodicity of seconds (2–10 sec) and decaseconds (15–40 sec). It was thought possible that several types of regular waves may coexist: phenomena of 2 or 3 accelerated waves and reduced frequency of spike activity of differing periodicity were observed in eight neurons within the same train of spikes. The origin and significance of rhythmically occurring changes in thalamic neuronal spike activity are discussed.A. A. Bogomolets Institute of Physiology, Academy of Sciences of the Ukrainian SSR; Institute of Neurosurgery, Ministry of Public Health of the Ukrainian SSR. Translated from Neirofiziologiya, Vol. 19, No. 2, pp. 192–201, March–April, 1987.     

多发性抽动症的脑电图观察

目的:进一步探究脑电图对多发性抽动症患儿的辅助诊断价值。方法:本文对45例多发性抽动症患儿进行脑电图描记录,选择理想信号段进行分析。结果发现24例异常,异常率为53.3%。其中中度异常6例,占25%,脑波表现为在高幅δ、θ波长程阵发的背景上偶发尖波;轻度异常18例,占75%,表现背景脑波频率变慢,出现高幅δ、θ波及活动,伴短程出现;正常21例,较同年龄组的脑电图调节差,波形杂乱。结论:脑电图反映脑功能活动,通过计算机分析方法可提供更多信息,并且脑电图操作方便,无痛无创,易于被儿童接受,在多发性抽动症早期临床诊断中具有较高的应用价值。     

Abnormal interictal gamma activity may manifest a seizure onset zone in temporal lobe epilepsy

Even though recent studies have suggested that seizures do not occur suddenly and that before a seizure there is a period with an increased probability of seizure occurrence, neurophysiological mechanisms of interictal and pre-seizure states are unknown. The ability of mathematical methods to provide much more sensitive tools for the detection of subtle changes in the electrical activity of the brain gives promise that electrophysiological markers of enhanced seizure susceptibility can be found even during interictal periods when EEG of epilepsy patients often looks 'normal'. Previously, we demonstrated in animals that hippocampal and neocortical gamma-band rhythms (30-100 Hz) intensify long before seizures caused by systemic infusion of kainic acid. Other studies in recent years have also drawn attention to the fast activity (>30 Hz) as a possible marker of epileptogenic tissue. The current study quantified gamma-band activity during interictal periods and seizures in intracranial EEG (iEEG) in 5 patients implanted with subdural grids/intracranial electrodes during their pre-surgical evaluation. In all our patients, we found distinctive (abnormal) bursts of gamma activity with a 3 to 100 fold increase in power at gamma frequencies with respect to selected by clinicians, quiescent, artifact-free, 7-20 min "normal" background (interictal) iEEG epochs 1 to 14 hours prior to seizures. Increases in gamma activity were largest in those channels which later displayed the most intensive electrographic seizure discharges. Moreover, location of gamma-band bursts correlated (with high specificity, 96.4% and sensitivity, 83.8%) with seizure onset zone (SOZ) determined by clinicians. Spatial localization of interictal gamma rhythms within SOZ suggests that the persistent presence of abnormally intensified gamma rhythms in the EEG may be an important tool for focus localization and possibly a determinant of epileptogenesis.     

Dopaminergic regulation of theta activity of septohippocampal neuron in the awake rabbit

The effects of dopamine reuptake blocker nomifensine and nonselective antagonist of dopamine receptors haloperidol on the theta rhythmicity of the medial septal neurons and hippocampal EEG were investigated in the rabbit. Bilateral intracerebroventricular infusion of nomifensine (9 micrograms in each ventriculus) produced an increase in both the rate of firing and the theta modulation of medial septal neurons; the theta power of the hippocampal EEG also augmented. The degree of neuronal theta stability (time constant of damping, tao theta) significantly increased. The frequency of rhythmic bursts in the neuronal firing also substantially elevated. The amplitude, regularity and frequency of theta waves in the hippocampal EEG also increased. The antagonist haloperidol (12.5 mg) caused the opposite effect. The theta activity of medial septal neurons and the theta power of the hippocampal EEG decreased after haloperidol injection. Theta rhythmicity of septal neurons significantly diminished, the rate of rhythmic bursts in the neuronal firing also decreased, although not substantially. The theta amplitude and regularity in the hippocampal EEG also decreased. Effects of both drugs built up rapidly and then gradually attenuated. Nomifensine infusion against the background of exposure to haloperidol provoked neither increasing neuronal firing rate, nor elevating theta activity. These finding suggest that dopaminergic system produces activation of the septohippocampal system in situations that require selective attention to functionally important information.     

Bilateral frontal theta-waves in EEG of 7–8-year-old children with learning difficulties: Qualitative and quantitative analysis

We analyzed EEG recorded in the rest condition (eye closed) in 22 children aged from 7 to 8 years old who experienced learning difficulties and whose EEG recordings were characterized by sporadic shortterm appearance of bilateral synchronous slow waves over the frontal and/or frontal and central cortices??frontal theta-waves (FTW). The vector autoregressive modeling was used in order to assess the strength of directed cortico-cortical functional connectivity pattern for FTW and for surrounding EEG. The comparison of the two patterns showed that FTW is characterized by diffuse strengthening of the functional links connecting frontal, central and (to some extent) temporal cortices as well as the links directed to the above regions from the other cortical areas. The results of the study suggest that FTW is most probably caused by the common for the frontal and central cortices neuronal theta activity synchronized via cortico-subcortical links. This suggestion is in a good agreement with the view that FTW reflects the alterations in functioning of fronto-thalamic system.     

Bilateral frontal theta-waves in EEG of 7-8-year-old children with learning difficulties: qualitative and quantitative analysis

We analyzed EEG recorded in the rest condition (eye closed) in 22 children aged from 7 to 8 years old who experienced learning difficulties and whose EEG recordings were characterized by sporadic short-term appearance of bilateral synchronous slow waves over the frontal and/or central cortices--frontal theta-waves (FTW). The vector autoregressive modeling was used in order to assess the strength of directed cortico-cortical functional connectivity pattern for FTW and for surrounding EEG. The comparison of the two patterns showed that FTW is characterized by diffuse strengthening of the functional links connecting frontal, central and (to some extent) temporal cortices as well as the links directed to the above regions from the other cortical areas. The results of the study suggest that FTW is most probably caused by the common for the fronto-central cortices neuronal theta activity synchronized via cortico-subcortical links. This suggestion is in a good agreement with the view that FTW reflects the alterations in functioning of fronto-thalamic system.     

Brain injury following cardiorespiratory arrest in cats. Effects of alphaxalone-alphadolone

The effects of alphaxalone-alphadolone acetate (27.07 microM/kg-7.68 microM/kg) on neurologic injury following acute cerebral ischemia induced by an 8 min cardiorespiratory arrest (CRA) were investigated in cats through the analysis of neurological deficit scores and brain electrical activity; i.e., electroencephalogram (EEG) from parieto-occipital cortices and EEG and multiunit activity (MUA) from mesencephalic reticular formation (MRF). The CRA resulted from electrically induced cardiac arrest and stopping of mechanical ventilation in paralyzed cats which were successfully resuscitated within the immediate 4 min after the end of CRA. Two groups of cats were studied: I. Untreated, which received saline iv; II. Treated, which received alphaxalone-alphadolone acetate iv, 7-9 min after the end of CRA. Neuromuscular blockade and mechanical ventilation were maintained until 8 h following the CRA; then the cats were allowed to recover spontaneous respiratory activity. EEG phenomena were different in untreated and treated cats during this immediate post-arrest period. The former showed rhythmic bursts of fast (12-20 Hz) EEG activity at 1-2 sec intervals from 15-20 min until 3-4 h after the CRA, abundant spikes and delta-like waves. By contrast, administration of alphaxalone-alphadolone acetate resulted in burst suppression EEG pattern during 1 h. Progressive recovery of background EEG activity occurred afterwards. MUA from MRF disappeared during the CRA, however 6 h later the mean MUA frequency in untreated cats ranged between 32-46% and in treated cats 18-27% of their control mean frequencies during paradoxical sleep (100%). Daily electrographic records were performed in all the cats during quiet attentive behavior at each of the five days following the CRA. Significant differences were found in the frequency distributions of MUA from MRF (1st day, p less than 0.01; 5th day, p less than 0.01) as well as in the cortical EEG waves (1st day, p less than 0.01; 5th day, p less than 0.05) before and after the CRA in the untreated group. A wide dispersion of MUA values, and increased proportions of delta and theta-like waves and spindle bursts, besides a significantly high (p less than 0.001) number of spikes occurred in these EEG records the days following the CRA. The frequency distributions of MUA and EEG did not significantly differ before and after the CRA in the treated group; however, a significantly high (p less than 0.05) number of spikes was found in treated cats following the CRA.(ABSTRACT TRUNCATED AT 400 WORDS)