Accuracy of high-density EEG electrode position measurement using an optical scanner compared with the photogrammetry method

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We measured EEG electrode positions in high-density array.

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We compared an optical scanner with the conventional photogrammetry method.

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The optical scanner was more accurate than photogrammetry.

The real-time scanning was feasible – it took 5–10 min per patient.

Objective

To determine the feasibility and accuracy of a handheld optical scanner to measure the three-dimensional (3D) EEG electrode coordinates in a high-density array of 256 electrodes.

Methods

We compared the optical scanning with a previously validated method, based on photogrammetry. Electrode coordinates were co-registered with the MRI of the patients, and mean distance error relative to the three-dimensional MRI reconstruction was determined for each patient. We included 60 patients: 30 were measured using the photogrammetry method, and 30 age and gender matched patients were measured with the optical scanner.

Results

Using the optical scanner, the mean distance error was 1.78 mm (95% confidence interval: 1.59–1.98 mm) which was significantly lower (p < 0.001) compared with the photogrammetry method (mean distance error: 2.43 mm; 95% confidence interval: 2.28–2.57 mm). The real-time scanning took 5–10 min per patient.

Conclusions

The handheld optical scanner is more accurate and feasible, compared to the photogrammetry method.

Significance

Measuring EEG electrode positions in high-density array, using the optical scanner is suitable for clinical implementation in EEG source imaging for presurgical evaluation.

Case report of a woman with anti amphiphysin positive stiff person syndrome

Stiff person syndrome is a rare neuroimmunological disease, characterized by severe, involuntary stiffness with superimposed painful muscle spasms, which are worsened by external stimuli. The classical form is associated with high levels of antibodies against glutamic acid decarboxylase. One of the variant forms is associated with antibodies against amphiphysin. This entity is a paraneoplastic syndrome, caused primarily by breast cancer, secondarily by lung cancer. Symptomatic therapy of anti amphiphysin positive stiff person syndrome includes treatment with benzodiazepines and baclofen (including intrathecal baclofen therapy). The effect of immunological therapies is controversial. Treatment of the underlying cancer may be very effective. In this report, we describe a 68 year old female presenting with an unusally rapidly developing anti amphiphysin positive stiff person syndrome, which was associated with breast cancer. Her painful spasms abolished after intrathecal baclofen treatment was initiated. Her condition improved spontaneously and significantly after cancer treatment, which enabled to start her complex rehabilitation and the simultaneous dose reduction of the intrathecal baclofen. The bedridden patient improved to using a rollator walker and the baclofen pump could be removed 18 monthes after breast surgery. This highlights the importance of cancer screening and treatment in anti amphiphysin positive stiff person syndrome cases.

Reduced CA2-CA3 Hippocampal Subfield Volume Is Related to Depression and Normalized by l-DOPA in Newly Diagnosed Parkinson's Disease

Hippocampal dysfunctions may play an important role in the non-motor aspects of Parkinson’s disease (PD), including depressive and cognitive symptoms. Fine structural alterations of the hippocampus and their relationship with symptoms and medication effects are unknown in newly diagnosed PD. We measured the volume of hippocampal subfields in 35 drug-naïve, newly diagnosed PD patients without cognitive impairment and 30 matched healthy control individuals. Assessments were performed when the patients did not receive medications and after a 24-week period of l-DOPA treatment. We obtained a T1-weighted 3D magnetization-prepared rapid acquisition gradient echo image at each assessment. FreeSurfer v6.0 was used for image analysis. Results revealed a selectively decreased CA2–CA3 volume in non-medicated PD patients, which was normalized after the 24-week treatment period. Higher depressive symptoms were associated with smaller CA2–CA3 volumes. These results indicate that the CA2–CA3 subfield is structurally affected in the earliest stage of PD in the absence of cognitive impairment. This structural anomaly, normalized by l-DOPA, is related to depressive non-motor symptoms.

European junior neurologists perceive various shortcomings in current residency curricula

BACKGROUND

Whether residency programs in Europe and neighboring countries appropriately prepare one for clinical practice is a matter of discussion.

AIMS OF THE STUDY

To assess perceived satisfaction and preparedness for clinical practice among residents and junior neurologists from Europe and neighboring countries.

MATERIAL AND METHODS

We inquired about the level of satisfaction with the quality of teaching, rotations and research opportunities of their residency program with an anonymous paper-based questionnaire. We assessed different aspects of practical training including clinical examination, diagnostic procedures, and patient management.

RESULTS

The survey revealed limited satisfaction with the overall training (47%). The quality of teaching was frequently perceived as good or excellent (73%), whereas supervision for patient care and diagnostic procedures was rated as improvable. Discontent related often to poor proficiency for neurological emergencies, diagnostic considerations, and therapeutic decisions. Whether the working time directive introduced by the European Union (EU) affected patient care or resident education or residents' quality of life remained ambiguous.

CONCLUSIONS

This cross-sectional survey disclosed shortcomings in current residency curricula. These concerned diagnostic and therapeutic procedures as well as practical skills, regardless of country, region, or institutional background. Initiatives aimed to harmonize postgraduate neurology training across Europe will need to consider these findings.

Insufficient global health education in European neurological post-graduate training: a European Association of Young Neurologists and Trainees survey

BACKGROUND AND PURPOSE

The awareness of and demand for neurological expertise in global health (GH) have emerged over recent years and have become more relevant due to the increasing numbers of refugees from developing countries arriving in Europe. This study aimed to assess the provision of GH education and opportunities for international exchange during neurology post-graduate training with a focus on Europe.

METHODS

We developed a questionnaire covering different aspects of and interest in GH education on behalf of the European Association of Young Neurologists and Trainees. Residents in neurology and junior neurologists (RJN) were approached to complete this survey.

RESULTS

Completed questionnaires were returned by 131 RJNs, of whom 65.7% were women and 84.0% were between 26 and 35 years old. In total, almost one-third (29.0%) of RJNs reported that their residency programs offered training in GH. Limited education was reported for women's or children's health and neurological disorders of immigrants and refugees, as only 22.1%, 25.2% and 22.1% of RJNs reported that such training was offered, respectively. The curriculum rarely included coverage of the global impact of neurological disorders. Definite plans to volunteer in a developing country were reported by 7.6%. The majority of the participants acknowledged the importance of GH training and international exchange during post-graduate education.

CONCLUSION

This survey corroborates the interest in and appreciation of GH education by European RJNs. However, there are shortcomings in training and opportunities for international exchange. Academic neurology and international bodies, including the European Academy of Neurology, are requested to address this.

International Issues: Cross-border mobility of junior neurologists within and to the European Union

OBJECTIVE

To assess the general interest in and motivation for cross-border mobility among residents and junior neurologists from member states of the European Union and neighboring countries.

METHODS

Questionnaire-based paper survey among 118 participants of a neurology course.

RESULTS

Ninety-seven (82%) participants returned the survey. Most of them had at one point considered relocating within or to the European Union for postgraduate education (87%) or employment (71%). Common motivations were superior prospects for clinical training (85%), resources at work and academic environment (both 80%), and remuneration (70%). Barely half of the surveyed intended to return to their home country. The attractiveness of Europe as a destination for migration was ranked over other continents. The most common reasons that reduce enthusiasm for relocation were the loss of family connection (55%) and uncertain future prospects (41%), whereas language barriers were less relevant (21%).

CONCLUSION

There is keen interest of the upcoming generation of neurologists to relocate within and to the European Union. The motives include regional differences in training and career opportunities as well as economic welfare. Appropriate steps toward the harmonization of educational and career prospects are urgently required to ensure adequate provision of neurology service and patient care throughout Europe.

The European Association of Young Neurologists and Trainees in 2013: striking a blow for European junior neurologists

BACKGROUND AND PURPOSE

The main objective of the European Association of Young Neurologists and Trainees (EAYNT), an independent Brussels-based association of junior neurologists, is to represent and promote the interests of European junior neurologists.

METHODS AND RESULTS

A wide variety of projects and activities are ongoing, carried out by members of the organization in close collaboration with major European and National Neurology bodies. Most recently, we surveyed European junior neurologists about their views on the European Board of Neurology Examination, the status of e-learning in postgraduate neurology training and migration patterns of young neurologists.

CONCLUSIONS

The aim of this paper is to outline the current and future activities of the EAYNT. We run a series of lectures ('EAYNT special sessions') at the major European conferences and disseminate information to young neurologists at the EAYNT booth. We provide information about travel grants, fellowships as well as sharing personal experiences of working abroad. EAYNT members have the opportunity to sit on the scientific subcommittees of the European Federation of Neurological Societies (EFNS) and European Neurological Society (ENS), to chair poster sessions and review abstracts. Furthermore, we continue to provide a forum for young neurologists from all over Europe to network and socialize by means of get-together events and hospital visits.