Cerebral blood flow and sources of abnormal EEG activity (VARETA) in neurocysticercosis

Persistent brainwave disruption and cognitive impairment induced by acute sarin surrogate sub-lethal dose exposure

Warfare neurotoxicants such as sarin, soman or VX, are organophosphorus compounds which irreversibly inhibit cholinesterase. High-dose exposure with nerve agents (NA) is known to produce seizure activity and related brain damage, while less is known about the effects of acute sub-lethal dose exposure. The aim of this study was to characterize behavioral, brain activity and neuroinflammatory modifications at different time points after exposure to 4-nitrophenyl isopropyl methylphosphonate (NIMP), a sarin surrogate. In order to decipher the impacts of sub-lethal exposure, we chose 4 different doses of NIMP each corresponding to a fraction of the median lethal dose (LD₅₀). First, we conducted a behavioral analysis of symptoms during the first hour following NIMP challenge and established a specific scoring scale for the intoxication severity. The intensity of intoxication signs was dose-dependent and proportional to the cholinesterase activity inhibition evaluated in mice brain. The lowest dose (0.3 LD₅₀) did not induce significant behavioral, electrocorticographic (ECoG) nor cholinesterase activity changes. Animals exposed to one of the other doses (0.5, 0.7 and 0.9 LD₅₀) exhibited substantial changes in behavior, significant cholinesterase activity inhibition, and a disruption of brainwave distribution that persisted in a dose-dependent manner. To evaluate long lasting changes, we conducted ECoG recording for 30 days on mice exposed to 0.5 or 0.9 LD₅₀ of NIMP. Mice in both groups showed long-lasting impairment of theta rhythms, and a lack of restoration in hippocampal ChE activity after 1-month post-exposure. In addition, an increase in neuroinflammatory markers (IBA-1, TNF-α, NF-κB) and edema were transiently observed in mice hippocampus. Furthermore, a novel object recognition test showed an alteration of short-term memory in both groups, 1-month post-NIMP intoxication. Our findings identified both transient and long-term ECoG alterations and some long term cognitive impairments following exposure to sub-lethal doses of NIMP. These may further impact morphopathological alterations in the brain.

Persistent decrease in alpha current density in fully remitted subjects with major depressive disorder treated with fluoxetine: A prospective electric tomography study

Major depressive disorder (MDD) is recurrent, and its pathophysiology is not fully understood. Studies using electric tomography (ET) have identified abnormalities in the current density (CD) of MDD subjects in regions associated with the neurobiology of MDD, such as the anterior cingulate cortex (ACC) and medial orbitofrontal cortex (mOFC). However, little is known regarding the long-term CD changes in MDD subjects who respond to antidepressants. The aim of this study was to compare CD between healthy and MDD subjects who received 1-year open-label treatment with fluoxetine. Thirty-two-channel electroencephalograms (EEGs) were collected from 70 healthy controls and 74 MDD subjects at baseline (pre-treatment), 1 and 2weeks and 1, 2, 6, 9 and 12months. Variable-resolution ET (VARETA) was used to assess the CD between subject groups at each time point. The MDD group exhibited decreased alpha CD (αCD) in the occipital and parietal cortices, ACC, mOFC, thalamus and caudate nucleus at each time point. The αCD abnormalities persisted in the MDD subjects despite their achieving full remission. The low sub-alpha band was different between the healthy and MDD subjects. Differences in the amount of αCD between sexes and treatment outcomes were observed. Lack of a placebo arm and the loss of depressed patients to follow-up were significant limitations. The persistence of the decrease in αCD might suggest that the underlying pathophysiologic mechanisms of MDD are not corrected despite the asymptomatic state of MDD subjects, which could be significant in understanding the highly recurrent nature of MDD.

The EEG of tropical encephalopathies

In addition to encountering most of the conditions treated by clinicians in the West, clinicians in the tropics are faced with unique tropical encephalopathies. These are largely but not entirely infectious in nature. Despite the relatively low cost of EEG technology, it remains unavailable in many low-income tropical settings even at the tertiary care level. Where available, the EEG recordings and interpretation are often of unacceptable quality. Nonetheless, there are existing data on the EEG patterns seen in malaria and a number of tropical viral, bacterial, and parasitic infestations.

An extension of the functional cerebral systems approach to hostility: a capacity model utilizing a dual concurrent task paradigm

Regulatory control of emotions and expressive fluency (verbal or design) have historically been associated with the frontal lobes. Moreover, research has demonstrated the importance of cerebral laterality with a prominent role of the right frontal regions in the regulation of negative affect (anger, hostility) and in the fluent production of designs rather than verbal fluency. In the present research, participants identified with high and with low levels of hostility were evaluated on a design fluency test twice in one experimental session. Before the second administration of the fluency test, each participant underwent physiological (cold pressor) stress. It was hypothesized that diminished right frontal capacity in high-hostile men would be evident through lowered performance on this cognitive stressor. Convergent validity of the capacity model was supported wherein high-hostile men evidenced reduced delta magnitude over the right frontal region after exposure to the physiological stressor but failed to maintain consistent levels of right cerebral activation across conditions. The results suggest an inability for high-hostile men to maintain stable levels of cerebral activation after exposure to physiological and cognitive stress. Moreover, low-hostiles showed enhanced cognitive performance on the design task with lower levels of arousal (heightened delta magnitude). In contrast, reduced arousal yielded increased executive deficits in high-hostiles as evidenced through increased perseverative errors on the design fluency task.

3D statistical parametric mapping of quiet sleep EEG in the first year of life

This paper extends previously developed 3D SPM for Electrophysiological Source Imaging (Bosch et al., 2001) for neonate EEG. It builds on a prior paper by our group that established age dependent means and standard deviations for the scalp EEG Broad Band Spectral Parameters of children in the first year of life. We now present developmental equations for the narrow band log spectral power of EEG sources, obtained from a sample of 93 normal neonates from age 1 to 10 months in quiet sleep. The main finding from these regressions is that EEG power from 0.78 to 7.5 Hz decreases with age and also for 45-50 Hz. By contrast, there is an increase with age in the frequency band of 19-32 Hz localized to parietal, temporal and occipital areas. Deviations from the norm were analyzed for normal neonates and 17 with brain damage. The diagnostic accuracy (measured by the area under the ROC curve) of EEG source SPM is 0.80, 0.69 for average reference scalp EEG SPM, and 0.48 for Laplacian EEG SPM. This superior performance of 3D SPM over scalp qEEG suggests that it might be a promising approach for the evaluation of brain damage in the first year of life.

Neurocysticercosis: fireflies in the central nervous system

Neurocysticercosis (NCC) is caused by cysticerci spreading to spinal or brain tissue. NCC causes headaches, seizures, and focal neurological deficits. NCC is one of the main causes of epilepsy worldwide. NCC can cause death if it is not adequately treated. NCC is preventable through education of proper handwashing techniques proper food handling, and separation of human and pig living quarters (CDC 1998). The International League Against Epilepsy (ILAE), the World Health Organization (WHO), and other international health organizations are attempting to rid the world of NCC through education. Cysticerci create cavities in the brain and other body tissue where their tiny bodies grow sometimes into tapeworms two to seven meters in length and can live up to 25 years in the human body. On magnetic resonance imaging (MRI) wormholes appear Often times, if best practice is followed, the patient's entire body is scanned and more craters appear. Some authors have stated that cysticerci on a computed topography (CT) scan are similar to a starry sky or fireflies (Kapur et al. 2007).

EEG sources in a group of patients with major depressive disorders

EEG sources were assessed in a group of patients with major moderate-severe depressive disorder (MDD) as classified by trained clinicians according to DSM-IV criteria. Frequency Domain Variable Resolution Electromagnetic Tomography (FD-VARETA) was used to calculate EEG sources. The Z-values indicated that EEG sources were abnormal (increase in current density) in all patients, with most demonstrating abnormal EEG sources in both hemispheres but with maximal inverse solution located primarily in the right. Twenty-nine patients had a predominant topography of the abnormal EEG maximal inverse solution in the frontal lobes. The remaining seven patients had a bilateral abnormal increase in current density in the superior parietal lobe. The EEG maximal abnormal inverse solution frequency was observed in both hemispheres such that the increases in current density were prevalent in alpha and theta bands. The results suggest that any of the two hemispheres could be affected by MDD, but abnormal EEG sources can be found more frequently in the right one, with the maximal abnormal inverse solution at the alpha and theta bands in frontal and parietal cortices.

On evaluation of spectrum estimators for EEG

In the search for how neonatal EEG is affected by asphyxia it is of importance to find reliable estimates of EEG power spectra. Several spectral estimation methods do exist, but since the true spectra are unknown it is hard to tell how well the estimators perform. Therefore a model to generate simulated EEG with known spectrum is proposed and the model is used to evaluate performance of several parametric and Fourier based spectral estimators.

Magnetoencephalographic analysis of cortical oscillatory activity in patients with brain tumors: Synthetic aperture magnetometry (SAM) functional imaging of delta band activity

Abnormal focal slow wave activity on electroencephalography and magnetoencephalography (MEG) is often seen in patients with various brain pathologies and MEG is capable of localizing cortical oscillatory activity with enhanced accuracy. In addition, MEG with synthetic aperture magnetometry (SAM) can depict changes in cortical oscillatory activity tomographically. Using SAM, we recorded cortical rhythms in patients with a brain tumor and evaluated the tomographic appearance of focal slow wave activity in relation to clinical signs and symptoms. Spontaneous MEG recordings were obtained in 15 patients with brain tumors. Statistically-determined power distributions in the delta-, theta-, and alpha-frequency bands were displayed tomographically and overlaid on individual magnetic resonance images. The location, strength and volume of enhanced activity were analyzed. Delta and theta band activities were significantly more intense in the cortex adjacent to tumors and in the surrounding edematous cortical areas than in other portions of the cortex. In 13 of the 15 patients, spatial distribution of enhanced focal delta activity coincided with the area responsible for the presenting signs and symptoms. Volumetric analysis revealed that emergence of tumor-related focal delta band activity in the cortex adjacent to a tumor, or with peritumoral edema, was greater for intra-axial tumors involving subcortical fibers than for extra-axial tumors. Patients with an increased volume of enhanced delta activity exhibited poor recovery of function in the early postoperative period. It is concluded that SAM imaging of focal delta activity can reveal functional alterations in cortical activity in patients with brain tumors and is useful for assessing cortical states associated with the existing pathology.

Specific EEG frequencies signal general common cognitive processes as well as specific task processes in man

The EEG of 10 normal male young adults was recorded during the performance of three different tasks: mental calculation, verbal working memory (VWM) and spatial working memory (SWM). The stimuli used in the three tasks were the same, only the instructions to the subjects were different. Narrow band analysis of the EEG and distributed sources for each EEG frequency were calculated using variable resolution electromagnetic tomography (VARETA). At some frequencies (1.56, 4.68, 7.80 to 10.92 Hz) at least two tasks produced similar EEG patterns that were interpreted as the reflex of common cognitive processes, such as attention, inhibition of irrelevant stimuli, etc. Specific changes were also observed at 2.34, 3.12, 3.90, 5.46 and 6.24 Hz. The first three of these frequencies showed similar changes during VWM and calculus at the left frontal cortex, suggesting the activation of working memory (WM) processes. The interaction effect at these frequencies was mainly observed at the anterior cingulate cortex and frontal cortex. At 5.46 and 6.24 Hz, changes were only observed during mental calculation.

Variable resolution electromagnetic tomography (VARETA) in evaluation of compression of cerebral arteries due to deep midline brain lesions

BACKGROUND

Hemispheric tumors produced electroencephalographic (EEG) delta activity mainly due to deafferentation of cerebral cortex. In small, deep midline lesions that compressed cerebral arteries, the most important abnormality should have been in EEG theta band that selectively responded to brain ischemia. Frequency domain-variable resolution electromagnetic tomography (FD-VARETA) has been applied satisfactorily to the study of brain tumors, cerebral infarcts, and brain hemorrhages and was shown to localize areas of hypoperfusion.

METHODS

Twelve patients with deep midline lesions compressing different cerebral arteries were studied. Computer tomography (CT) and/or magnetic resonance imaging (MRI) as well as quantitative EEG with source calculation in frequency domain were obtained. Brain electromagnetic tomographies (BETs) were calculated to evaluate localization and extension of functional abnormalities.

RESULTS

Ten of twelve cases presented abnormal sources in theta band as main abnormal source. In only two cases was the main source in delta band, but these cases also had abnormal Z values in theta band. In four patients there were only abnormal values in theta range. Sources of abnormal theta activity were observed in regions irrigated by the arteries compressed.

CONCLUSIONS

In deep midline lesions, compression of cerebral arteries producing relative ischemia may explain abnormal EEG sources in theta band. Patients with main source in theta band showed vascular compression and some patients exhibited vasogenic edema. Thus, theta might be due to relative ischemia produced by both hypoperfusion and edema. Once again, VARETA has found to be very useful in evaluation of functional abnormalities.

Remote sessions and frequency analysis for improved insight into cerebral function during pediatric and neonatal intensive care

A project involving recording and analysing EEG together with cardiovascular signals and temperature has been initiated. The aim of this project is to establish difficulties and possibilities involved with implementing a system for remote sessions and analysing EEG in correlation with other physiological signals. One objective is to find indicators of cerebral function during postasphyxia neonatal intensive care and pediatric cardiopulmonary bypass surgery with hypothermia. Remote sessions for joint interpretation have been carried out between pediatricians and clinical neurophysiologists, and EEG has been analyzed using frequency analyzing tools. One result is the discovery of reversible spectral changes coinciding with blood pressure falls, which may indicate loss of autoregulation function. This finding is one outcome from initial use of a system, developed during the project to facilitate communication about, and analysis of the recorded signals. Thus, already from a limited number of remote sessions and the use of basic signal processing techniques, important results have been achieved and better insight has been gained of how cerebral function is affected by cardiopulmonary bypass surgery. In this paper, we present our experiences from introducing a system for remote consultations, and evaluate the use for such a system in the current applications.

N400 during lexical decision tasks: a current source localization study

OBJECTIVE

Our primary aim in the present study was to establish the anatomic and psychophysiological correlates of automatic and controlled semantic priming.

METHODS

Current sources were calculated on N400 component data from a previous study on lexical decision tasks [Clin Neurophysiol 1999;110:813] using the variable resolution electromagnetic tomography method (VARETA). In this study, two experiments were carried out, one using directly related pairs and the other one using mediated related pairs. Each experiment consisted of 3 tasks that required different levels of contribution from controlled processes.

RESULTS

Average source localization images showed the brain structures involved in lexical decision tasks. The automatic component of the N400 effect was related to activation of occipitotemporal and parahippocampal gyri and anterior temporal lobes bilaterally. The expectancy strategy was related to activation of the right posterior temporal and right frontal areas. The postlexical strategy was associated with activation of right frontal, anterior cingulate and bilateral superior parietal areas.

CONCLUSIONS

The findings indicated that the current sources of the N400 varied according to the relative contributions of automatic and controlled mechanisms. Moreover, the sources of the N400 effect depended on the type of strategy used.

Sources of EEG activity in learning disabled children

The sources of different EEG frequencies were studied in 25 normal children and 46 learning disabled (not otherwise specified) children between 7 and 11 years old. The EEG sources were computed using Frequency-domain Variable Resolution Electromagnetic Tomography which produces a three dimensional picture of the currents at each EEG frequency. Significant differences between groups were observed. LD children showed more theta activity (3.5 to 7.02 Hz) in the frontal lobes and control children more alpha (9.75 to 12.87 Hz) in occipital areas. These results may support the maturational lag hypothesis, as the neurobiological cause of learning deficiencies not otherwise specified.