scholarly journals Effect of sevoflurane on high-frequency brain electrical activity

2020 ◽  
Vol 6 (6) ◽  
pp. 23-28
Author(s):  
N. B. Arkhipova ◽  
M. V. Aleksandrov
Keyword(s):  
Electrical Activity ◽  
High Frequency ◽  
Slow Wave Sleep ◽  
Epileptiform Activity ◽  
Temporal Cortex ◽  
Epileptogenic Zone ◽  
Brain Electrical Activity ◽  
Surgery Outcome ◽  
Wide Range ◽  
Deep Brain

Background. In 30 % of cases with epilepsy, it qualifies as medically intractable and requires surgical treatment. The need for improvement of epilepsy surgery effectiveness demands updating of the preoperative assessment protocols. Intraoperative wide-range electrocorticography is a novel technique for defining resection volume in focal structural epilepsy. Combined analysis of high-frequency and epileptiform activity provides additional information and allows prognosticating of surgery outcome. However, consistent evaluation of intraoperative monitoring results is only possible when general anesthetic effect on brain electrical activity is taken into account.Objective. This study was aimed at evaluation of anesthetic gas sevoflurane effect on high-frequency brain electrical activity, recorded directly from the cortex or deep brain structures.Design and methods. Eight patients were included in this study (2 females, 6 males), aged 19 to 47, with a long-term epilepsy (disease duration 15 to 38 years). Prolonged electrocorticographic monitoring was indicated to these patients, combined with eloquent zones mapping in some cases. Patients were implanted with grid electrodes on frontal and temporal cortex, and deep brain Spencer electrodes into the mesial temporal lobe. Wide-range electrocorticography was recorded during slow-wave sleep and intraoperatively under sevoflurane anesthesia. Pathological high-frequency oscillations (pHFOs) rate was counted.Results. In seven patients pHFOs were recorded extraoperatively. Pathological HFO rate varied between 13 and 30 % (mean — 19 %). Distribution of pHFO did not change due to anesthesia effects. Mean background noise amplitude was significantly decreased intraoperatively (z = 2.45; p = 0.014). This effect facilitated visual marking of pHFOs. There were no trends in comparison between extraoperative and intraoperative pHFO rate.Conclusion. Well-controlled levels of general anesthesia obtained with sevoflurane (0,9-1,1 MAC) showed minimal effect on high-frequency brain electrical activity. This allows thorough analysis of wide-range electrocorticogiaphy without waking the patient and provides more information about the extension of the epileptogenic zone and its resection rate intraoperatively.

scholarly journals Association of fast ripples on intracranial EEG and outcomes after epilepsy surgery

Neurology ◽  
2020 ◽  
Vol 95 (16) ◽  
pp. e2235-e2245
Author(s):  
Päivi Nevalainen ◽  
Nicolás von Ellenrieder ◽  
Petr Klimeš ◽  
François Dubeau ◽  
Birgit Frauscher ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Slow Wave Sleep ◽  
Seizure Outcome ◽  
Incomplete Resection ◽  
Epileptogenic Zone ◽  
Poor Prognostic Factor ◽  
Individual Level ◽  
Poor Outcome ◽  
Surgery Outcome ◽  
The Individual

ObjectiveTo examine whether fast ripples (FRs) are an accurate marker of the epileptogenic zone, we analyzed overnight stereo-EEG recordings from 43 patients and hypothesized that FR resection ratio, maximal FR rate, and FR distribution predict postsurgical seizure outcome.MethodsWe detected FRs automatically from an overnight recording edited for artifacts and visually from a 5-minute period of slow-wave sleep. We examined primarily the accuracy of removing ≥50% of total FR events or of channels with FRs to predict postsurgical seizure outcome (Engel class I = good, classes II–IV = poor) according to the whole-night and 5-minute analysis approaches. Secondarily, we examined the association of low overall FR rates or absence or incomplete resection of 1 dominant FR area with poor outcome.ResultsThe accuracy of outcome prediction was highest (81%, 95% confidence interval [CI] 67%–92%) with the use of the FR event resection ratio and whole-night recording (vs 72%, 95% CI 56%–85%, for the visual 5-minute approach). Absence of channels with FR rates >6/min (p = 0.001) and absence or incomplete resection of 1 dominant FR area (p < 0.001) were associated with poor outcome.ConclusionsFRs are accurate in predicting epilepsy surgery outcome at the individual level when overnight recordings are used. Absence of channels with high FR rates or absence of 1 dominant FR area is a poor prognostic factor that may reflect suboptimal spatial sampling of the epileptogenic zone or multifocality, rather than an inherently low sensitivity of FRs.Classification of evidenceThis study provides Class II evidence that FRs are accurate in predicting epilepsy surgery outcome.

scholarly journals Features of brain electrical activity in adult patients with POLG-related disorders

2021 ◽  
Vol 12 (4) ◽  
pp. 205-215
Author(s):  
P. A. Fedin ◽  
E. P. Nuzhnyi ◽  
T. Yu. Noskova ◽  
Yu. A. Seliverstov ◽  
S. A. Klyushnikov ◽  
...  
Keyword(s):  
Electrical Activity ◽  
Epileptiform Activity ◽  
Brain Regions ◽  
Adult Patients ◽  
Brain Electrical Activity ◽  
Wave Groups ◽  
Delta Wave ◽  
Theta Waves ◽  
Delta Activity ◽  
Occipital Lobes

Introduction. Epilepsy is a common feature of mitochondrial disorders, including those associated with mutations in the POLG gene. Nevertheless, brain electrical activity features of POLG-related disorders in adult patients have not been adequately studied. Objective. To study the features and characteristics of the electroencephalography (EEG) pattern in adult patients with POLG-related disorders. Material and methods. Eight patients were examined: 7 with SANDO (Sensory Ataxic Neuropathy, Dysarthria, Ophthalmoparesis) syndrome, and 1 with MEMSA (Myoclonic Epilepsy Myopathy Sensory Ataxia) syndrome; median age was 32.5 years. All patients underwent routine EEG monitoring using a 19-channel electroencephalograph according to the generally accepted method. Results. Epileptic seizures were found in 3 patients, for 2 of them – as the first manifestation of the disease. In 6 patients, theta waves predominated in the occipital regions. Of those 6 patients, in 5 bilateral synchronous bursts of theta and delta wave groups were identified being more prominent in the frontocentral regions; 4 patients had transient non-lateralized delta activity in the occipital and parieto-occipital brain regions. In all patients, opening eyes led to the depression of rhythms and burst suppression. After photostimulation, in 2 cases bilateral synchronous bursts of delta and theta wave groups were recorded predominantly in frontal lobes. In 3 patients during hyperventilation an increase in delta activity in the occipital lobes and bilateral synchronous bursts of delta wave groups were observed. Epileptiform activity was recorded in 2 cases. Conclusion. In adult patients with POLG-related disorders, regardless of the clinical manifestation, typical EEG features include generalized background slowing, theta and delta bursts in occipital lobes with their suppression by opening eyes.

scholarly journals Identification of Epileptogenic and Non-epileptogenic High-Frequency Oscillations Using a Multi-Feature Convolutional Neural Network Model

2021 ◽  
Vol 12 ◽  
Author(s):  
Guoping Ren ◽  
Yueqian Sun ◽  
Dan Wang ◽  
Jiechuan Ren ◽  
Jindong Dai ◽  
...  
Keyword(s):  
Neural Network ◽  
Convolutional Neural Network ◽  
High Frequency ◽  
Slow Wave Sleep ◽  
Intractable Epilepsy ◽  
Wavelet Spectrum ◽  
Epileptogenic Zone ◽  
High Frequency Oscillations ◽  
Scale Transformations ◽  
Better Than

Accurately identifying epileptogenic zone (EZ) using high-frequency oscillations (HFOs) is a challenge that must be mastered to transfer HFOs into clinical use. We analyzed the ability of a convolutional neural network (CNN) model to distinguish EZ and non-EZ HFOs. Nineteen medically intractable epilepsy patients with good surgical outcomes 2 years after surgery were studied. Five-minute interictal intracranial electroencephalogram epochs of slow-wave sleep were selected randomly. Then 5 s segments of ripples (80–200 Hz) and fast ripples (FRs, 200–500 Hz) were detected automatically. The EZs and non-EZs were identified using the surgery resection range. We innovatively converted all epochs into four types of images using two scales: original waveforms, filtered waveforms, wavelet spectrum images, and smoothed pseudo Wigner–Ville distribution (SPWVD) spectrum images. Two scales were fixed and fitted scales. We then used a CNN model to classify the HFOs into EZ and non-EZ categories. As a result, 7,000 epochs of ripples and 2,000 epochs of FRs were randomly selected from the EZ and non-EZ data for analysis. Our CNN model can distinguish EZ and non-EZ HFOs successfully. Except for original ripple waveforms, the results from CNN models that are trained using fixed-scale images are significantly better than those from models trained using fitted-scale images (p &lt; 0.05). Of the four fixed-scale transformations, the CNN based on the adjusted SPWVD (ASPWVD) produced the best accuracies (80.89 ± 1.43% and 77.85 ± 1.61% for ripples and FRs, respectively, p &lt; 0.05). The CNN using ASPWVD transformation images is an effective deep learning method that can be used to classify EZ and non-EZ HFOs.

scholarly journals Altered sleep intensity upon DBS to hypothalamic sleep-wake centers in rats

2021 ◽  
Author(s):  
Sophie Masneuf ◽  
Lukas L. Imbach ◽  
Fabian Buechele ◽  
Giovanni Colacicco ◽  
Marco Penner ◽  
...  
Keyword(s):  
High Frequency ◽  
Slow Wave Sleep ◽  
Spectral Power ◽  
High Frequency Stimulation ◽  
Delta Power ◽  
Bipolar Stimulation ◽  
Frequency Stimulation ◽  
Ventrolateral Preoptic Nucleus ◽  
And Behavior ◽  
Deep Brain

Deep brain stimulation (DBS) has been scarcely investigated in the field of sleep research. We hypothesize that DBS onto hypothalamic sleep- and wake-promoting centers will produce significant neuromodulatory effects, and potentially become a therapeutic strategy for patients suffering severe, drug-refractory sleep-wake disturbances. We aimed to investigate whether continuous electrical high-frequency DBS, such as that often implemented in clinical practice, in the ventrolateral preoptic nucleus (VLPO) or the perifornical area of the posterior lateral hypothalamus (PeFLH), significantly modulates sleep-wake characteristics and behavior. We implanted healthy rats with electroencephalographic/electromyographic electrodes and recorded vigilance states in parallel to bilateral bipolar stimulation of VLPO and PeFLH at 125 Hz at 90 microA over 24 h to test the modulating effects of DBS on sleep-wake proportions, stability and spectral power in relation to baseline. We unexpectedly found that VLPO DBS at 125 Hz deepens slow-wave sleep as measured by increased delta power, while sleep proportions and fragmentation remain unaffected. Thus, the intensity, but not the amount of sleep or its stability, is modulated. Similarly, the proportion and stability of vigilance states remained altogether unaltered upon PeFLH DBS but, in contrast to VLPO, 125 Hz stimulation unexpectedly weakened SWS, evidenced by reduced delta power. This study provides novel insights into non-acute functional outputs of major sleep-wake centers in the rat brain in response to electrical high-frequency stimulation, a paradigm frequently used in human DBS. In the conditions assayed, while exerting no major effects on sleep-wake architecture, hypothalamic high-frequency stimulation arises as a provocative sleep intensity-modulating approach.

scholarly journals Altered sleep intensity upon DBS to hypothalamic sleep–wake centers in rats

2021 ◽  
Vol 12 (1) ◽  
pp. 611-625
Author(s):  
Sophie Masneuf ◽  
Lukas L. Imbach ◽  
Fabian Büchele ◽  
Giovanni Colacicco ◽  
Marco Penner ◽  
...  
Keyword(s):  
High Frequency ◽  
Slow Wave Sleep ◽  
Spectral Power ◽  
High Frequency Stimulation ◽  
Delta Power ◽  
Bipolar Stimulation ◽  
Frequency Stimulation ◽  
Ventrolateral Preoptic Nucleus ◽  
And Behavior ◽  
Deep Brain

Abstract Deep brain stimulation (DBS) has been scarcely investigated in the field of sleep research. We hypothesize that DBS onto hypothalamic sleep- and wake-promoting centers will produce significant neuromodulatory effects and potentially become a therapeutic strategy for patients suffering severe, drug-refractory sleep–wake disturbances. We aimed to investigate whether continuous electrical high-frequency DBS, such as that often implemented in clinical practice, in the ventrolateral preoptic nucleus (VLPO) or the perifornical area of the posterior lateral hypothalamus (PeFLH), significantly modulates sleep–wake characteristics and behavior. We implanted healthy rats with electroencephalographic/electromyographic electrodes and recorded vigilance states in parallel to bilateral bipolar stimulation of VLPO and PeFLH at 125 Hz and 90 µA over 24 h to test the modulating effects of DBS on sleep–wake proportions, stability and spectral power in relation to the baseline. We unexpectedly found that VLPO DBS at 125 Hz deepens slow-wave sleep (SWS) as measured by increased delta power, while sleep proportions and fragmentation remain unaffected. Thus, the intensity, but not the amount of sleep or its stability, is modulated. Similarly, the proportion and stability of vigilance states remained altogether unaltered upon PeFLH DBS but, in contrast to VLPO, 125 Hz stimulation unexpectedly weakened SWS, as evidenced by reduced delta power. This study provides novel insights into non-acute functional outputs of major sleep–wake centers in the rat brain in response to electrical high-frequency stimulation, a paradigm frequently used in human DBS. In the conditions assayed, while exerting no major effects on the sleep–wake architecture, hypothalamic high-frequency stimulation arises as a provocative sleep intensity-modulating approach.

Fit Vs Faint: Assessing Work Causation in “Idiopathic Fall” Cases

2014 ◽  
Vol 19 (5) ◽  
pp. 3-12
Author(s):  
Lorne Direnfeld ◽  
David B. Torrey ◽  
Jim Black ◽  
LuAnn Haley ◽  
Christopher R. Brigham
Keyword(s):  
Blood Flow ◽  
Electrical Activity ◽  
Loss Of Consciousness ◽  
Brain Electrical Activity ◽  
Medical Terminology ◽  
Scientific Analysis ◽  
Medical Causation ◽  
The Individual ◽  
The Brain ◽  
Current Science

Abstract When an individual falls due to a nonwork-related episode of dizziness, hits their head and sustains injury, do workers’ compensation laws consider such injuries to be compensable? Bearing in mind that each state makes its own laws, the answer depends on what caused the loss of consciousness, and the second asks specifically what happened in the fall that caused the injury? The first question speaks to medical causation, which applies scientific analysis to determine the cause of the problem. The second question addresses legal causation: Under what factual circumstances are injuries of this type potentially covered under the law? Much nuance attends this analysis. The authors discuss idiopathic falls, which in this context means “unique to the individual” as opposed to “of unknown cause,” which is the familiar medical terminology. The article presents three detailed case studies that describe falls that had their genesis in episodes of loss of consciousness, followed by analyses by lawyer or judge authors who address the issue of compensability, including three scenarios from Arizona, California, and Pennsylvania. A medical (scientific) analysis must be thorough and must determine the facts regarding the fall and what occurred: Was the fall due to a fit (eg, a seizure with loss of consciousness attributable to anormal brain electrical activity) or a faint (eg, loss of consciousness attributable to a decrease in blood flow to the brain? The evaluator should be able to fully explain the basis for the conclusions, including references to current science.

scholarly journals High-fidelity transmission of high-frequency burst stimuli from peripheral nerve to thalamic nuclei in children with dystonia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Estefanía Hernandez-Martin ◽  
Enrique Arguelles ◽  
Yifei Zheng ◽  
Ruta Deshpande ◽  
Terence D. Sanger
Keyword(s):  
Deep Brain Stimulation ◽  
Peripheral Nerve ◽  
Brain Stimulation ◽  
High Frequency ◽  
Sensory Information ◽  
Brain Structures ◽  
High Fidelity ◽  
Thalamic Nuclei ◽  
Frequency Burst ◽  
Deep Brain

AbstractHigh-frequency peripheral nerve stimulation has emerged as a noninvasive alternative to thalamic deep brain stimulation for some patients with essential tremor. It is not known whether such techniques might be effective for movement disorders in children, nor is the mechanism and transmission of the peripheral stimuli to central brain structures understood. This study was designed to investigate the fidelity of transmission from peripheral nerves to thalamic nuclei in children with dystonia undergoing deep brain stimulation surgery. The ventralis intermediate (VIM) thalamus nuclei showed a robust evoked response to peripheral high-frequency burst stimulation, with a greatest response magnitude to intra-burst frequencies between 50 and 100 Hz, and reliable but smaller responses up to 170 Hz. The earliest response occurred at 12–15 ms following stimulation onset, suggesting rapid high-fidelity transmission between peripheral nerve and thalamic nuclei. A high-bandwidth, low-latency transmission path from peripheral nerve to VIM thalamus is consistent with the importance of rapid and accurate sensory information for the control of coordination and movement via the cerebello-thalamo-cortical pathway. Our results suggest the possibility of non-invasive modulation of thalamic activity in children with dystonia, and therefore the possibility that a subset of children could have beneficial clinical response without the need for invasive deep brain stimulation.

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