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Shi J, Gong X, Song Z, Xie W, Yang Y, Sun X, Wei P, Wang C, Zhao G. EPAT: a user-friendly MATLAB toolbox for EEG/ERP data processing and analysis. Front Neuroinform 2024; 18:1384250. [PMID: 38812743 PMCID: PMC11133744 DOI: 10.3389/fninf.2024.1384250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/18/2024] [Indexed: 05/31/2024] Open
Abstract
Background At the intersection of neural monitoring and decoding, event-related potential (ERP) based on electroencephalography (EEG) has opened a window into intrinsic brain function. The stability of ERP makes it frequently employed in the field of neuroscience. However, project-specific custom code, tracking of user-defined parameters, and the large diversity of commercial tools have limited clinical application. Methods We introduce an open-source, user-friendly, and reproducible MATLAB toolbox named EPAT that includes a variety of algorithms for EEG data preprocessing. It provides EEGLAB-based template pipelines for advanced multi-processing of EEG, magnetoencephalography, and polysomnogram data. Participants evaluated EEGLAB and EPAT across 14 indicators, with satisfaction ratings analyzed using the Wilcoxon signed-rank test or paired t-test based on distribution normality. Results EPAT eases EEG signal browsing and preprocessing, EEG power spectrum analysis, independent component analysis, time-frequency analysis, ERP waveform drawing, and topological analysis of scalp voltage. A user-friendly graphical user interface allows clinicians and researchers with no programming background to use EPAT. Conclusion This article describes the architecture, functionalities, and workflow of the toolbox. The release of EPAT will help advance EEG methodology and its application to clinical translational studies.
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Affiliation(s)
- Jianwei Shi
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute, Beijing, China
| | - Xun Gong
- School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, China
| | - Ziang Song
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute, Beijing, China
| | - Wenkai Xie
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute, Beijing, China
| | - Yanfeng Yang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute, Beijing, China
| | - Xiangjie Sun
- School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, China
| | - Penghu Wei
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute, Beijing, China
| | - Changming Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute, Beijing, China
| | - Guoguang Zhao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute, Beijing, China
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Zhang J, Wang G, Li Z, Pang G. Advanced perioperative assessment of neurological function in acute Stanford A aortic dissection. Int J Neurosci 2024:1-11. [PMID: 38682651 DOI: 10.1080/00207454.2024.2346152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 04/17/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE Acute Stanford Type A aortic dissection (AAAD) is a critical condition in vascular surgery, and total aortic arch replacement surgery is the preferred method to save patients' lives. In recent years, as clinical research has advanced, there has been a growing realization of the close association between poor postoperative outcomes in patients and neurological functional deficits. Neurological function monitoring is a medical technique used to evaluate and monitor the functional status of the nervous system. METHODS This monitoring involves the assessment of various aspects of the nervous system, including but not limited to nerve conduction velocity, neuromuscular function, electroencephalographic activity, and sensory nerve transmission. Neurological function monitoring has broad clinical applications and can be used to diagnose and monitor many neurological disorders, helping physicians understand patients' neurological functional status and guide treatment plans. During the postoperative recovery process, neurological function monitoring can assist physicians in assessing the potential impact of surgery on the nervous system and monitor the recovery of patients' neurological function. RESULTS Studies have shown that neurological function monitoring holds promise in predicting neurological functional prognosis and interventions for patients with aortic dissection. CONCLUSION Therefore, the primary objective of this study is to evaluate the effectiveness and reliability of various intraoperative neurological monitoring techniques, neuroimaging examinations, and biomarkers in predicting and assessing postoperative neurological outcomes in patients undergoing AAAD surgery.
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Affiliation(s)
- Jinpeng Zhang
- Department of Cardiothoracic Surgery, Jincheng People's Hospital, Jincheng Hospital Affiliated to Changzhi Medical College, Jincheng, China
| | - Guangjun Wang
- Department of Cardiothoracic Surgery, Jincheng People's Hospital, Jincheng Hospital Affiliated to Changzhi Medical College, Jincheng, China
| | - Zhongping Li
- Department of Critical Care Medicine, Jincheng People's Hospital, Jincheng Hospital Affiliated to Changzhi Medical College, Jincheng, China
| | - Guofen Pang
- Department of Critical Care Medicine, Jincheng People's Hospital, Jincheng Hospital Affiliated to Changzhi Medical College, Jincheng, China
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Chiem E, Zhao K, Stark G, Ghiani CA, Colwell CS, Paul KN. Sex differences in sleep architecture in a mouse model of Huntington's disease. J Neurosci Res 2024; 102:e25290. [PMID: 38284849 DOI: 10.1002/jnr.25290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 01/30/2024]
Abstract
Sleep and circadian rhythm disturbances are common features of Huntington's disease (HD). HD is an autosomal dominant neurodegenerative disorder that affects men and women in equal numbers, but some epidemiological studies as well as preclinical work indicate there may be sex differences in disease presentation and progression. Since sex differences in HD could provide important insights to understand cellular and molecular mechanism(s), we used the bacterial artificial chromosome transgenic mouse model of HD (BACHD) to examine whether sex differences in sleep/wake cycles are detectable in an animal model of the disease. Electroencephalography/electromyography (EEG/EMG) was used to measure sleep/wake states and polysomnographic patterns in young adult (12-week-old) male and female wild-type and BACHD mice. Our findings show that male, but not female, BACHD mice exhibited increased variation in phases of the rhythms as compared to age- and sex-matched wild-types. For both rapid-eye movement (REM) and non-rapid eye movement (NREM) sleep, genotypic and sex differences were detected. In particular, the BACHD males spent less time in NREM sleep and exhibited a more fragmented sleep than the other groups. Finally, in response to 6 h of sleep deprivation, both genotypes and sexes displayed the predicted homeostatic responses to sleep loss. These findings suggest that females are relatively protected early in disease progression in this HD model.
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Affiliation(s)
- Emily Chiem
- Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, California, USA
- Molecular, Cellular, Integrative Physiology Program, University of California Los Angeles, Los Angeles, California, USA
| | - Kevin Zhao
- Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, California, USA
| | - Gemma Stark
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
| | - Cristina A Ghiani
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Christopher S Colwell
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
| | - Ketema N Paul
- Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, California, USA
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
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4
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Huang XF, Xu MX, Chen YF, Lin YQ, Lin YX, Wang F. Serum neuronal pentraxin 2 is related to cognitive dysfunction and electroencephalogram slow wave/fast wave frequency ratio in epilepsy. World J Psychiatry 2023; 13:714-723. [PMID: 38058685 PMCID: PMC10696288 DOI: 10.5498/wjp.v13.i10.714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/08/2023] [Accepted: 09/22/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Cognitive dysfunction in epileptic patients is a high-incidence complication. Its mechanism is related to nervous system damage during seizures, but there is no effective diagnostic biomarker. Neuronal pentraxin 2 (NPTX2) is thought to play a vital role in neurotransmission and the maintenance of synaptic plasticity. This study explored how serum NPTX2 and electroencephalogram (EEG) slow wave/fast wave frequency ratio relate to cognitive dysfunction in patients with epilepsy. AIM To determine if serum NPTX2 could serve as a potential biomarker for diagnosing cognitive impairment in epilepsy patients. METHODS The participants of this study, conducted from January 2020 to December 2021, comprised 74 epilepsy patients with normal cognitive function (normal group), 37 epilepsy patients with cognitive dysfunction [epilepsy patients with cognitive dysfunction (ECD) group] and 30 healthy people (control group). The mini-mental state examination (MMSE) scale was used to evaluate cognitive function. We determined serum NPTX2 levels using an enzyme-linked immunosorbent kit and calculated the signal value of EEG regions according to the EEG recording. Pearson correlation coefficient was used to analyze the correlation between serum NPTX2 and the MMSE score. RESULTS The serum NPTX2 level in the control group, normal group and ECD group were 240.00 ± 35.06 pg/mL, 235.80 ± 38.01 pg/mL and 193.80 ± 42.72 pg/mL, respectively. The MMSE score was lowest in the ECD group among the three, while no significant difference was observed between the control and normal groups. In epilepsy patients with cognitive dysfunction, NPTX2 level had a positive correlation with the MMSE score (r = 0.367, P = 0.0253) and a negative correlation with epilepsy duration (r = -0.443, P = 0.0061) and the EEG slow wave/fast wave frequency ratio value in the temporal region (r = -0.339, P = 0.039). CONCLUSION Serum NPTX2 was found to be related to cognitive dysfunction and the EEG slow wave/fast wave frequency ratio in patients with epilepsy. It is thus a potential biomarker for the diagnosis of cognitive impairment in patients with epilepsy.
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Affiliation(s)
- Xiao-Fen Huang
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Ming-Xia Xu
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Yue-Fan Chen
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Yun-Qing Lin
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Yuan-Xiang Lin
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
| | - Feng Wang
- Department of Neurosurgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, Fujian Province, China
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Sun X, Zhao J, Guo C, Zhu X. Early Prediction of Epilepsy after Encephalitis in Childhood Based on EEG and Clinical Features. Emerg Med Int 2023; 2023:8862598. [PMID: 37485251 PMCID: PMC10359137 DOI: 10.1155/2023/8862598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 07/25/2023] Open
Abstract
Objective The present study was designed to establish and evaluate an early prediction model of epilepsy after encephalitis in childhood based on electroencephalogram (ECG) and clinical features. Methods 255 patients with encephalitis were randomly divided into training and verification sets and were divided into postencephalitic epilepsy (PE) and no postencephalitic epilepsy (no-PE) according to whether epilepsy occurred one year after discharge. Univariate and multivariate logistic regression analyses were used to screen the risk factors for PE. The identified risk factors were used to establish and verify a model. Results This study included 255 patients with encephalitis, including 209 in the non-PE group and 46 in the PE group. Univariate and multiple logistic regression analysis showed that hemoglobin (OR = 0.968, 95% CI = 0.951-0.958), epilepsy frequency (OR = 0.968, 95% CI = 0.951-0.958), and ECG slow wave/fast wave frequency (S/F) in the occipital region were independent influencing factors for PE (P < 0.05).The prediction model is based on the above factors: -0.031 × hemoglobin -2.113 × epilepsy frequency + 7.836 × occipital region S/F + 1.595. In the training set and the validation set, the area under the ROC curve (AUC) of the model for the diagnosis of PE was 0.835 and 0.712, respectively. Conclusion The peripheral blood hemoglobin, the number of epileptic seizures in the acute stage of encephalitis, and EEG slow wave/fast wave frequencies can be used as predictors of epilepsy after encephalitis.
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Affiliation(s)
- Xiaojuan Sun
- Department of Pediatrics, The Second Affiliated Hospital of Nantong University, Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Jinhua Zhao
- Department of Pediatrics, The Second Affiliated Hospital of Nantong University, Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Chunyun Guo
- Department of Pediatrics, The Second Affiliated Hospital of Nantong University, Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Xiaoxiao Zhu
- Department of Pediatrics, The Second Affiliated Hospital of Nantong University, Nantong First People's Hospital, Nantong, Jiangsu, China
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Meng H, Wei JH, Yu PZ, Ren JX, Tang MY, Sun JY, Yan XY, Su J. Insights into Advanced Neurological Dysfunction Mechanisms Following DBS Surgery in Parkinson's Patients: Neuroinflammation and Pyroptosis. Curr Issues Mol Biol 2023; 45:4480-4494. [PMID: 37232753 DOI: 10.3390/cimb45050284] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/17/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023] Open
Abstract
Parkinson's disease is a severe neurodegenerative disorder. Currently, deep brain electrical stimulation (DBS) is the first line of surgical treatment. However, serious neurological impairments such as speech disorders, disturbances of consciousness, and depression after surgery limit the efficacy of treatment. In this review, we summarize the recent experimental and clinical studies that have explored the possible causes of neurological deficits after DBS. Furthermore, we tried to identify clues from oxidative stress and pathological changes in patients that could lead to the activation of microglia and astrocytes in DBS surgical injury. Notably, reliable evidence supports the idea that neuroinflammation is caused by microglia and astrocytes, which may contribute to caspase-1 pathway-mediated neuronal pyroptosis. Finally, existing drugs and treatments may partially ameliorate the loss of neurological function in patients following DBS surgery by exerting neuroprotective effects.
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Affiliation(s)
- Hao Meng
- Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, 126 Xinmin Street, Changchun 130021, China
| | - Jia-Hang Wei
- Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, 126 Xinmin Street, Changchun 130021, China
| | - Peng-Zheng Yu
- Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, 126 Xinmin Street, Changchun 130021, China
| | - Jia-Xin Ren
- Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, 126 Xinmin Street, Changchun 130021, China
| | - Meng-Yao Tang
- Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, 126 Xinmin Street, Changchun 130021, China
| | - Jun-Yi Sun
- Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, 126 Xinmin Street, Changchun 130021, China
| | - Xiao-Yu Yan
- Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, 126 Xinmin Street, Changchun 130021, China
| | - Jing Su
- Department of Pathophysiology, College of Basic Medical Sciences, Jilin University, 126 Xinmin Street, Changchun 130021, China
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7
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Chiem E, Zhao K, Stark G, Ghiani CA, Colwell CS, Paul KN. Sex Differences in Sleep Phenotypes in the BACHD Mouse Model of Huntington's Disease. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.28.538324. [PMID: 37162913 PMCID: PMC10168394 DOI: 10.1101/2023.04.28.538324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Sleep and circadian rhythm disturbances are common features of Huntington's disease (HD). HD is an autosomal dominant neurodegenerative disorder that affects men and women in equal numbers, but some epidemiological studies as well as preclinical work indicate there may be sex differences in disease progression. Since sex differences in HD could provide important insights to understand cellular and molecular mechanism(s), we used the bacterial artificial chromosome transgenic mouse model of HD (BACHD) to examine whether sex differences in sleep/wake cycles are detectable in an animal model of the disease. Electroencephalography/electromyography (EEG/EMG) was used to measure sleep/wake states and polysomnographic patterns in young adult (12 week-old) male and female wild-type and BACHD mice. Our findings show that male, but not female, BACHD mice exhibited increased variation in phases of the rhythms as compared to age and sex matched wild-types. For both Rapid-eye movement (REM) and Non-rapid eye movement (NREM) sleep, genotypic and sex differences were detected. In particular, the BACHD males spent less time in NREM and exhibited a more fragmented sleep than the other groups. Both male and female BACHD mice exhibited significant changes in delta but not in gamma power compared to wild-type mice. Finally, in response to a 6-hrs sleep deprivation, both genotypes and sexes displayed predicted homeostatic responses to sleep loss. These findings suggest that females are relatively protected early in disease progression in this HD model.
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Affiliation(s)
- Emily Chiem
- Department of Integrative Biology and Physiology, University of California Los Angeles
- Molecular, Cellular, Integrative Physiology program, University of California Los Angeles
| | - Kevin Zhao
- Department of Integrative Biology and Physiology, University of California Los Angeles
| | - Gemma Stark
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles
| | - Cristina A. Ghiani
- Department of Pathology and Laboratory Medicine, University of California Los Angeles
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles
| | | | - Ketema N. Paul
- Department of Integrative Biology and Physiology, University of California Los Angeles
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles
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Shivaraja TR, Remli R, Kamal N, Wan Zaidi WA, Chellappan K. Assessment of a 16-Channel Ambulatory Dry Electrode EEG for Remote Monitoring. SENSORS (BASEL, SWITZERLAND) 2023; 23:3654. [PMID: 37050713 PMCID: PMC10098757 DOI: 10.3390/s23073654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
Ambulatory EEGs began emerging in the healthcare industry over the years, setting a new norm for long-term monitoring services. The present devices in the market are neither meant for remote monitoring due to their technical complexity nor for meeting clinical setting needs in epilepsy patient monitoring. In this paper, we propose an ambulatory EEG device, OptiEEG, that has low setup complexity, for the remote EEG monitoring of epilepsy patients. OptiEEG's signal quality was compared with a gold standard clinical device, Natus. The experiment between OptiEEG and Natus included three different tests: eye open/close (EOC); hyperventilation (HV); and photic stimulation (PS). Statistical and wavelet analysis of retrieved data were presented when evaluating the performance of OptiEEG. The SNR and PSNR of OptiEEG were slightly lower than Natus, but within an acceptable bound. The standard deviations of MSE for both devices were almost in a similar range for the three tests. The frequency band energy analysis is consistent between the two devices. A rhythmic slowdown of theta and delta was observed in HV, whereas photic driving was observed during PS in both devices. The results validated the performance of OptiEEG as an acceptable EEG device for remote monitoring away from clinical environments.
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Affiliation(s)
- Theeban Raj Shivaraja
- Department of Electrical, Electronics and System Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Rabani Remli
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
- Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
| | - Noorfazila Kamal
- Department of Electrical, Electronics and System Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Wan Asyraf Wan Zaidi
- Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
- Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
| | - Kalaivani Chellappan
- Department of Electrical, Electronics and System Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
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Normative Structure of Resting-State EEG in Bipolar Derivations for Daily Clinical Practice: A Pilot Study. Brain Sci 2023; 13:brainsci13020167. [PMID: 36831710 PMCID: PMC9953767 DOI: 10.3390/brainsci13020167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
We used numerical methods to define the normative structure of resting-state EEG (rsEEG) in a pilot study of 37 healthy subjects (10-74 years old), using a double-banana bipolar montage. Artifact-free 120-200 s epoch lengths were visually identified and divided into 1 s windows with a 10% overlap. Differential channels were grouped by frontal, parieto-occipital, and temporal lobes. For every channel, the power spectrum was calculated and used to compute the area for delta (0-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), and beta (13-30 Hz) bands and was log-transformed. Furthermore, Shannon's spectral entropy (SSE) and coherence by bands were computed. Finally, we also calculated the main frequency and amplitude of the posterior dominant rhythm. According to the age-dependent distribution of the bands, we divided the patients in the following three groups: younger than 20; between 21 and 50; and older than 51 years old. The distribution of bands and coherence was different for the three groups depending on the brain lobes. We described the normative equations for the three age groups and for every brain lobe. We showed the feasibility of a normative structure of rsEEG picked up with a double-banana montage.
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Evaluation of the Patient With Paroxysmal Spells Mimicking Epileptic Seizures. Neurologist 2022:00127893-990000000-00040. [PMID: 36223312 DOI: 10.1097/nrl.0000000000000469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The diagnostic issue of paroxysmal spells, including epileptic seizure (ES) mimics, is one that neurologists frequently encounter. This review provides an up-to-date overview of the most common causes of ES mimics encountered in the outpatient setting. REVIEW SUMMARY Paroxysmal spells are characterized by changes in awareness, attention, perception, or abnormal movements. These can be broadly classified as ES and nonepileptic spells (NES). NES mimics ES but are distinguished by their symptomatology and lack of epileptiform activity on electroencephalography. NES may have psychological or physiological underpinnings. Psychogenic non-ES are the most common mimics of ES. Physiological causes of NES include syncope, cerebrovascular, movement, and sleep-related disorders. CONCLUSIONS Distinguishing NES from ES at times may be challenging even to the most experienced clinicians. However, detailed history with an emphasis on the clinical clues, including taking a moment-by-moment history of the event from the patient and observers and physical examination, helps create an appropriate differential diagnosis to guide further diagnostic testing. An accurate diagnosis of NES prevents iatrogenic harm, including unnecessary exposure to antiseizure medications and overuse of health care resources. It also allows for the correct specialist referral and appropriate treatment.
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11
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Remifentanil pharmacodynamics during conscious sedation using algometry: a more clinically relevant pharmacodynamical model. Br J Anaesth 2022; 129:868-878. [DOI: 10.1016/j.bja.2022.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 07/16/2022] [Accepted: 08/10/2022] [Indexed: 11/18/2022] Open
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12
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Li J, Zhu X, Pan S, Lu Y, Hu X. Utilization of quantitative electroencephalogram in China: an online questionnaire survey. ACTA EPILEPTOLOGICA 2022. [DOI: 10.1186/s42494-022-00099-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Quantitative electroencephalogram (QEEG) is a tool that uses a computer to analyze brain activity monitored by electroencephalogram (EEG) according to measurements such as frequency, amplitude, and slope. The purpose of this study was to understand the current situation of QEEG utilization in China and further compare the situations among different regions and different levels of hospitals.
Methods
An online questionnaire comprising 14 questions was designed. Statistical description and analysis were made for the results of the questionnaire survey.
Results
A total of 158 people from 134 medical institutions participated in the survey. The participants came from 21 provinces, accounting for 61.76% (21/34) of the 34 provincial administrative regions in China. The Eastern China region accounted for 66.42% (89/134) of all the medical institutions that participated in this survey. Among the institutions surveyed, QEEG was routinely used in only 23.88% (32/134) of them. Among the medical institutions in which QEEG was routinely used, 87.50% (28/32) of them were 3A-grade hospitals. Among the institutions with routine use of QEEG, 56.25% (18/32) were affiliated hospitals of medical schools. There was a significant difference in the utilization of QEEG between the 3A-grade and non-3A-grade hospitals (P = 0.040) and between the hospitals affiliated to medical schools and those non-affiliated to medical schools (P = 0.020).
Conclusions
The utilization of QEEG is still limited in China. There are differences in the use of QEEG among different hospitals and regions.
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Seibert KM, Lee W, Eid A, Espinal AE, Klein SA, Abumurad SK, Tao JX, Issa NP. EEG background frequency is associated with discharge outcomes in non-ICU hospitalized patients with COVID-19. Front Neurol 2022; 13:941903. [PMID: 36147043 PMCID: PMC9487016 DOI: 10.3389/fneur.2022.941903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To assess risk factors for encephalopathy in non-ICU hospitalized patients with COVID-19 and the effect of encephalopathy on short-term outcomes. Methods We collected clinical and electrophysiological characteristics of fifty patients with COVID-19 infection admitted to a ward service and who had an electroencephalogram (EEG) performed. Associations with short-term outcomes including hospital length of stay and discharge disposition were determined from univariate and multivariate statistical analysis. Results Clinical delirium was associated with encephalopathy on EEG, cefepime use was associated with increased length of stay, and of all factors analyzed, background frequency on EEG alone was correlated with discharge disposition. Conclusion Encephalopathy is one of the major determinants of short-term outcomes in hospitalized non-ICU patients with COVID-19.
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Electroencephalography Findings in Older Adults Undergoing Geriatric Treatment: A Surrogate for the Outcome? Brain Sci 2022; 12:brainsci12070839. [PMID: 35884646 PMCID: PMC9312893 DOI: 10.3390/brainsci12070839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/14/2022] [Accepted: 06/24/2022] [Indexed: 12/10/2022] Open
Abstract
Background: Comprehensive geriatric care (CGC) is a multidisciplinary approach developed to meet the needs of older patients. Electroencephalography (EEG) provides valuable information for monitoring the cerebral function. As a surrogate, EEG findings may help to estimate the course of diseases as well as the treatment outcomes. Objectives: Therefore, the aim of the present study is to investigate EEG findings in older patients receiving CGC. Methods: Patients with an initial EEG in a geriatric unit between May 2019 and April 2020 and treated using the CGC approach were analyzed. EEG abnormalities were defined as generalized (diffuse) background slowing and/or intermittent/persistent focal slowing and/or epileptiform discharges. Assessment results for the Barthel index (BI), Tinetti Balance and Gait test (TBGT), and Timed Up and Go test (TUG) were analyzed in relation to the presence of EEG abnormalities. Results: The study included 398 patients (mean age: 83.0 ± 6.57 years, 69.3% were female). Abnormal EEG patterns were found in 94 (23.6%) patients. Patients with EEG abnormalities had a mean age of 83.4 years versus a mean of 82.8 years in those without (p = 0.451). Based on all calculated scores, the majority of the patients improved after CGC, with a tendency to higher-grade improvements in those without EEG abnormalities (BI: 86.2% vs. 75.5%, p = 0.024; TUG: 53.3% vs. 31.9%, p < 0.001); for TBGT, only a gradual difference was detected (TBGT: 79.9% vs. 71.3%, p = 0.088). The presence of EEG abnormalities was associated with the parameters dementia (36.2% vs. 22.4%, p = 0.010), known epilepsy/seizure (19.1% vs. 5.9%, p < 0.001), structural brain lesion (47.9% vs. 19.7%, p < 0.001), and delirium (9.6% vs. 3.6%, p = 0.030) during hospitalization. Conclusions: We found EEG abnormalities in almost a quarter of the patients treated in the geriatric unit. In older patients, the presence of EEG abnormalities is associated with lower improvements after CGC.
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A Survey on EEG Signal Processing Techniques and Machine Learning: Applications to the Neurofeedback of Autobiographical Memory Deficits in Schizophrenia. ELECTRONICS 2021. [DOI: 10.3390/electronics10233037] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In this paper, a general overview regarding neural recording, classical signal processing techniques and machine learning classification algorithms applied to monitor brain activity is presented. Currently, several approaches classified as electrical, magnetic, neuroimaging recordings and brain stimulations are available to obtain neural activity of the human brain. Among them, non-invasive methods like electroencephalography (EEG) are commonly employed, as they can provide a high degree of temporal resolution (on the order of milliseconds) and acceptable space resolution. In addition, it is simple, quick, and does not create any physical harm or stress to patients. Concerning signal processing, once the neural signals are acquired, different procedures can be applied for feature extraction. In particular, brain signals are normally processed in time, frequency, and/or space domains. The features extracted are then used for signal classification depending on its characteristics such us the mean, variance or band power. The role of machine learning in this regard has become of key importance during the last years due to its high capacity to analyze complex amounts of data. The algorithms employed are generally classified in supervised, unsupervised and reinforcement techniques. A deep review of the most used machine learning algorithms and the advantages/drawbacks of most used methods is presented. Finally, a study of these procedures utilized in a very specific and novel research field of electroencephalography, i.e., autobiographical memory deficits in schizophrenia, is outlined.
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Rodríguez Quintana JH, Bueno SJ, Zuleta-Motta JL, Ramos MF, Vélez-van-Meerbeke A. Utility of Routine EEG in Emergency Department and Inpatient Service. Neurol Clin Pract 2021; 11:e677-e681. [PMID: 34840882 DOI: 10.1212/cpj.0000000000000961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/31/2020] [Indexed: 11/15/2022]
Abstract
Objective The most important indication for EEGs is the investigation of epileptic and nonepileptic seizures. However, it is unclear whether EEG in the emergency depatment (ED) can be useful in managing other conditions. Our objective was to investigate the usefulness of EEGs in the ED. Methods We performed an observational, descriptive, retrospective study based on clinical records between 2018 and 2019. We evaluated patients admitted to our ED or hospital wards who underwent an EEG. We defined the EEG results as useful when they prompted changes in antiepileptic drug (AED) treatment or clinical management. Results We gathered information from 236 patients with a mean age of 59.23 years (SD ±22.6), of whom 47.9% were women. In patients with seizures, 18.2% were generalized, 27.1% were focal, and 18.6% were unknown. Overall, 25.8% of the EEGs were abnormal. However, in patients with a history of predisposing conditions for epileptic seizures or encephalopathies, the tracing was abnormal in 47.5%. The most frequent alteration on the abnormal EEGs was generalized slowing (18.2%). The EEG was useful in 76.7% of patients: AEDs changed in 8.4% and clinical management changed in 76.2% of patients. The usefulness of EEGs associated with acute ischemic lesions on CT (p = 0.023) and with the diagnosis of vasovagal syncope (p = 0.022). Conclusions Routine EEG is useful in the ED, even in patients with a normal CT or MR brain image, because it helps determine clinical management or AED changes.
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Affiliation(s)
- Jesús H Rodríguez Quintana
- Hospital Universitario Mayor Méderi (JHRQ), Fundación Cardioinfantil (JHRQ, SJB, JLZ-M) and Neuroscience Research Group (NeURos) (JHRQ, MFR, AV-v-M), Escuela de Medicina y Ciencias de la Salud-Universidad del Rosario (MFR), Bogotá, Colombia
| | - Silvia Juliana Bueno
- Hospital Universitario Mayor Méderi (JHRQ), Fundación Cardioinfantil (JHRQ, SJB, JLZ-M) and Neuroscience Research Group (NeURos) (JHRQ, MFR, AV-v-M), Escuela de Medicina y Ciencias de la Salud-Universidad del Rosario (MFR), Bogotá, Colombia
| | - Jessica L Zuleta-Motta
- Hospital Universitario Mayor Méderi (JHRQ), Fundación Cardioinfantil (JHRQ, SJB, JLZ-M) and Neuroscience Research Group (NeURos) (JHRQ, MFR, AV-v-M), Escuela de Medicina y Ciencias de la Salud-Universidad del Rosario (MFR), Bogotá, Colombia
| | - Mario Federico Ramos
- Hospital Universitario Mayor Méderi (JHRQ), Fundación Cardioinfantil (JHRQ, SJB, JLZ-M) and Neuroscience Research Group (NeURos) (JHRQ, MFR, AV-v-M), Escuela de Medicina y Ciencias de la Salud-Universidad del Rosario (MFR), Bogotá, Colombia
| | - Alberto Vélez-van-Meerbeke
- Hospital Universitario Mayor Méderi (JHRQ), Fundación Cardioinfantil (JHRQ, SJB, JLZ-M) and Neuroscience Research Group (NeURos) (JHRQ, MFR, AV-v-M), Escuela de Medicina y Ciencias de la Salud-Universidad del Rosario (MFR), Bogotá, Colombia
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Jaseja H. Pedunculopontine Nucleus--Rapid Eye Movement Sleep--Electroencephalogram--Desynchronization (PRED) Axis in the Evolution of Epilepsy: A Novel Concept. J Epilepsy Res 2021; 11:1-5. [PMID: 34395217 PMCID: PMC8357554 DOI: 10.14581/jer.21001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/28/2021] [Accepted: 03/07/2021] [Indexed: 11/03/2022] Open
Abstract
Epilepsy is one of the commonest and oldest neurological diseases in the history of mankind, the exact pathophysiology of the evolution of which still remains elusive. The intimate and intriguing relation between epilepsy and sleep has been known for a long time. Rapid eye movement sleep (REMS) is well documented to exert potent antiepileptic action in human epilepsies and the underlying mechanism of which is largely based on its property to induce widespread electroencephalogram (EEG)-desynchronization. The pedunculopontine nucleus (PPN) owing to its property to enhance REMS has recently been under study for its potential role in intractable epilepsy (IE) and has been proposed as a novel deep brain stimulation target in IE. This brief paper unfolds the existing role of PPN, REMS, and EEG-desynchronization (PRED) in the evolution of epilepsy in an axial manner, the realization and comprehension of which is likely to open new avenues for further understanding of epileptogenesis, improved treatment of epilepsy and reducing the risk of IE.
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Electroencephalography in Orthostatic Tremor: A Prospective Study of 30 Patients. Tremor Other Hyperkinet Mov (N Y) 2021; 11:18. [PMID: 34046248 PMCID: PMC8139292 DOI: 10.5334/tohm.596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Orthostatic tremor (OT) is characterized by a sensation of instability while standing, associated with high frequency (1318 Hz) tremor in the legs. Small retrospective series have reported electroencephalography (EEG) findings in OT with discordant results. Methods We prospectively enrolled 30 OT subjects. Mean age = 68.3 (range 5487) with mean disease duration 16.3 years (range 444). A modified 1020 system EEG recording with additional midline electrodes was obtained. EMG electrodes were placed on quadricep muscles. EEG recording was performed at rest, during sleep and while standing unassisted. Results In all subjects, EEG showed normal background, normal drowsiness and/or stage 2 sleep, and normal responses to hyperventilation and photic stimulation. These normal results persisted during stance. EEG abnormalities were found in 3 subjects (anterior-mid temporal slow activity), but were not position-dependent and were judged unlikely to be related to OT. Tremor artifact while standing was noted in all subjects, however it was measurable in 26 with frequency in the OT range in 25. When compared with EMG, the average difference in frequency was small at 1.2 Hz (range 0.52.5, p 0.46). Visual EEG analysis in OT patients did not reveal electrographic abnormalities even upon standing unassisted. Discussion EEG was normal on this prospective, relatively large OT series. Clinicians interpreting video-EEGs should be aware of the OT artifact that can be seen in EEG and EKG leads mostly while standing.
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Hasan TF, Tatum WO. When should we obtain a routine EEG while managing people with epilepsy? Epilepsy Behav Rep 2021; 16:100454. [PMID: 34041475 PMCID: PMC8141667 DOI: 10.1016/j.ebr.2021.100454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/24/2021] [Accepted: 04/22/2021] [Indexed: 11/30/2022] Open
Abstract
More than eight decades after its discovery, routine electroencephalogram (EEG) remains a safe, noninvasive, inexpensive, bedside test of neurological function. Knowing when a routine EEG should be obtained while managing people with epilepsy is a critical aspect of optimal care. Despite advances in neuroimaging techniques that aid diagnosis of structural lesions in the central nervous system, EEG continues to provide critical diagnostic evidence with implications on treatment. A routine EEG performed after a first unprovoked seizure can support a clinical diagnosis of epilepsy and differentiate those without epilepsy, classify an epilepsy syndrome to impart prognosis, and characterize seizures for antiseizure management. Despite a current viral pandemic, EEG services continue, and the value of routine EEG is unchanged.
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Affiliation(s)
- Tasneem F. Hasan
- Department of Neurology, Ochsner Louisiana State University Health Sciences Center, Shreveport, LA, United States
| | - William O. Tatum
- Department of Neurology, Mayo Clinic, Jacksonville, FL, United States
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Höller Y, Nardone R. Quantitative EEG biomarkers for epilepsy and their relation to chemical biomarkers. Adv Clin Chem 2020; 102:271-336. [PMID: 34044912 DOI: 10.1016/bs.acc.2020.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The electroencephalogram (EEG) is the most important method to diagnose epilepsy. In clinical settings, it is evaluated by experts who identify patterns visually. Quantitative EEG is the application of digital signal processing to clinical recordings in order to automatize diagnostic procedures, and to make patterns visible that are hidden to the human eye. The EEG is related to chemical biomarkers, as electrical activity is based on chemical signals. The most well-known chemical biomarkers are blood laboratory tests to identify seizures after they have happened. However, research on chemical biomarkers is much less extensive than research on quantitative EEG, and combined studies are rarely published, but highly warranted. Quantitative EEG is as old as the EEG itself, but still, the methods are not yet standard in clinical practice. The most evident application is an automation of manual work, but also a quantitative description and localization of interictal epileptiform events as well as seizures can reveal important hints for diagnosis and contribute to presurgical evaluation. In addition, the assessment of network characteristics and entropy measures were found to reveal important insights into epileptic brain activity. Application scenarios of quantitative EEG in epilepsy include seizure prediction, pharmaco-EEG, treatment monitoring, evaluation of cognition, and neurofeedback. The main challenges to quantitative EEG are poor reliability and poor generalizability of measures, as well as the need for individualization of procedures. A main hindrance for quantitative EEG to enter clinical routine is also that training is not yet part of standard curricula for clinical neurophysiologists.
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Affiliation(s)
- Yvonne Höller
- Faculty of Psychology, University of Akureyri, Akureyri, Iceland.
| | - Raffaele Nardone
- Department of Neurology, Franz Tappeiner Hospital, Merano, Italy; Spinal Cord Injury and Tissue Regeneration Center, Salzburg, Austria; Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria
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Koshiyama D, Miyakoshi M, Tanaka-Koshiyama K, Joshi YB, Molina JL, Sprock J, Braff DL, Light GA. Neurophysiologic Characterization of Resting State Connectivity Abnormalities in Schizophrenia Patients. Front Psychiatry 2020; 11:608154. [PMID: 33329160 PMCID: PMC7729083 DOI: 10.3389/fpsyt.2020.608154] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/04/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Patients with schizophrenia show abnormal spontaneous oscillatory activity in scalp-level electroencephalographic (EEG) responses across multiple frequency bands. While oscillations play an essential role in the transmission of information across neural networks, few studies have assessed the frequency-specific dynamics across cortical source networks at rest. Identification of the neural sources and their dynamic interactions may improve our understanding of core pathophysiologic abnormalities associated with the neuropsychiatric disorders. Methods: A novel multivector autoregressive modeling approach for assessing effective connectivity among cortical sources was developed and applied to resting-state EEG recordings obtained from n = 139 schizophrenia patients and n = 126 healthy comparison subjects. Results: Two primary abnormalities in resting-state networks were detected in schizophrenia patients. The first network involved the middle frontal and fusiform gyri and a region near the calcarine sulcus. The second network involved the cingulate gyrus and the Rolandic operculum (a region that includes the auditory cortex). Conclusions: Schizophrenia patients show widespread patterns of hyper-connectivity across a distributed network of the frontal, temporal, and occipital brain regions. Results highlight a novel approach for characterizing alterations in connectivity in the neuropsychiatric patient populations. Further mechanistic characterization of network functioning is needed to clarify the pathophysiology of neuropsychiatric and neurological diseases.
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Affiliation(s)
- Daisuke Koshiyama
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Makoto Miyakoshi
- Swartz Center for Neural Computation, University of California, San Diego, La Jolla, CA, United States
| | | | - Yash B Joshi
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Juan L Molina
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Joyce Sprock
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - David L Braff
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Gregory A Light
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States.,VISN-22 Mental Illness, Research, Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, United States
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