Quantitative electroencephalography in cerebral ischemia. Detection of abnormalities in "normal" EEGs

Prolonged deficit of low gamma oscillations in the peri-infarct cortex of mice after stroke

Days and weeks after an ischemic stroke, the peri-infarct area adjacent to the necrotic tissue exhibits very intense synaptic reorganization aimed at regaining lost functions. In order to enhance functional recovery, it is important to understand the mechanisms supporting neural repair and neuroplasticity in the cortex surrounding the lesion. Brain oscillations of the local field potential (LFP) are rhythmic fluctuations of neuronal excitability that synchronize neuronal activity to organize information processing and plasticity. Although the oscillatory activity of the brain has been probed after stroke in both animals and humans using electroencephalography (EEG), the latter is ineffective to precisely map the oscillatory changes in the peri-infarct zone where synaptic plasticity potential is high. Here, we worked on the hypothesis that the brain oscillatory system is altered in the surviving peri-infarct cortex, which may slow down the functional repair and reduce the recovery. In order to document the relevance of this hypothesis, oscillatory power was measured at various distances from the necrotic core at 7 and 21 days after a permanent cortical ischemia induced in mice. Delta and theta oscillations remained at a normal power in the peri-infarct cortex, in contrast to low gamma oscillations that displayed a gradual decrease, when approaching the border of the lesion. A broadband increase of power was also observed in the homotopic contralateral sites. Thus, the proximal peri-infarct cortex could become a target of therapeutic interventions applied to correct the oscillatory regimen in order to boost post-stroke functional recovery.

The use of routine EEG in acute ischemic stroke patients without seizures: generalized but not focal EEG pathology is associated with clinical deterioration

PURPOSE

Specialized electroencephalography (EEG) methods have been used to provide clues about stroke features and prognosis. However, the value of routine EEG in stroke patients without (suspected) seizures has been somewhat neglected. We aimed to assess this in a group of acute ischemic stroke patients in regard to short-term prognosis and basic stroke features.

METHODS

We assessed routine (10-20) EEG findings in 69 consecutive acute ischemic stroke patients without seizures. Associations between EEG abnormalities and NIHSS scores, clinical improvement or deterioration as well as MRI stroke characteristics were evaluated.

RESULTS

Mean age was 69 ± 18 years, 43 of the patients (62.3%) were men. Abnormal EEG was found in 40 patients (58%) and was associated with higher age (p = 0.021). The most common EEG pathology was focal slowing (30; 43.5%). No epileptiform potentials were found. Abnormal EEG in general and generalized or focal slowing in particular was significantly associated with higher NIHSS score on admission and discharge as well as with hemorrhagic transformation of the ischemic lesion. Abnormal EEG and generalized (but not focal) slowing were associated with clinical deterioration ( p = 0.036, p = 0.003). Patients with lacunar strokes had no EEG abnormalities.

CONCLUSIONS

Abnormal EEG in general and generalized slowing in particular are associated with clinical deterioration after acute ischemic stroke. The study demonstrates the value of routine EEG as a simple diagnostic tool in the evaluation of stroke patients especially with regard to short-term prognosis.

Robust neuroprosthetic control from the stroke perilesional cortex

Intracortical brain-machine interfaces (BMIs) may eventually restore function in those with motor disability after stroke. However, current research into the development of intracortical BMIs has focused on subjects with largely intact cortical structures, such as those with spinal cord injury. Although the stroke perilesional cortex (PLC) has been hypothesized as a potential site for a BMI, it remains unclear whether the injured motor cortical network can support neuroprosthetic control directly. Using chronic electrophysiological recordings in a rat stroke model, we demonstrate here the PLC's capacity for neuroprosthetic control and physiological plasticity. We initially found that the perilesional network demonstrated abnormally increased slow oscillations that also modulated neural firing. Despite these striking abnormalities, neurons in the perilesional network could be modulated volitionally to learn neuroprosthetic control. The rate of learning was surprisingly similar regardless of the electrode distance from the stroke site and was not significantly different from intact animals. Moreover, neurons achieved similar task-related modulation and, as an ensemble, formed cell assemblies with learning. Such control was even achieved in animals with poor motor recovery, suggesting that neuroprosthetic control is possible even in the absence of motor recovery. Interestingly, achieving successful control also reduced locking to abnormal oscillations significantly. Our results thus suggest that, despite the disrupted connectivity in the PLC, it may serve as an effective target for neuroprosthetic control in those with poor motor recovery after stroke.

Visual-evoked potentials in patients with brain circulatory problems

PURPOSE

The aim of this study was to find out if local brain circulatory problems may influence visual-evoked potentials (VEP).

PATIENTS AND METHODS

Thirty-eight patients were divided into the following groups: (I) those with hemianopsia or quadrantanopsia and hemiparesis after brain stroke; (II) those with hemianopsia or quadrantanopsia without paresis after brain stroke; and (III) those with amaurosis fugax. The control group consisted of 38 patients. The VEP pattern (PVEP) and flash VEP (FVEP) were examined monocularly using two electrodes placed at O1 and O2. Latency and amplitude of the N75, P100 and N2, P2 waves were measured. The Newman-Keuls test was used for statistical analysis.

RESULTS

In PVEP, no differences between the groups were observed. In FVEP, the mean P2 latency was significantly longer in group I than in group III, and the P2 amplitude was significantly lower in all examined groups when compared with the control group. PVEP and FVEP revealed differences in P latency over 3 ms between brain hemispheres and differences in P amplitude over 30% in all examined groups. In the control group, there were no differences in latency between brain hemispheres and only a small difference in amplitude.

CONCLUSION

Local brain circulatory problems that may lead to brain ischemia cause differences in VEP amplitude and latency between brain hemispheres. Changes in VEPs observed in patients with amaurosis fugax may be considered the result of recurrent brain ischemia.

Alterations in spontaneous brain oscillations during stroke recovery

Amplitude or frequency alterations of spontaneous brain oscillations may reveal pathological phenomena in the brain or predict recovery from brain lesions, but the temporal evolution and the functional significance of these changes is not well known. We performed follow-up recordings of spontaneous brain oscillations with whole-head MEG in 16 patients with first-ever stroke in the middle cerebral artery territory, affecting upper limb motor function, 1-7 days (T0), 1 month (T1), and 3 months (T2) after stroke, with concomitant clinical examination. Clinical test results improved significantly from T0 to T1 or T2. During recovery (at T1 and T2), the strength of temporo-parietal ≈ 10-Hz oscillations in the affected hemisphere (AH) was increased as compared with the unaffected hemisphere. Abnormal low-frequency magnetic activity (ALFMA) at ≈ 1 Hz in the AH was detected in the perilesional cortex in seven patients at T0. In four of these, ALFMA persisted at T2. In patients with ALFMA, the lesion size was significantly larger than in the rest of the patients, and worse clinical outcome was observed in patients with persisting ALFMA. Our results indicate that temporo-parietal ≈ 10-Hz oscillations are enhanced in the AH during recovery from stroke. Moreover, stroke causes ALFMA, which seems to persist in patients with worse clinical outcome.

Analysis of using the tongue deviation angle as a warning sign of a stroke

Background

The symptom of tongue deviation is observed in a stroke or transient ischemic attack. Nevertheless, there is much room for the interpretation of the tongue deviation test. The crucial factor is the lack of an effective quantification method of tongue deviation. If we can quantify the features of the tongue deviation and scientifically verify the relationship between the deviation angle and a stroke, the information provided by the tongue will be helpful in recognizing a warning of a stroke.

Methods

In this study, a quantification method of the tongue deviation angle was proposed for the first time to characterize stroke patients. We captured the tongue images of stroke patients (15 males and 10 females, ranging between 55 and 82 years of age); transient ischemic attack (TIA) patients (16 males and 9 females, ranging between 53 and 79 years of age); and normal subjects (14 males and 11 females, ranging between 52 and 80 years of age) to analyze whether the method is effective. In addition, we used the receiver operating characteristic curve (ROC) for the sensitivity analysis, and determined the threshold value of the tongue deviation angle for the warning sign of a stroke.

Results

The means and standard deviations of the tongue deviation angles of the stroke, TIA, and normal groups were: 6.9 ± 3.1, 4.9 ± 2.1 and 1.4 ± 0.8 degrees, respectively. Analyzed by the unpaired Student’s t-test, the p-value between the stroke group and the TIA group was 0.015 (>0.01), indicating no significant difference in the tongue deviation angle. The p-values between the stroke group and the normal group, as well as between the TIA group and the normal group were both less than 0.01. These results show the significant differences in the tongue deviation angle between the patient groups (stroke and TIA patients) and the normal group. These results also imply that the tongue deviation angle can effectively identify the patient group (stroke and TIA patients) and the normal group. With respect to the visual examination, 40% and 32% of stroke patients, 24% and 16% of TIA patients, and 4% and 0% of normal subjects were found to have tongue deviations when physicians “A” and “B” examined them. The variation showed the essentiality of the quantification method in a clinical setting. In the receiver operating characteristic curve (ROC), the Area Under Curve (AUC, = 0.96) indicates good discrimination. The tongue deviation angle more than the optimum threshold value (= 3.2°) predicts a risk of stroke.

Conclusions

In summary, we developed an effective quantification method to characterize the tongue deviation angle, and we confirmed the feasibility of recognizing the tongue deviation angle as an early warning sign of an impending stroke.

Cortical sources of EEG rhythms in congestive heart failure and Alzheimer's disease

INTRODUCTION

The brain needs continuous oxygen supply even in resting-state. Hypoxia enhances resting-state electroencephalographic (EEG) rhythms in the delta range, and reduces those in the alpha range, with a pattern similar to that observed in Alzheimer's disease (AD). Here we tested whether resting-state cortical EEG rhythms in patients with congestive heart failure (CHF), as a model of acute hypoxia, present frequency similarities with AD patients, comparable by cognitive status revealed by the mini mental state examination (MMSE).

METHODS

Eyes-closed EEG data were recorded in 10 CHF patients, 20 AD patients, and 20 healthy elderly subjects (Nold) as controls. LORETA software estimated cortical EEG generators.

RESULTS

Compared to Nold, both AD and CHF groups presented higher delta (2-4Hz) and lower alpha (8-13Hz) temporal sources. The highest delta and lowest alpha sources were observed in CHF subjects. In these subjects, the global amplitude of delta sources correlated with brain natriuretic peptide (BNP) level in the blood, as a marker of disease severity.

CONCLUSIONS

Resting-state delta and alpha rhythms suggest analogies between the effects of acute hypoxia and AD neurodegeneration on the cortical neurons' synchronization.

SIGNIFICANCE

Acute ischemic hypoxia could affect the mechanisms of cortical neural synchronization generating resting state EEG rhythms, inducing the "slowing" of EEG rhythms typically observed in AD patients.

Decreased α event-related synchronization in the left posterior temporal cortex in schizophrenia: a magnetoencephalography-beamformer study

Alpha rhythm is one of the most prominent electromagnetic changes in the brain, and electroencephalography (EEG) alpha reactivity disturbance may sometimes represent an early sign of cerebral dysfunction. Although magnetoencephalography (MEG) has a better spatial resolution than EEG, it has not extensively been used to explore alpha-power change deficits in schizophrenia as a possible neurophysiological marker of the disease. The purpose of this study was to use MEG to identify abnormalities in alpha synchronization induced by eye-closing in schizophrenia patients compared to healthy controls, and to investigate whether alpha reactivity deficits correlate with clinical features of the disorder. MEG data were recorded in 22 schizophrenia patients and 20 age- and gender-matched controls during eyes-open/eyes-closed resting states. Cortical sources of event-related synchronization (ERS) were estimated using multiple source beamformer, and BrainVoyager was used for statistic group analysis. A significant decrease in ERS in the upper alpha band (10-13 Hz) was found in the left posterior temporal region in schizophrenia patients relative to controls, and this activity showed correlation with visual memory scores. This upper alpha ERS deficit may indicate left temporal dysfunction and visual-information processing impairment in schizophrenia, and upon further confirmation it might represent a neurophysiological state marker of the disorder.

Event-related desynchronization of sensorimotor EEG rhythms in hemiparetic patients with acute stroke

Previous neuroimaging studies based on neurovascular coupling have shown that stroke affects both, strength and spatial extent of brain activation during upper limb movements. Here, we investigated the sub-second amplitude dynamics of a direct neuronal measure, i.e., event-related desynchronization (ERD) of EEG oscillations during finger movements, in patients with acute cortical and subcortical stroke. Acute cortical strokes were found to decrease the ERD of alpha oscillations for the affected pericentral sensorimotor areas compared to a control group. Within the cortical stroke group, the affected hemisphere showed a smaller alpha-ERD compared to the unaffected hemisphere when each was contralateral to the acting hand. Furthermore, when cortical stroke patients moved their paretic hand, the ipsilateral (i.e., contralesional) alpha-ERD was stronger than the contralateral (ipsilesional) ERD. Interestingly, the alpha-ERD amplitude in a hemisphere with a cortical stroke was relatively well preserved for non-paretic hand movements compared to alpha-ERD amplitude for paretic hand movements. This finding provides a new perspective for assessing the rehabilitative potential, which could be utilized through training of the still responsive cortical network, e.g., via enforced use of the paretic hand.

Influence of subcortical ischemic stroke on cortical neural network

Stroke has remained as a leading cause of death and neurological disability worldwide in the past decades. Previous structural and functional studies reported little information regarding cortical neural network after stroke. Using the causality measure based on multi-channel electroencephalograph (EEG), i.e. partial directed coherence (PDC) in this paper, we investigated the different network patterns involved in pre-motor and parietal areas (F3, F4, C3, C4, P3 and P4) in three groups of patients who suffered unilateral or bilateral hemispheric stroke in basal ganglia with extension into corona radiate. Compared with the results in the control group, stroke patients showed: 1) more vulnerable long-distance intra- and inter-hemispheric interactions due to the ischemic injury; 2) strengthened short-distance interactions between the central areas in the intact hemisphere with the injured counterpart, which implied a functional compensation after unilateral stroke; 3) more suppression of cortical connections after bilateral hemispheric stroke than those with unilateral stroke. Causal interdependence by PDC analysis provides a new insight of cortical functional network following stroke.

Source analysis of alpha rhythm reactivity using LORETA imaging with 64-channel EEG and individual MRI

Conventional EEG and quantitative EEG visual stimuli (close-open eyes) reactivity analysis have shown their usefulness in clinical practice; however studies at the level of EEG generators are limited. The focus of the study was visual reactivity of cortical resources in healthy subjects and in a stroke patient. The 64 channel EEG and T1 magnetic resonance imaging (MRI) studies were obtained from 32 healthy subjects and a middle cerebral artery stroke patient. Low Resolution Electromagnetic Tomography (LORETA) was used to estimate EEG sources for both close eyes (CE) vs. open eyes (OE) conditions using individual MRI. The t-test was performed between source spectra of the two conditions. Thresholds for statistically significant t values were estimated by the local false discovery rate (lfdr) method. The Z transform was used to quantify the differences in cortical reactivity between the patient and healthy subjects. Closed-open eyes alpha reactivity sources were found mainly in posterior regions (occipito-parietal zones), extended in some cases to anterior and thalamic regions. Significant cortical reactivity sources were found in frequencies different from alpha (lower t-values). Significant changes at EEG reactivity sources were evident in the damaged brain hemisphere. Reactivity changes were also found in the "healthy" hemisphere when compared with the normal population. In conclusion, our study of brain sources of EEG alpha reactivity provides information that is not evident in the usual topographic analysis.

QEEG prognostic value in acute stroke

The objective of our study is to determine the predictive value of QEEG in patients suffering from an acute ischemic cerebral stroke. Twenty-eight patients were studied within the first 72 hours of clinical evolution of middle cerebral artery territory ischemic stroke. Thirty-seven QEEG recordings were obtained: 13 in the first 24 hours after cerebral stroke onset, 9 between 24-48 hours and 15 between 48-72 hours. Absolute Energies (AE) were the QEEG selected variables for statistical analysis: first, AE Z values were calculated using the Cuban QEEG norms, then the maximum and minimum AE Z values were selected within each frequency band and total power. The medians of the five neighboring Z values were also chosen. Regression models were estimated using the RANKIN scores as dependent variables and the selected QEEG variables as independent, then outcome predictions at hospital discharge and 3 months later were calculated. Percentages of concordance and errors between the estimated and real outcome scores were obtained. Alpha and theta AE were the best predictor for short-term outcome and delta AE for long-term outcome. We conclude that QEEG performed within the first 72 hours of ischemic stroke might be a powerful tool predicting short- and long-term outcome.

Assessing acute middle cerebral artery ischemic stroke by quantitative electric tomography

This paper focuses on the application of quantitative electric tomography (qEEGT) to map changes in EEG generators for detection of early signs of ischemia in patients with acute middle cerebral artery stroke. Thirty-two patients were studied with the diagnosis of acute ischemic stroke of the left middle cerebral artery territory, within the first 24 hours of their clinical evolution. Variable Resolution Electrical Tomography was used for estimating EEG source generators. High resolution source Z-spectra and 3- dimensional images of Z values for all the sources at each frequency were obtained for all cases. To estimate statistically significant increments and decrements of brain electric activity within the frequency spectra, the t-Student vs. Zero test was performed. A significant increment of delta activity was observed on the affected vascular territory, and a more extensive increment of theta activity was detected. A significant alpha decrement was found in the parieto-occipital region of the affected cerebral hemisphere (left), and in the medial and posterior region of the right hemisphere. These findings suggest that qEEGT Z delta images are probably related to the main ischemic core within the affected arterial territory; penumbra, diaschisis, edema, might explain those observed theta and alpha abnormalities. It was concluded that qEEGT is useful for the detection of early signs of ischemia in acute ischemic stroke.

Frequency asymmetry of sleep spindles associated with focal pathology

Focal cerebral lesions are often associated with voltage asymmetry of sleep spindles, usually with depressed voltage on the side of the lesion. In this report, we document a case in which a brain tumor was associated with a frequency asymmetry in addition to a voltage asymmetry of sleep spindles. The slower frequency spindles occurred on the side of the lesion.

Spectral EEG analysis following hemispheric stroke: evidences of transhemispheric diaschisis

Quantitative EEG frequency analysis was performed within the acute stage and after the recovery in 40 patients with hemispheric stroke in order to analyze ipsi- and contralateral alpha peak frequency (APF) and band power changes. Localization of hemispheric lesion was determined by computer tomography. Changes of clinical scores were compared with the alpha asymmetries. In the cases of small subcortical infarcts good improvement of alpha activity was observed over the affected hemisphere; contralateral APF was relatively preserved. Bilateral symmetric reduction of APF was found in territorial middle cerebral artery infarcts, with poor tendency of recovery of alpha power and neurologic status. These findings suggest transitory derangement of alpha generators in the contralateral hemisphere evidenced by APF and power asymmetries. EEG signs of contralateral alpha reduction may be due to the remote effect of primary ischemic lesion indicating an electrical diaschisis phenomenon in the acute phase of stroke. EEG signs of diaschisis may anticipate a poor recovery of alpha activity and clinical status in the post-stroke period.

QEEG and evoked potentials in central nervous system Lyme disease

Quantitative EEG, flash visual evoked potentials, auditory evoked potentials to common and rare tones, and median nerve somatosensory evoked potentials were obtained from 12 patients with active CNS Lyme disease and from 11 patients previously treated for active CNS Lyme disease. Abnormal QEEG and/or EPs were found in 75% of the active Lyme disease patients and in 54% of the post CNS Lyme disease patients. Three different types of neurophysiological abnormality were observed in these patients including QEEG slowing, possible signs of cortical hyperexcitability, and focal patterns indicating disturbed interhemispheric relationships. In patients tested before and after treatment QEEG and EP normalization was associated with clinical improvement.

Topographic EEG changes due to hypobaric hypoxia at simulated high altitude

Multichannel human EEG signals were studied topographically in subjects exposed to an atmosphere of reduced air pressure in a chamber in which high-altitude conditions were simulated. EEG signals from 16 electrodes placed on the scalp were recorded simultaneously with electrocardiography and vertical eye movement. Baseline records were first obtained at sea level (PRE 0 m), and then at reduced air pressures corresponding to the altitudes of 3000 m, 4000 m, and 6000 m, respectively, and after returning to sea level (POST 0 m). A complete set of EEG records under all 6 conditions was obtained in 5 of the 15 subjects, and under 5 conditions (all except the 6000 m condition) in 3 other subjects. The spectral powers of 1 min epochs of the multichannel EEG signal under each altitude condition were compared to that at PRE 0 m using analysis of variance. Under the 3000 m condition, the spectral power of the 10-11 Hz components was significantly decreased and, with increasing altitude, significant decrease of spectral power was observed in a wider range of the alpha frequency band. Under the 6000 m condition, the decrease of spectral power of the alpha band in the posterior brain areas was -7 dB compared to the baseline. In contrast, the spectral power of the theta frequency band in anterior brain areas increased significantly in the 5000 m and 6000 m conditions. At the POST 0 m condition after return from the 5000 m condition (without exposure to the 6000 m condition), the EEG showed recovery to the level of the baseline PRE 0 m condition.(ABSTRACT TRUNCATED AT 250 WORDS)

Electroencephalography improves the prediction of functional outcome in the acute stage of cerebral ischemia

BACKGROUND AND PURPOSE

We studied the value of clinical and electroencephalographic assessment in patients with acute first-ever supratentorial ischemia in predicting functional outcome after 1 year.

METHODS

In 55 consecutive patients admitted after a median interval of less than 24 hours, the degree of handicap was dichotomized as moderate (Rankin grade 1, 2, or 3) or severe (Rankin grade 4 or 5). Clinical deficits were categorized according to signs of a lacunar or a cortical syndrome. Without knowledge of clinical data, electroencephalograms (EEGs) were classified according to findings predicting good or poor prognosis. The outcome after 1 year was assessed as good (Rankin grade 3 or less) or poor (Rankin grade 4 or 5 or death from stroke) and was correlated to clinical data and to EEG findings in the acute stage.

RESULTS

Thirty patients with a moderate handicap on admission all had a good outcome (predictive value [PV] of the initial handicap, 1.00; 95% confidence interval [CI], 0.88 to 1.00). Of the 25 patients with severe handicap on admission a poor outcome occurred in 13 (PV, 0.52; 95% CI, 0.31 to 0.72). If these patients with severe handicap at baseline were subdivided according to clinical features, a lacunar syndrome predicted good outcome in 4 of 5 patients (PV, 0.80; 95% CI, 0.28 to 1.00), but a cortical syndrome predicted poor outcome in only 12 of 20 patients (PV, 0.60; 95% CI, 0.36 to 0.81). Of the 20 patients with severe handicap and a cortical syndrome at baseline, an EEG with features predicting a good prognosis correctly predicted good outcome in 6 of 7 patients (PV, 0.86; 95% CI, 0.42 to 1.00). An EEG with features predicting poor prognosis correctly predicted poor outcome in 11 of 13 patients (PV, 0.85; 95% CI, 0.55 to 0.98).

CONCLUSIONS

Electroencephalography improves the prediction of functional outcome in patients with a severe neurological deficit in the acute stage of cerebral ischemia. This may have implications for the design of future intervention trials in acute stroke.

Neurometrics in cerebral ischemia and uremic encephalopathy

The neurometric method as introduced by John was used to study three groups of patients with cerebral ischemia, three groups of patients with renal disease and an additional normal control group. The traditional neurometric approach was slightly modified: relative band power values were not expressed as a percentage of the total power per derivation but as a percentage of the "global power"; frequency matrices were used in addition to power matrices. From the study of the three groups of patients with one-sided supratentorial ischemia it appeared that sensitivity and specificity are completely satisfactory when using neurometrics in patients with severe ischemia in the middle cerebral artery territory studied within 48 hours of the onset of the stroke. However, in ischemia patients with less pronounced clinical signs and especially in patients without persistent neurological deficit the sensitivity is much lower. In studying dialysed and non-dialysed renal patients signs of an (often subclinical) encephalopathy could be detected in approximately 37% of all patients. Follow-up studies of the ischemia patients and the renal patients over a period of several years revealed a parallelism between clinical scores and qEEG scores in the ischemia patients; almost all qEEG improvement occurred in the first three months after the stroke. The qEEG profile of the groups of dialysed patients tended to be more or less stable over a period of several years.

Topographic EEG mapping in cerebrovascular disease

Topographic EEG based on the power spectral data were correlated with cortical CBF and CMRO2 which were provided by positron emission tomography (PET) in patients with cerebral infarction. Delta and theta activities correlated negatively with CBF and CMRO2 whereas alpha activity correlated positively. For delta activity, both absolute (AP) and relative power (RP) showed significant correlation with CBF and CMRO2. For alpha activity, RP showed closer correlation with CBF and CMRO2 than did AP. The z-scores for these power data also showed significant correlation with the PET data although the degree of correlations did not improved even with the z-score. Topographic EEG images including AP, RP and their z-score maps well corresponded with the PET images: z-score maps were considered to be useful tool in topographical extraction of the features of the EEG power data.

Topographic EEG in brain ischemia--correlation with blood flow and metabolism

A review is made of topographic EEG analyses in patients with brain ischemia. Features correlating EEG measures and vascular and metabolic studies are presented and discussed within the content of the stage of ischemia. Quantitative EEG data was found to provide useful information regarding the effects of brain ischemia.