Decrease in phase slip rates and phase cone structures during seizure evolution and epileptogenic activities derived from microgrid ECoG data.

Sudden phase changes are related to cortical phase transitions, which likely change in frequency and spatial distribution as epileptogenic activity evolves. A 100 s long section of micro-ECoG data obtained before and during a seizure was selected and analyzed. In addition, nine other short-duration epileptic events were also examined.

Increased Phase Cone Turnover in 80-250 Hz Bands Occurs in the Epileptogenic Zone During Interictal Periods.

We found that phase cone clustering patterns in EEG ripple bands demonstrate an increased turnover rate in epileptogenic zones compared to adjacent regions. We employed 256 channel EEG data collected in four adult subjects with refractory epilepsy. The analysis was performed in the 80-150 and 150-250 Hz ranges.

Safety of slow-pulsed transcranial electrical stimulation in acute spike suppression.

We examined the effects of slow-pulsed transcranial electrical stimulation (TES) in suppressing epileptiform discharges in seven adults with refractory epilepsy. An MRI-based realistic head model was constructed for each subject and co-registered with 256-channel dense EEG (dEEG). Interictal spikes were localized, and TES targeted the cortical source of each subject's principal spike population.

Oscillatory Patterns of Phase Cone Formations near to Epileptic Spikes Derived from 256-Channel Scalp EEG Data.

Our objective was to determine if there are any distinguishable phase cone clustering patterns present near to epileptic spikes. These phase cones arise from episodic phase shifts due to the coordinated activity of cortical neurons at or near to state transitions and can be extracted from the high-density scalp EEG recordings. The phase cone clustering activities in the low gamma band (30-50 Hz) and in the ripple band (80-150 Hz) were extracted from the analytic phase after taking Hilbert transform of the 256-channel high density (dEEG) data of adult patients.

EEG source imaging of epileptic activity at seizure onset.

Surgical resection of the seizure onset zone (SOZ) requires that this region of the cortex is accurately localized. The onset of a seizure may be marked by transient discharges, but it also may be accompanied by oscillatory, sinusoidal electrographic activity, such as the EEG theta rhythm. However, because of the superposition of the seizure signal with other electrical signals, including noise artifacts and non-seizure brain activity, noninvasive Electrical Source Imaging (ESI) of the ictal EEG activity at seizure onset remains a challenging task for surgical planning.

A double-blind, randomised, placebo-controlled study of roxithromycin and doxycycline combination, roxithromycin alone, or matching placebo for 12 weeks in adults with frequent exacerbations of chronic obstructive pulmonary disease.

Background: Azithromycin prophylaxis has been shown to reduce COPD exacerbations but there is poor evidence for other antibiotics. We compared exacerbation rates in COPD patients with a history of frequent exacerbations (at least three moderate or severe COPD exacerbations in the past two years) during a 12-week treatment course and over a subsequent 48-week follow up period.

Results: 292 patients were randomised to one of three treatments for 12 weeks: roxithromycin 300 mg daily and doxycycline 100 mg daily (n = 101); roxithromycin 300 mg daily (n = 97); or matching placebos (n = 94).

Spatiotemporal phase clusters and phase synchronization patterns derived from high density EEG and ECoG recordings.

High density scalp EEG and subdural ECoG recordings provide an opportunity to map the electrical activity of the cortex with high spatial resolution. The spatial power spectral densities conform to a power law distribution with some nonlinear variations. The spatiotemporal patterns of phase derived from these data sets have unique features, such as, amplitude and phase modulation waves and also exhibited formation of spatial phase cluster patterns.

Auditory click stimuli evoke event-related potentials in the visual cortex.

The objective of this study was to determine whether unimodal auditory stimuli evoke event-related potentials (ERPs) in brain areas normally designated as the visual cortex (VC). The topographical distribution of ERPs evoked by auditory click stimuli was measured from (a) electroencephalographic electrodes on the scalp of six neurologically normal adult human participants and (b) intracranial electrodes implanted on the cortex of one epileptic adult human participant. In all participants, unimodal click stimuli evoked ERPs over both the auditory cortex (AC) and the VC.

Stochastic Behavior of Phase Synchronization Index and Cross-Frequency Couplings in Epileptogenic Zones during Interictal Periods Measured with Scalp dEEG.

The stochastic behavior of the phase synchronization index (SI) and cross-frequency couplings on different days during a hospital stay of three epileptic patients was studied for non-invasive localization of the epileptogenic areas from high density, 256-channel, scalp EEG (dEEG) recordings. The study was performed with short-duration (0-180 s), seizure-free, epileptiform-free, and spike-free interictal dEEG data on different days of three subjects. The seizure areas were localized with subdural recordings with an 8 × 8 macro-electrode grid array and strip electrodes.

Methods for examining electrophysiological coherence in epileptic networks.

Epilepsy may reflect a focal abnormality of cerebral tissue, but the generation of seizures typically involves propagation of abnormal activity through cerebral networks. We examined epileptiform discharges (spikes) with dense array electroencephalography (dEEG) in five patients to search for the possible engagement of pathological networks. Source analysis was conducted with individual electrical head models for each patient, including sensor position measurement for registration with MRI with geodesic photogrammetry; tissue segmentation and skull conductivity modeling with an atlas skull warped to each patient's MRI; cortical surface extraction and tessellation into 1 cm(2) equivalent dipole patches; inverse source estimation with either minimum norm or cortical surface Laplacian constraints; and spectral coherence computed among equivalent dipoles aggregated within Brodmann areas with 1 Hz resolution from 1 to 70 Hz.

Epilepsy surgery after treatment of pediatric malignant brain tumors.

Epilepsy surgery is common in the face of benign brain tumors, but rarely for patients with a history of malignant brain tumors. Seizures are a common sequelae in survivors of malignant pediatric brain tumors. Medical management alone may not adequately treat epilepsy, including in this group.

Noninvasive localization of epileptic sites from stable phase synchronization patterns on different days derived from short duration interictal scalp dEEG.

The stochastic behavior of the phase synchronization index (SI) on different days during a hospital stay of epileptic patients was studied for noninvasive localization of the epileptogenic areas from high density (256 channel) scalp EEG recordings. The study was performed on three subjects with interictal EEG data on different days. The seizure areas were localized with subdural recordings with an 8 × 8 grid electrode array.

Late-onset temporal lobe epilepsy in a patient with juvenile myoclonic epilepsy.

We report a patient with longstanding, severe juvenile myoclonic epilepsy who subsequently developed features of temporal lobe epilepsy, which gradually became clinically dominant. Over the years, there was an electrographic evolution from the typical generalised epileptiform patterns, characteristic of juvenile myoclonic epilepsy, to the novel appearance of interictal temporal spikes immediately preceding bisynchronous discharges, and subsequently to temporal intermittent rhythmic delta activity and temporal lobe-onset seizures. In this rare case of coexistent primary generalised epilepsy and focal epilepsy, the epileptic networks of the two forms of epilepsy appear to overlap.

A possible physiological basis for the discontinuity of consciousness.

A comparison is made between the frequency of local minima in the analytic power (AP) of intracranial EEG (ECoG) from waking and unconscious human subjects and the frequency of putative frames of consciousness reported in earlier psychological literature. In ECoG from unconscious subjects, the frequency of deep minima in AP is found to be a linear function of bandwidth. In contrast, in ECoG from conscious subjects, the bandwidth/minima-frequency curve saturates or plateaus at minima frequencies similar to the frequencies of previously reported frames of consciousness.

Noninvasive epileptic seizure localization from stochastic behavior of short duration interictal high density scalp EEG data.

The stochastic behavior of the phase synchronization index (SI) in different EEG bands was examined for noninvasive localization of the epileptogenic areas from the short duration (30-60 s), seizure-free and spike-free high density (256 channel) scalp EEG data. We also examined the cross-frequency and cross-electrode coupling in different EEG bands. EEG data of four subjects was used.

Behavioral states may be associated with distinct spatial patterns in electrocorticogram.

To determine if behavioral states are associated with unique spatial electrocorticographic (ECoG) patterns, we obtained recordings with a microgrid electrode array applied to the cortical surface of a human subject. The array was constructed with the intent of extracting maximal spatial information by optimizing interelectrode distances. A 34-year-old patient with intractable epilepsy underwent intracranial ECoG monitoring after standard methods failed to reveal localization of seizures.

Comparing noninvasive dense array and intracranial electroencephalography for localization of seizures.

Objective: To compare the localization of the seizure onset zone estimated from ictal recordings with high spatial resolution, 256-channel scalp dense array electroencephalographic video long-term monitoring (LTM) with the aid of source analysis with that obtained from subsequent intracranial ictal recordings.

Methods: Ten patients with medically refractory epilepsy, all surgical candidates, underwent intracranial LTM after standard noninvasive evaluation failed to provide adequate localizing information regarding ictal origins. Before invasive studies, all patients underwent dense array electroencephalographic LTM in which habitual clinical seizures were recorded for each patient.

Transition from cortical slow oscillations of sleep to spike-wave seizures.

Objective: In cats, spike-wave (SW) seizures have been observed to emerge from cortical slow oscillations (CSOs) and spindles in sleep. We examined a patient's generalized SW seizures that appeared to emerge from CSOs in sleep.

Methods: Dense array (256-channel) electroencephalographic (dEEG) data were recorded during long-term monitoring for localizing seizure onset for neurosurgical planning.

Intracranial EEG power spectra and phase synchrony during consciousness and unconsciousness.

Power density spectra and phase synchrony measurements were taken from intracranial electrode grids implanted in epileptic subjects. Comparisons were made between data from the waking state and from the period of unconsciousness immediately following a generalised tonic-clonic seizure. Power spectra in the waking state resembled coloured noise.

Evidence that juvenile myoclonic epilepsy is a disorder of frontotemporal corticothalamic networks.

The purpose of this study is to determine regions of cerebral cortex activated during the onset and propagation of dense array electroencephalographic (dEEG) epileptiform discharges in patients with juvenile myoclonic epilepsy (JME), through the use of 256 channel, dense array scalp EEG recordings. Ten patients (16-58 years old) with the clinical diagnosis of JME comprised the study group. In all cases the MRI and neurological exams were normal, while standard EEG recordings documented typical "generalized" 4-6 Hz epileptiform patterns.

Localization and classification of phonemes using high spatial resolution electrocorticography (ECoG) grids.

We present results of cortical activity during phoneme pronunciation, recorded using miniaturized electrocorticography grids with high spatial resolution. A patient implanted with the miniature grid was instructed to audibly pronounce one of four phonemes. For each phoneme, we observed distinct spatial correlation patterns at the 3mm electrode spacing.

Comparative analysis of temporal dynamics of EEG and phase synchronization of EEG to localize epileptic sites from high density scalp EEG interictal recordings.

Our objective was to examine if the high-density, 256 channel, scalp interictal EEG data can be used for localizing the epilepsy areas in patients. This was done by examining the long-range temporal correlations (LRTC) of EEGs and also that of the phase synchronization index (SI) of EEGs. It was found that the LRTC of scalp SI plots were better in localizing the seizure areas as compared with the LRTC of EEGs alone.