Assessment Of Cerebral Function Research Articles

Neurophysiological features in patients with psychopathological disorders in the right hemisphere stroke

Neurophysiological changes and functional activity of the brain on the electroencephalogram after a cerebral infarction reflect the direct electromagnetic activity of neurons that can be measured in the affected areas of the brain. EEG signals provide a non-invasive and sensitive indicator of brain function during mental processes. Its main use is in the assessment of cerebral function, and not in the detection of structural abnormalities. There is a lot of evidence that the analysis of the electrical fields of the brain can detect changes in the behavior of brain signals in neurological patients. The aim of the study was to establish correlational relationships between the development of psychopathological disorders and neurophysiological changes using EEG in right hemisphere stroke. The subject of the study was neglect and its relationship with neurophysiological changes and functional activity of the brain. Twenty-three patients with a right-hemisphere stroke who were undergoing inpatient treatment in the medical and diagnostic department No. 1 of the LORITOM PE. The correlation of the reduced α-index in patients with manifestations of unilateral neglect on the background curve was determined in the cohort of subjects. Moderate irritation phenomena was noted closer to the center in the parietal and to the right in the temporal and parietal leads in patients with neglect syndrome. While without manifestations of hemineglect, moderate phenomena of irritation was noted mainly parasagittal and on the left. A trend of slow-wave activity in the frontal areas in patients with neglect syndrome has been demonstrated. The prospect of further research in the field of psychopathological disorders is shown which will significantly increase the efficiency of diagnosis and treatment and as a result increase the degree of restoration of impaired functions of post-stroke patients, the level of their social and everyday adaptation and accordingly the quality of life. Keywords: electroencephalography, unilateral neglect, hemineglect.

Utilization of EEG in A Teaching Hospital: A Descriptive Cross-Sectional Study

INTRODUCTION Electroencephalography is a safe, convenient, non-invasive, and inexpensive technique that allows assessment of cerebral function and detects physiological manifestations of abnormal cortical excitability. Published literature about its utilization and application is sparse from this part of the world. 
 METHODOLOGY It is a descriptive, cross-sectional study conducted in Nepalgunj Medical College, Kohalpur, Nepal. All the subjects referred for EEG evaluation from January 2019 to December 2020 (two years) were enrolled and EEG was performed. A self-designed proforma was used to record different variables and data was analyzed using Statistical Package for the Social Sciences version 21.0 for Windows.
 RESULT Of total 246 subjects, 53.3% were male and 58.9% of the subjects were 20 years or younger by age. Maximum (35.8%) number of referrals came from the department of psychiatry. Generalized seizure discharge was the most common EEG diagnosis and presence of seizure activity was noted in 37%of patients.
 CONCLUSION EEG is utilized by different specialities commonly for seizure disorder, psychiatric disorders and headaches.

Interleukin-6 Receptor Antibodies for Modulating the Systemic Inflammatory Response after Out-of-Hospital Cardiac Arrest (IMICA): study protocol for a double-blinded, placebo-controlled, single-center, randomized clinical trial

BackgroundResuscitated out-of-hospital cardiac arrest (OHCA) patients who remain comatose at admission are at high risk of morbidity and mortality. This has been attributed to the post-cardiac arrest syndrome (PCAS) which encompasses multiple interacting components, including systemic inflammation. Elevated levels of circulating interleukin-6 (IL-6), a pro-inflammatory cytokine, is associated with worse outcomes in OHCA patients, including higher vasopressor requirements and higher mortality rates. In this study, we aim to reduce systemic inflammation after OHCA by administering a single infusion of tocilizumab, an IL-6 receptor antibody approved for use for other indications.MethodsInvestigator-initiated, double-blinded, placebo-controlled, single-center, randomized clinical trial in comatose OHCA patients admitted to an intensive cardiac care unit. Brief inclusion criteria: OHCA of presumed cardiac cause, persistent unconsciousness, age ≥ 18 years. Intervention: 80 patients will be randomized in a 1:1 ratio to a single 1-h intravenous infusion of either tocilizumab or placebo (NaCl). During the study period, patients will receive standard of care, including sedation and targeted temperature management of 36 ° for at least 24 h, vasopressors and/or inotropes as/if needed, prophylactic antibiotics, and any additional treatment at the discretion of the treating physician. Blood samples are drawn for measurements of biomarkers included in the primary and secondary endpoints during the initial 72 h. Primary endpoint: reduction in C-reactive protein (CRP). Secondary endpoints (abbreviated): cytokine levels, markers of brain, cardiac, kidney and liver damage, hemodynamic and hemostatic function, adverse events, and follow-up assessment of cerebral function and mortality.DiscussionWe hypothesize that reducing the effect of circulating IL-6 by administering an IL-6 receptor antibody will mitigate the systemic inflammatory response and thereby modify the severity of PCAS, in turn leading to lessened vasopressor use, more normal hemodynamics, and better organ function. This will be assessed by primarily focusing on hemodynamics and biomarkers of organ damage during the initial 72 h.In addition, pro-inflammatory and anti-inflammatory cytokines will be measured to assess if cytokine patterns are modulated by IL-6 receptor blockage.Trial registrationClinicalTrials.gov Identifier: NCT03863015; submitted February 22, 2019, first posted March 5, 2019.EudraCT: 2018-002686-19; date study was authorized to proceed: November 7, 2018.

Electroencephalogram Analysis

Cerebral hemorrhage may cause cognitive dysfunction. Electroencephalogram (EEG) is a noninvasive diagnostic tool for assessment of cerebral function. A total of 174 patients (including cognitively impaired and cognitively normal) with cerebral hemorrhage, and 120 healthy persons (CN), were recruited between August 2008 and July 2012 at the Department of Neurology. EEG was used to analyze cerebral function of patients and normal persons. Correlation, clustering and concordance analyses were performed to analyze the relationship between EEG power and Montreal Cognitive Assessment (MoCA) scores. Cognitively impaired patients had a significantly decreased EEG beta power (0.793 ± 0.176 µV(2)) compared with cognitively normal patients (1.589 ± 0.205 µV(2), P < .01) or healthy persons (1.651 ± 0.185 µV(2), P < .01). Significantly negative correlations between beta power and hemorrhage region, size, amount, and patients' age were apparent (r = -0.91888, -0.78569, -0.84961, and -0.80365, respectively, all Ps < .001). There was good concordance between the K-means clustering algorithm calculating beta power and MoCA scoring (κ = .904, P < .001). In conclusion, the analysis method of EEG (beta power) abnormalities holds considerable promise to assess cognitive impairment after cerebral hemorrhage. Cognitive impairment was negatively correlated to hemorrhage region, size, amount, and age.

PREDICTIVE VALUE OF AMPLITUDE-INTEGRATED ELECTROENCEPHALOGRAPHY ON OUTCOME IN NEONATAL EXTRACORPOREAL MEMBRANE OXYGENATION

INTRODUCTION: The early and accurate assessment of cerebral function in neonates who undergo extracorporeal membrane oxygenation (ECMO) may identify high-risk infants who are amenable to neuroprotective strategies or, at least, in need of more detailed neuroimaging and neurodevelopmental follow-up. OBJECTIVE: The specific aims of this study were to assess the clinical utility and long-term predictive value of amplitude-integrated electroencephalography (aEEG) in neonatal ECMO. METHODS: Thirty-four infants who required ECMO for respiratory failure were enrolled in the study prospectively. Serial aEEGs were recorded before, during, and after ECMO and classified by 2 independent interpreters on the basis of background pattern and amplitude criteria. Surviving infants were followed up to 18 to 22 months and assessed with a structured neurologic examination and formal developmental testing by using the Bayley Scales of Infant Development II. The primary outcome was death or neurodevelopmental impairment (defined as moderate-to-severe cerebral palsy and/or a Mental Developmental Index or Psychomotor Development Index score of &amp;lt;70). RESULTS: Preliminary data analysis on the first 20 patients was performed. Thirteen patients survived, 3 died while on ECMO, and 4 died before discharge. All surviving infants were evaluated at follow-up. A severely abnormal aEEG predicted death or moderate-to-severe neurodevelopmental impairment with a sensitivity of 0.85 (95% confidence interval [CI]: 0.70–0.95), a specificity of 0.57 (95% CI: 0.3–0.76), a positive predictive value of 0.79 (95% CI: 0.65–0.88), and a negative predictive value of 0.67 (95% CI: 0.35–0.88). CONCLUSIONS: aEEG is a useful neuromonitoring tool during neonatal ECMO.

Stroke rehabilitation in a patient with cerebellar cognitive affective syndrome

Objective: It has become evident that the cerebellum plays a role in cognitive function, and Schmahmann et al. have introduced the term “Cerebellar cognitive affective syndrome (CCAS).” In the present paper we report a patient with cerebellar hemorrhage who developed CCAS.Design: A case study.Methods: The patient was a 61-year-old right-handed man who was admitted to our hospital because of sudden headache, dizziness and vomiting. The patient showed ataxia of the trunk and the extremities, but no paralysis and disturbance of sensation. He was disoriented in time and showed recent memory disturbance, disturbance of attention, impairment of executive functions and reduced volition, and due to these symptoms, his daily living was also severely impaired.Results: With the aim of returning home, the patient received exercise therapy and cognitive rehabilitation, while home modification was performed, and living at home under the supervision of his family became possible. Cognitive function improved, while memory and attention disturbance, impairment of executive function remained.Conslusion: Cognitive dysfunction in patients with cerebellar damage is assumed to develop from disturbance of the cerebrocerebellar circuit, and that rehabilitation of these patients must include assessment of not only the motor function, but also of detailed assessment of cerebral function.

Use of the Wavelength Differential Method to Eliminate Baseline Drift in the Assessment of Cerebral Function Using NIRS

Use of the Wavelength Differential Method to Eliminate Baseline Drift in the Assessment of Cerebral Function Using NIRS

Monitoring of head injury by myotatic reflex evaluation

OBJECTIVES(1) To establish the feasibility of myotatic reflex measurement in patients with head injury. (2) To test the hypothesis that cerebral dysfunction after head injury causes myotatic reflex abnormalities through...

Electroencephalography.

Notwithstanding recent advances in neuroimaging, EEG remains a major technique for investigation of the brain. Its main applications are in assessment of cerebral function rather than for detecting structural abnormalities. The principal clinical applications are in epilepsy, states of altered consciousness including postanoxic and traumatic coma, the parasomnias, dementias, toxic confusional states, cerebral infections, and various other encephalopathies. Abnormalities in EEG reflect general pathophysiological processes, raised intracranial pressure, cerebral anoxia, or oedema, epileptogenesis etc, and show little specificity for a particular disease. Consequently, they need to be interpreted in a particular clinical context; the use of routine EEG examination for screening purposes is rarely of value. Conversely, the investigation becomes most cost effective when applied to specific problems--for instance, monitoring serial changes in postanoxic coma or during open heart surgery, differential diagnosis (by telemetric ictal recordings) of epileptic and non-epileptic attacks, and providing early prediction of outcome after stroke. High technological standards and an individualised problem solving approach are prerequisites of a cost effective, reliable clinical EEG service. These are most likely to be achieved by a considered, selective referral policy, the use where necessary of prolonged complex procedures such as telemetry, and the avoidance of routine examinations of dubious clinical relevance.

The assessment of cerebral function during paediatric cardiopulmonary bypass.

The assessment of cerebral function during paediatric cardiopulmonary bypass.

Utility of serial EEGs in neonates during extracorporeal membrane oxygenation

We found electroencephalographic (EEG) studies to be useful for monitoring cerebral function, for confirming seizure activity, and for limited prediction of short-term outcome in 145 neonates who required extra-corporeal membrane oxygenation (ECMO) of reversible respiratory failure. The EEG tracings were classified as normal or as mildly, moderately, or markedly abnormal; abnormal recordings were further classified as focal, diffuse, or predominantly lateralized. A significant decrease in frequency and degree of EEG abnormalities was observed in recordings obtained after ECMO compared to those obtained prior to ( P = .001) or during ECMO ( P = .001). There was no significant increase in marked EEG abnormalities when recordings obtained before and during ECMO were compared ( P = 0.41). Of 11 infants with electrographic seizures during ECMO, 7 (64%) either died during their nursery courses or were developmentally handicapped at age 1 year which is a significantly greater adverse outcome than that observed in infants without EEG seizure activity ( P < .003). No consistently lateralized EEG abnormalities were observed during or after ECMO when compared to tracings obtained before cannulation of the right common carotid artery. There was no acute change in EEG rhythm or amplitude over the right cerebral hemisphere during right common carotid artery cannulation. Our observations support the value of serial EEG in the assessment of cerebral function in critically ill infants undergoing ECMO. They further suggest that, in this patient population, cannulation of the right common carotid artery is a safe procedure that does not result in lateralized abnormalities of cerebral electrical activity.

The assessment of cerebral function.

The assessment of cerebral function.

The EEG in Acute Cerebral Anoxia: Assessment of Cerebral Function and Prognosis in Patients Resuscitated After Cardio-respiratory Arrest

Back to table of contents Previous article Next article ArticleNo AccessThe EEG in Acute Cerebral Anoxia: Assessment of Cerebral Function and Prognosis in Patients Resuscitated After Cardio-respiratory ArrestCHARLES E. HENRYCHARLES E. HENRYSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.132.6.682AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail "The EEG in Acute Cerebral Anoxia: Assessment of Cerebral Function and Prognosis in Patients Resuscitated After Cardio-respiratory Arrest." American Journal of Psychiatry, 132(6), p. 682 Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited ByNone Volume 132Issue 6 June 1975Pages 682-682 Metrics PDF download History Published online 1 April 2006 Published in print 1 June 1975

Head injury with suspected subdural hematoma. Effect on EEG.

MORE than a century ago, Virchow 1 pointed out the difficult problems often encountered when attempting to diagnose subdural hemorrhage. Unfortunately, not all of the problems have been solved. The electroencephalogram now has become a valuable and practical supplement to the clinical neurologic evaluation for diagnosis of intracranial lesions, and it has been widely used for assessment of cerebral function after head injury. In 1940 Jasper and co-workers 2 found low-amplitude activity in EEGs recorded from scalp areas overlying subdural hematomas; in the same year Walter 3 reported the occurrence of abnormal slow (delta) activity overlying epidural hematomas. Since that time, most investigators have found a high proportion of abnormal EEGs associated with either subdural or epidural hematomas, 4,5 but there has been disagreement regarding the relative importance of the different types of EEG abnormality for diagnosis and localization of these lesions. Some authors 6-12 have emphasized the localizing

Cerebral effects of experimental hypothermia.

SINCE hypothermia was first suggested as a technique which would permit intracardiac surgery under direct vision,* the possibility of a deleterious effect of the low body temperatures upon the brain has been considered. It has been observed that animals † and humans ‡ enter a narcotic state when the rectal temperatures fall below 30 C. Although no gross cerebral damage has been noted from simple cooling in dogs, it was considered expedient to study the cerebral effects of cooling more carefully and to search for any evidence of permanent injury to the central nervous system. Monkeys, being the highest order of animals available, were chosen for this study. Survival rate, electroencephalographic changes, behavior test performance, reflexes, and changes in cardiovascular and respiratory control were selected as factors in the assessment of cerebral function. Simpson7investigated the effects of lowering the body temperature of the monkey under ether anesthesia, with