Hypothermia related changes in electrocortical activity at stepwise increase of intracranial pressure in piglets

Proceedings of the first international workshop on advances in electrocorticography

In October 2009, a group of neurologists, neurosurgeons, computational neuroscientists, and engineers congregated to present novel developments transforming human electrocorticography (ECoG) beyond its established relevance in clinical epileptology. The contents of the proceedings advanced the role of ECoG in seizure detection and prediction, neurobehavioral research, functional mapping, and brain-computer interface technology. The meeting established the foundation for future work on the methodology and application of surface brain recordings.

A survey on application of quantitative methods on analysis of brain parameters changing with temperature

Brain temperature fluctuations occur in consequence of physiological and pathophysiological conditions and indicate changes in brain metabolism, cerebral blood flow (CBF), brain functions and neural damage. Lowering the brain temperature of patients with traumatic brain injuries achieves considerable improvements. When the human brain is cooled down to 30°C, it switches to a sub functional regime where it can live longer with less oxygen, glucose and other supplies. Fluctuations in brain temperature cause changes in brain parameters which can be measured by electroencephalogram (EEG) and transcranial Doppler (TCD). It is very important to understand the temperature dependencies of brain's electrical activity and blood flow and their interrelations considering the good clinical results achieved by lowering the brain temperature of neurologically injured patients. Since protecting the patient's brain is of primary importance in many fields including cardiology, neurology, traumatology and anesthesia it can be clearly seen that this subject is very important. In this study, we survey the "state-of-the-art" in analysis of EEG and TCD brain parameters changing with temperature and present further research opportunities.

Quantitative EEG assessment of brain injury and hypothermic neuroprotection after cardiac arrest

In this paper we provide a quantitative electroencephalogram (EEG) analysis to study the effect of hypothermia on the neurological recovery of brain after cardiac arrest. We hypothesize that the brain injury results in a reduction in information of the brain rhythm. To measure the information content of the EEG a new measure called information quantity (IQ), which is the Shannon entropy of decorrelated EEG signals, is developed. For decorrelating EEG signals, we use the discrete wavelet transform (DWT) which is known to have good decorrelating properties and to show a good match to the standard clinical bands in EEG. In simulation for measuring the amount of information, the IQ shows better tracking capability for dynamic amplitude change and frequency component change than conventional entropy-based measures. Experiments are carried out in rodents to monitor the neurological recovery after cardiac arrest. In addition, EEG signal recovery under normothermic (37 degrees C) and hypothermic (33 degrees C) resuscitation following 5, 7 and 9 minutes of cardiac arrest is recorded and analyzed. Experimental results show that the IQ is higher for hypothermic than normothermic rats. The results quantitatively support the hypothesis that hypothermia accelerates the recovery of brain injury after cardiac arrest.

Quantitative EEG and neurological recovery with therapeutic hypothermia after asphyxial cardiac arrest in rats

We test the hypothesis that quantitative electroencephalogram (qEEG) can be used to objectively assess functional electrophysiological recovery of brain after hypothermia in an asphyxial cardiac arrest rodent model. Twenty-eight rats were randomly subjected to 7-min (n = 14) and 9-min (n = 14) asphyxia times. One half of each group (n = 7) was randomly subjected to hypothermia (T = 33 degrees C for 12 h) and the other half (n = 7) to normothermia (T = 37 degrees C). Continuous physiologic monitoring of blood pressure, EEG, and core body temperature monitoring and intermittent arterial blood gas (ABG) analysis was undertaken. Neurological recovery after resuscitation was monitored using serial Neurological Deficit Score (NDS) calculation and qEEG analysis. Information Quantity (IQ), a previously validated measure of relative EEG entropy, was employed to monitor electrical recovery. The experiment demonstrated greater recovery of IQ in rats treated with hypothermia compared to normothermic controls in both injury groups (P < 0.05). The 72-h NDS of the hypothermia group was also significantly improved compared to the normothermia group (P < 0.05). IQ values measured at 4 h had a strong correlation with the primary neurological outcome measure, 72-h NDS score (Pearson correlation 0.746, 2-tailed significance <0.001). IQ is sensitive to the acceleration of neurological recovery as measured NDS after asphyxial cardiac arrest known to occur with induced hypothermia. These results demonstrate the potential utility of qEEG-IQ to track the response to neuroprotective hypothermia during the early phase of recovery from cardiac arrest.

Quantitative EEG and effect of hypothermia on brain recovery after cardiac arrest

In this paper, we provide a quantitative electroencephalogram (EEG) analysis to study the effect of hypothermia on the neurological recovery of brain after cardiac arrest. We hypothesize that the brain injury results in a reduction in information of the brain rhythm. To measure the information content of the EEG a new measure called information quantity (IQ), which is the Shannon entropy of decorrelated EEG signals, is developed. For decorrelating EEG signals, we use the discrete wavelet transform (DWT) which is known to have good decorrelating properties and to show a good match to the standard clinical bands in EEG. In measuring the amount of information, IQ shows better tracking capability for dynamic amplitude change and frequency component change than conventional entropy-based measures. Experiments are carried out in rodents (n = 30) to monitor the neurological recovery after cardiac arrest. In addition, EEG signal recovery under normothermic (37 degrees C) and hypothermic (33 degrees C) resuscitation following 5, 7, and 9 min of cardiac arrest is recorded and analyzed. Experimental results show that the IQ is greater for hypothermic than normothermic rats, with an IQ difference of more than 0.20 (0.20 +/- 0.11 is 95% condidence interval). The results quantitatively support the hypothesis that hypothermia accelerates the electrical recovery from brain injury after cardiac arrest.

Traumatic injury in the developing brain–effects of hypothermia

Little is known about the underlying mechanisms of head trauma in the developing brains, despite considerable social and economic impact following such injuries. Age has been shown to substantially influence morbidity and mortality. Children younger than 4 years of age had worse cognitive, motor, and brain atrophy outcomes than children 6 years of age and older. Younger children tend to more frequently suffer from diffuse cerebral swelling compared to adults. Typical autoptic findings also include axonal injury and ischemic neurodegeneration. These differences impact not only the primary response of the brain to injury but the secondary response as well. The complexity of damaging mechanisms in traumatic brain injury contributes to the problem of determining effective therapy. As an alternative/ adjunct to pharmacological approaches, hypothermia has been shown to be cerebroprotective in traumatized adult brains. Although a large number of animal studies have shown protective effects of hypothermia in a variety of damaging mechanisms after TBI, little data exist for young, developing brains. The injury mechanisms of TBI in the immature, effects of hypothermia following resuscitation on adult and immature traumatized brains, and some possible mechanisms of action of hypothermia in the immature traumatized brain are discussed in this review.

Influence of sepsis on sevoflurane minimum alveolar concentration in a porcine model

Sevoflurane is widely used in anaesthetic protocols for patients undergoing surgical procedures. However, there are no reports on the influence of sepsis on minimum alveolar concentration of sevoflurane (MAC(SEV)) in animals or in humans. The aim of this study was to test the hypothesis that sepsis could alter the MAC(SEV) in a normotensive septic pig model. Twenty young, healthy pigs were used. After they had received 10 mg kg(-1) of ketamine i.m. for premedication, anaesthesia was established with propofol 3 mg kg(-1) and the trachea was intubated. Sevoflurane was used as the sole anaesthetic agent. Baseline haemodynamic recording included electrocardiography, carotid artery blood pressure and a pulmonary thermodilution catheter. Baseline MAC(SEV) in each pig was evaluated by pinching with a haemostat applied for 1 min to a rear dewclaw. MAC(SEV) was determined using incremental changes in sevoflurane concentration until purposeful movement appeared. Pigs were assigned randomly to two groups: the saline group (n = 10) received a 1-h i.v. infusion of sterile saline solution while the sepsis group (n = 10) received a 1-h i.v. infusion of live Pseudomonas aeruginosa. Epinephrine and hydroxyethylstarch were used to maintain normotensive and normovolemic haemodynamic status. In both groups, MAC(SEV) was evaluated 5 h after infusion. Significant increases in mean artery pulmonary pressure, filling, epinephrine and vascular pulmonary resistances occurred in the sepsis group. MAC(SEV) for the saline group was 2.4% [95% confidence interval (CI) 2.1-2.55%] and the MAC(SEV) for the sepsis group was 1.35% (95% CI 1.2-1.45%, P<0.05). These data indicate that MAC(SEV) is significantly decreased in this normotensive septic pig model.