Single-sweep cortical somatosensory evoked potentials: N20 and evoked bursts in sevoflurane anaesthesia

Cortical evoked responses to median nerve stimulation were recorded from 21 subjects during sevoflurane anaesthesia at the level of burst suppression in EEG. The N20/P22 wave had the typical form of a negative wave postcentrally, and positive precentrally. The amplitude exceeded 4 μV in all patients, making it easily visible without averaging on the low-amplitude suppression. These results show that two kinds of somatosensory evoked potential can be studied without averaging during EEG suppression in deep anaesthesia. One is the localised N20/P22 wave, which is seen regularly during suppression after stimuli with intervals exceeding 1 s. The other is the burst, involving the whole cortex, which is not evoked by every stimulus. We suggest that somatosensory evoked potentials can be monitored during sevoflurane-induced EEG suppression, and often can be evaluated reliably from a couple of single sweeps with stimulation interval exceeding 1 s. The enhancement of early cortical components of SEP, their adaptation to repeated stimuli, and the disappearance of later polysynaptic components during EEG suppression, give new possibilities to study the generators of SEP and the different effects of anaesthetics.     

NeuMonD: a tool for the development of new indicators of anaesthetic effect.

Electroencephalogram (EEG) signals and auditory evoked potentials (AEPs) have been suggested as a measure of depth of anaesthesia, because they reflect activity of the main target organ of anaesthesia, the brain. The online signal processing module NeuMonD is part of a PC-based development platform for monitoring "depth" of anaesthesia using EEG and AEP data. NeuMonD allows collection of signals from different clinical monitors, and calculation and simultaneous visualisation of several potentially useful parameters indicating "depth" of anaesthesia using different signal processing methods. The main advantage of NeuMonD is the possibility of early evaluation of the performance of parameters or indicators by the anaesthetist in the clinical environment which may accelerate the process of developing new, multiparametric indicators of anaesthetic "depth".     

Suppression of F-VEP during isoflurane-induced EEG suppression

We recorded visual evoked potentials (VEPs) to flash stimuli in moderately deep anaesthesia when EEG showed burst suppression pattern. Flash VEPs could consistently be recorded in all 8 test subjects during bursts but not during suppressions. We conclude that during isoflurane-induced EEG suppression VEPs to flash stimuli are also suppressed. This effect should be taken into account in evoked potential testing during anaesthesia.     

Anaesthesia Monitoring by Recurrence Quantification Analysis of EEG Data

Appropriate monitoring of the depth of anaesthesia is crucial to prevent deleterious effects of insufficient anaesthesia on surgical patients. Since cardiovascular parameters and motor response testing may fail to display awareness during surgery, attempts are made to utilise alterations in brain activity as reliable markers of the anaesthetic state. Here we present a novel, promising approach for anaesthesia monitoring, basing on recurrence quantification analysis (RQA) of EEG recordings. This nonlinear time series analysis technique separates consciousness from unconsciousness during both remifentanil/sevoflurane and remifentanil/propofol anaesthesia with an overall prediction probability of more than 85%, when applied to spontaneous one-channel EEG activity in surgical patients.     

Changes in EEG power, acoustic evoked potentials and heart rate after mildly arousing non-acoustic priming stimuli in carp (Cyprinus carpio).

1. Changes in EEG power spectrum of carp to a priming non-acoustic stimulus followed by acoustic clicks were compared to those due to acoustic clicks delivered alone. Recordings were made from the telencephalon, midbrain and medulla. Acoustic evoked potentials (AEPs) to the clicks were also recorded. 2. EEG power changes to non-acoustic stimuli occurred over the whole 1-40 Hz frequency range and were regionally specific and consistent. 3. The changes in the EEG midfrequency 12-24 Hz power spectrum to non-acoustic stimuli were significantly correlated with changes in the AEP to subsequent clicks. An elevated medullary AEP amplitude and reduced duration were correlated with increased medullary EEG power and increased midbrain AEP duration. 4. Telencephalic EEG power changes were inversely related to changes in medullary and midbrain AEP amplitude.     

Dynamic EEG topography and analysis of epileptic spikes and evoked potentials following thalamic stimulation

Dynamic EEG topography is used to study evoked potentials following thalamic stimulation as well as epileptic spikes and spike-wave complexes during stereotactic operations. Dynamic EEG topography is an effective method for displaying the distribution pattern of evoked potentials following thalamic stimulation. This technique makes it possible to observe successive increases in augmenting responses and to define the localization of epileptic foci.     

Brain’s alpha activity is highly reduced in euthymic bipolar disorder patients

Brain’s alpha activity and alpha responses belong to major electrical signals that are related to sensory/cognitive signal processing. The present study aims to analyze the spontaneous alpha activity and visual evoked alpha response in drug free euthymic bipolar patients. Eighteen DSM-IV euthymic bipolar patients (bipolar I n = 15, bipolar II n = 3) and 18 healthy controls were enrolled in the study. Patients needed to be euthymic at least for 4 weeks and psychotrop free for at least 2 weeks. Spontaneous EEG (4 min eyes closed, 4 min eyes open) and evoked alpha response upon application of simple visual stimuli were analyzed. EEG was recorded at 30 positions. The digital FFT-based power spectrum analysis was performed for spontaneous eyes closed and eyes open conditions and the response power spectrum was also analyzed for simple visual stimuli. In the analysis of spontaneous EEG, the ANOVA on alpha responses revealed significant results for groups (F(1,34) = 8.703; P < 0.007). Post-hoc comparisons showed that spontaneous EEG alpha power of healthy subjects was significantly higher than the spontaneous EEG alpha power of euthymic patients. Furthermore, visual evoked alpha power of healthy subjects was significantly higher than visual evoked alpha power of euthymic patients (F(1,34) = 4.981; P < 0.04). Decreased alpha activity in spontaneous EEG is an important pathological EEG finding in euthymic bipolar patients. Together with an evident decrease in evoked alpha responses, the findings may lead to a new pathway in search of biological correlates of cognitive impairment in bipolar disorder.     

Side Effects of Long-Acting Local Anaesthetics in Patients with Preexisting Cardiovascular Condition

The oral surgical anaesthesia is field in which usually long-acting local anaesthetics are being used. Some of the currently used acting local anaesthetics as Levobupivacaine or Ropivacaine have reduced cardiac toxicity. The aim of this review is to provide an overview of acting mechanisms when anaesthetic agents are applied in oral surgery and the effect that they may have in patients with chronic concurrent cardiac conditions. There are notable linking the property of the local anaesthetics lipid solubility and the potency of local anaesthetic-induced vasoconstriction which can additionally compromise cardiac function in patients with previously impaired cardiac function.     

Neurophysiological indices of CNS plasticity in the course of treatment of head trauma in adolescents

Using the methods of quantitative EEG analysis and cognitive evoked potentials, we investigated delayed consequences of head trauma (HT) after nootropic therapy with cerebrolysin. The study was performed in 30 12-to 19-year-old adolescents who had had severe HT with brain contusion one to five years prior to the study and manifested asthenic symptoms. During the study, they underwent treatment with 30 daily intramuscular injections of cerebrolysin at a dose of 0.1 ml/kg body weight. A positive effect on the functional state of the brain was found in 77% of patients. It was expressed as the appearance of the occipital α rhythm in the EEGs, an increase in the EEG spectral power, normalization of frequency parameters of the α rhythm, a decrease in the power spectrum of the low-frequency θ and δ EEG activity, and shortening of the P300 peak latency. These changes were associated with an improvement of the general clinical state and the psychometric indices of attention and memory in the patients.     

Towards a Unified Understanding of Event-Related Changes in the EEG: The Firefly Model of Synchronization through Cross-Frequency Phase Modulation

Although event-related potentials (ERPs) are widely used to study sensory, perceptual and cognitive processes, it remains unknown whether they are phase-locked signals superimposed upon the ongoing electroencephalogram (EEG) or result from phase-alignment of the EEG. Previous attempts to discriminate between these hypotheses have been unsuccessful but here a new test is presented based on the prediction that ERPs generated by phase-alignment will be associated with event-related changes in frequency whereas evoked-ERPs will not. Using empirical mode decomposition (EMD), which allows measurement of narrow-band changes in the EEG without predefining frequency bands, evidence was found for transient frequency slowing in recognition memory ERPs but not in simulated data derived from the evoked model. Furthermore, the timing of phase-alignment was frequency dependent with the earliest alignment occurring at high frequencies. Based on these findings, the Firefly model was developed, which proposes that both evoked and induced power changes derive from frequency-dependent phase-alignment of the ongoing EEG. Simulated data derived from the Firefly model provided a close match with empirical data and the model was able to account for i) the shape and timing of ERPs at different scalp sites, ii) the event-related desynchronization in alpha and synchronization in theta, and iii) changes in the power density spectrum from the pre-stimulus baseline to the post-stimulus period. The Firefly Model, therefore, provides not only a unifying account of event-related changes in the EEG but also a possible mechanism for cross-frequency information processing.     

Single-trial detection for intraoperative somatosensory evoked potentials monitoring

Abnormalities of somatosensory evoked potentials (SEPs) provide effective evidence for impairment of the somatosensory system, so that SEPs have been widely used in both clinical diagnosis and intraoperative neurophysiological monitoring. However, due to their low signal-to-noise ratio (SNR), SEPs are generally measured using ensemble averaging across hundreds of trials, thus unavoidably producing a tardiness of SEPs to the potential damages caused by surgical maneuvers and a loss of dynamical information of cortical processing related to somatosensory inputs. Here, we aimed to enhance the SNR of single-trial SEPs using Kalman filtering and time–frequency multiple linear regression (TF-MLR) and measure their single-trial parameters, both in the time domain and in the time–frequency domain. We first showed that, Kalman filtering and TF-MLR can effectively capture the single-trial SEP responses and provide accurate estimates of single-trial SEP parameters in the time domain and time–frequency domain, respectively. Furthermore, we identified significant correlations between the stimulus intensity and a set of indicative single-trial SEP parameters, including the correlation coefficient (between each single-trial SEPs and their average), P37 amplitude, N45 amplitude, P37-N45 amplitude, and phase value (at the zero-crossing points between P37 and N45). Finally, based on each indicative single-trial SEP parameter, we investigated the minimum number of trials required on a single-trial basis to suggest the existence of SEP responses, thus providing important information for fast SEP extraction in intraoperative monitoring.     

Driving activity. A quantitative study.

A comparative study of driving activity between normal subjects and neurological patients was performed. Driving activity was considered as the energy of the visual evoked potentials filtered at the same frequency of stimulation (1, 2, 4, 7, 10, 12 and 15 cps) using a CAT 400 C computer as a digital filter. The hemispheric symmetry of the responses was measured by the Pearson product moment correlation coefficient and the signal energy ratio. Each symmetry measure for every patient was compared with the normal values and considered abnormal when differences were greater than 3 SD from the normal mean. Of 25 patients 14 of them with a normal EEG, 23 presented severe alterations in the symmetry of the filtered visual evoked responses. Each patient showed a peculiar pattern of abnormality. It is concluded that the procedure described is a very powerful method in the discrimination of brain lesions.     

A computer system for neurosurgical patient monitoring.

The variables monitored in intensive care units are generally late indicators of neurologic deterioration. A system based on a LINC-8 computer was therefore developed for on-line monitoring of evoked potentials, electroencephalography (EEG), and transcranial and transthoracic impedances as well as conventional parameters. Somatosensory evoked potentials are recorded at either 30 min or 1 h intervals. One minute epochs of EEG are analyzed every 10 min using a peak-detection algorithm. Impedances and conventional parameters are also monitored at 10 min intervals. In a study of 50 patients, the technical feasibility of this type of monitoring with a small laboratory computer has been demonstrated. In some instances, evoked potentials and EEG show changes prior to detectable neurologic changes. The study suggests that this type of monitoring can provide a valuable adjunct for evaluation of physiologic function in neurosurgical intensive care.     

The Influence of Wavelets on Multiscale Analysis and Parametrization of Midlatency Auditory Evoked Potentials

This work shows methodological aspects of heuristic pattern recognition in auditory evoked potentials. A linear and a nonlinear transformation based on wavelet transform are presented. They result in a statistical error model and an entropy function related to the Gibbs function and describe changes in midlatency auditory evoked potentials induced by general anaesthesia. The same transformations were calculated using 12 common wavelets. We present a method to compare the two defined parametrizations with respect to their ability to discriminate two defined states which is responsive and unresponsive depending on the wavelet used for the analysis. Auditory evoked potentials of 60 patients undergoing general anaesthesia were analysed. We propose the defined statistical error model and the entropy function as a very robust measure of changes in auditory evoked potentials. The influence of the wavelets suggest that for each parametrization the goodness of the wavelet should be validated.     

Method for predicting an EEG waveform as an aid to the accurate recording of evoked potentials

Evoked potentials are the brain's responses to incoming stimuli and are usually recorded under noisy circumstances. To improve the signal-to-noise ratio, signal averaging has been widely applied to the recorded data, but an improved method is required. A method of EEG waveform prediction for the accurate recording of evoked potentials is proposed, and an electroencephalographic waveform predicted by using an EEG model and a nonlinear exponentially weighted least squares method, subtracting the predicted EEG waveform from the raw data and extracting the evoked waveform. By the use of this method, we have successfully predicted the EEG waveform and detected the evoked potential with only a small number of averages.     

视力与视觉诱发电位的相关分析

对104例病人的图形翻转VEP的瞬态波形各参数,以及9例正常或近视学生的稳态曲线功率谱与视力之间的关系进行了多元相关统计分析,旨在探讨VEP的哪些参数可客观地评估视力.结果表明,瞬态VEP的波形参数中以13’格诱发的N_1P_1、P_1N_2的峰峰值及P_(100)潜伏期与视力的相关系数最大,故认为,分析视力时以平均P_(100)波的波幅值和P_(100)波潜伏期作指标较为灵敏;而稳态、VEP能谱曲线则显示,视力与平均相叶能谱或刺激频率点的能谱相关性较大,与二次谐波的相关性则小.     

Single evoked potential reconstruction by means of wavelet transform

We would like to propose a method of single evoked potential (EP) extraction free from assumptions and based on a novel approach — the wavelet representation of the signal. Wavelets were introduced by Grossman and Morlet in 1984. The method is based on the multiresolution signal decomposition. Wavelets are already used for speech recognition, geophysics investigations and fractal analysis. This method seems to be a useful improvement upon Fourier Transform analysis, since it provides simultaneous information on frequency and time localization of the signal. We would like to introduce wavelet formalism for the first time to brain signal analysis. One of the most important problems in this field is the analysis of evoked potentials. This signal has an amplitude several times smaller than EEG, therefore stimulus-synchronized averaging is commonly used. This method is based on several assumptions. Namely it is postulated that: 1) EP are characterized by a deterministic repeatable pattern, 2) EEG has purely stochastic character, 3) EEG and EP are independent. These assumptions have been challenged e.g. the variability of the EP pattern was demonstrated by John (1973) by means of factor analysis. In view of the works of Sayers et al. (1974) and Baar (1988) EP reflects the reorganization of the spontaneous activity under the influence of a stimulus and it is connected with the redistribution of EEG phases. Several attempts to overcome the limitation of the averaging method have been made. Heintze and Künkel (1984) used an autoregressive moving average (ARMA) model to extract evoked potentials from 2 segments. This was possible under two condiitons: high signal to noise ratio and clear separation of the EEG and EP spectra. These assumptions are not easy to fulfill, though. Cerutti et al. (1987) modeled background EEG activity by means of an AR process and event related brain activity by ARMA. In this way they were able to find a filter extracting single EP. Nevertheless, their method was not quite free of assumptions, since they since they used averaged EP to define their ARMA filter. In the following we shall briefly describe the method of the multiresolution decomposition and we will apply it to the analysis and reconstruction of single evoked potentials.     

Analysis of visual evoked potentials through Wiener filtering applied to a small number of sweeps

We introduce a method for processing visual evoked potentials, on the basis of a Wiener filter algorithm applied to a small number of consecutive responses. The transfer function of the filter is obtained by taking into account both the average of 99 sweeps (as an estimate of the true signal) and the EEG signal just before the stimulus onset (as an estimate of the noise superimposed on each individual response). The process acts as a sweep-by-sweep filter (in the sense of the mean square error) which considers the possible non-stationarities of the EEG signal during a complete clinical procedure. The average of a small number of consecutive filtered sweeps reveals variations in the morphology of the evoked responses which produce a change in the principal latencies. Applications are foreseen in neurophysiological studies of visual evoked potential responses, and in the clinic, where it is important to evaluate adaptive mechanisms, dynamic changes in single groups of visual evoked potentials and cognitive responses.     

The graph theoretical analysis of the SSVEP harmonic response networks

Steady-state visually evoked potentials (SSVEP) have been widely used in the neural engineering and cognitive neuroscience researches. Previous studies have indicated that the SSVEP fundamental frequency responses are correlated with the topological properties of the functional networks entrained by the periodic stimuli. Given the different spatial and functional roles of the fundamental frequency and harmonic responses, in this study we further investigated the relation between the harmonic responses and the corresponding functional networks, using the graph theoretical analysis. We found that the second harmonic responses were positively correlated to the mean functional connectivity, clustering coefficient, and global and local efficiencies, while negatively correlated with the characteristic path lengths of the corresponding networks. In addition, similar pattern occurred with the lowest stimulus frequency (6.25 Hz) at the third harmonic responses. These findings demonstrate that more efficient brain networks are related to larger SSVEP responses. Furthermore, we showed that the main connection pattern of the SSVEP harmonic response networks originates from the interactions between the frontal and parietal–occipital regions. Overall, this study may bring new insights into the understanding of the brain mechanisms underlying SSVEP.     

Infant Auditory Processing and Event-related Brain Oscillations

Rapid auditory processing and acoustic change detection abilities play a critical role in allowing human infants to efficiently process the fine spectral and temporal changes that are characteristic of human language. These abilities lay the foundation for effective language acquisition; allowing infants to hone in on the sounds of their native language. Invasive procedures in animals and scalp-recorded potentials from human adults suggest that simultaneous, rhythmic activity (oscillations) between and within brain regions are fundamental to sensory development; determining the resolution with which incoming stimuli are parsed. At this time, little is known about oscillatory dynamics in human infant development. However, animal neurophysiology and adult EEG data provide the basis for a strong hypothesis that rapid auditory processing in infants is mediated by oscillatory synchrony in discrete frequency bands. In order to investigate this, 128-channel, high-density EEG responses of 4-month old infants to frequency change in tone pairs, presented in two rate conditions (Rapid: 70 msec ISI and Control: 300 msec ISI) were examined. To determine the frequency band and magnitude of activity, auditory evoked response averages were first co-registered with age-appropriate brain templates. Next, the principal components of the response were identified and localized using a two-dipole model of brain activity. Single-trial analysis of oscillatory power showed a robust index of frequency change processing in bursts of Theta band (3 - 8 Hz) activity in both right and left auditory cortices, with left activation more prominent in the Rapid condition. These methods have produced data that are not only some of the first reported evoked oscillations analyses in infants, but are also, importantly, the product of a well-established method of recording and analyzing clean, meticulously collected, infant EEG and ERPs. In this article, we describe our method for infant EEG net application, recording, dynamic brain response analysis, and representative results.