Biomedical subjects
Publications and source records attributed to H Eskola.
Resistivity values were measured from living human brain tissue in nine patients. A monopolar needle electrode was used with a measurement frequency of 50 kHz. Mean values were 3.51 Ohms m for grey matter and 3.91 Ohms m for white matter. Cerebrospiral fluid had a mean value of 0.80 Ohms m. Values for tumour tissues were dependent on the type of tumour and ranged from 2.30 to 9.70 Ohms m.
Two inverse algorithms were applied for solving the EEG inverse problem assuming a single dipole as a source model. For increasing the efficiency of the forward computations the lead field approach based on the reciprocity theorem was applied. This method provides a procedure to calculate the computationally heavy forward problem by a single solution for each EEG lead. A realistically shaped volume conductor model with five major tissue compartments was employed to obtain the lead fields of the standard 10-20 EEG electrode system and the scalp potentials generated by simulated dipole sources. A least-squares method and a probability-based method were compared in their performance to reproduce the dipole source based on the reciprocal forward solution. The dipole localization errors were 0 to 9 mm and 2 to 22 mm without and with added noise in the simulated data, respectively. The two different inverse algorithms operated mainly very similarly. The lead field method appeared applicable for the solution of the inverse problem and especially useful when a number of sources, e.g., multiple EEG time instances, must be solved.
The paper describes the application of new semi-automatic segmentation software to the task of detection of anatomical structures and lesion and their three-dimensional (3D) visualisation in 23 patients with secondary progressive multiple sclerosis (MS). The purpose is to study the correlation between magnetic resonance imaging (MRI) parameters (volumes of plaques and cerebrospinal fluid spaces) and clinical deficits (neurological deficits in the form of EDSS and RFSS scores, and neuropsychological deficits). The software operates in PC/Windows and PC/NeXTstep environments and utilises graphical user interfaces. Quantitative accuracy is measured by performing segmentation of fluid-filled syringes (relative error of 1.5%), and reproducibility is measured by intra- and inter-observer studies (3% and 7% variability, respectively). The mean volumes of MS plaques show significant correlations with the total RFSS scores (p = 0.04). Relative intracranial cerebrospinal fluid (CSF) space volumes show statistically significant correlation with EDSS scores (p = 0.01). The mean volume of MS plaques shows a significant correlation with the overall neuropsychological deficits (p = 0.03). 3D visualisation helps to understand the relationship of lesions to the surrounding brain structures. The use of semiautomatic segmentation techniques is recommended in the clinical diagnosis of MS patients.
The effects of tissue resistivities on EEG amplitudes were studied using an anatomically accurate computer model based on the finite difference method (FDM) and lead field analysis covering the whole brain area with 180,000 nodes. Five tissue types and three lead fields were considered for analysis. The changes in sensitivity distribution are directly comparable to changes in the potential distribution on the scalp. The results indicate that a 10% decrease in any tissue resistivity caused 3.0-4.1% differences in the sensitivity distributions of the selected EEG leads. The applied 10% decrease in the resistivity values covers only a fraction of the range of variation of 50% to 100% reported in the literature. The use of a 55% decreased skull resistivity value or a commonly applied three-compartment model increased the differences to 28% and 33%, respectively. In conclusion, both a realistic anatomy and accurate resistivity data are important in EEG head models.
Segmentation software is described, developed for medical image processing and run on Windows. The software applies basic image processing techniques through a graphical user interface. For particular applications, such as brain lesion segmentation, the software enables the combination of different segmentation techniques to improve its efficiency. The program is applied for magnetic resonance imaging, computed tomography and optical images of cryosections. The software can be utilised in numerous applications, including pre-processing for three-dimensional presentations, volumetric analysis and construction of volume conductor models.
This paper describes a segmentation method primarily developed for reconstructing resistive head models for electroencephalographic modelling purposes. The method was implemented by combining several image processing techniques, such as amplitude segmentation, region growing, and image fusion. Also a graphical user interface was developed to enable semiautomatic approach to the segmentation process. This method was developed especially for segmentation of the brain and skull from T1-weighted magnetic resonance images, but can also be applied in any segmentation procedure. The entire project was implemented successfully in a PC-based computer running the Unix/NeXTstep operating system.
It is generally believed that because the skull has low conductivity to electric current but is transparent to magnetic fields, the measurement sensitivity of the magnetoencephalography (MEG) in the brain region should be more concentrated than that of the electroencephalography (EEG). It is also believed that the information recorded by these techniques is very different. If this were indeed the case, it might be possible to justify the cost of MEG instrumentation which is at least 25 times higher than that of EEG instrumentation. The localization of measurement sensitivity using these techniques was evaluated quantitatively in an inhomogeneous spherical head model using a new concept called half-sensitivity volume (HSV). It is shown that the planar gradiometer has a far smaller HSV than the axial gradiometer. However, using the EEG it is possible to achieve even smaller HSV's than with whole-head planar gradiometer MEG devices. The micro-superconducting quantum interference device (SQUID) MEG device does have HSV's comparable to those of the EEG. The sensitivity distribution of planar gradiometers, however, closely resembles that of dipolar EEG leads and, therefore, the MEG and EEG record the electric activity of the brain in a very similar way.
Transcranial magnetic stimulation (TMS) provides a method to noninvasive excitation of the facial nerve in its intracranial segment close to the internal acoustic meatus. Thus, the site of facial nerve activation with TMS is proximal to or within the site of the lesion in Bell's palsy. To evaluate the prognostic capability of TMS in unilateral Bell's palsy we examined 137 patients with this method, and compared the results with electroneuronography (ENoG). Within 0-4 days from the onset of palsy, the patients with elicitable TMS responses recovered better than those in whom TMS responses were not elicitable. If TMS was performed 5-9 days or 10-28 days after the onset of palsy, it did not provide any prognostic information. Based on amplitude side-to-side differences, ENoG did not contribute prognostic information during the first 9 days from the onset of palsy. Later on, 10-28 days after the onset of palsy, ENoG showed an increased capability to discriminate the patients with poor prognosis. Thus, elicitable facial motor response with TMS predicts good prognosis of Bell's palsy at an early stage whereas poor response with ENoG predicts less favorable prognosis at a later stage.
The aim of this study was to examine the neuronographic findings of electrical and transcranial magnetic stimulation of the facial nerve and to compare their ability to predict clinical recovery from idiopathic facial nerve palsy (Bell's palsy). Eighty-six patients were examined clinically and neurophysiologically immediately on presentation to Tampere University Hospital. Electroneuronography (ENoG) and transcranial magnetic stimulation (TMS) were performed 1-6 times for each patient. The time interval between each examination varied from 2 to 7 days. Seventy-eight patients were followed for a median period of 13 months after the onset of palsy. Facial nerve function was graded according to the House-Brackmann grading system. Relative amplitude differences of ENoG and TMS during the acute phase were then correlated with clinical outcome. Statistical analysis of the results showed that a TMS response elicitable during the first 5 days of the palsy was correlatable with a good prognosis. ENoG results correlated with clinical outcome at a later time from onset of symptoms. TMS was well tolerated and no adverse effects were seen. These results indicate that TMS is a useful method for the early prediction of outcome in patients with Bell's palsy.
Electric transcranial stimulation (TCS) is useful for clinical studies. It is, however, painful and not generally used for awake subjects. By means of topical anaesthesia and nerve blockades we wanted to find out which structures of the scalp and cranium are sensitive to electric TCS. Altogether 21 subjects participated in the present study. Our data show that pain experienced by the subjects during electric TCS is brought about by activation of the pain receptors in the scalp under the stimulating electrodes. Topical anaesthetic cream is incapable of attenuating this pain. The periosteum does not seem to be much more sensitive electric stimulation than rest of the scalp. Furthermore, contractions of facial and neck muscles do not seem to have a significant role in pain generation in electric TCS. Pain can be prevented if sufficiently large areas of the scalp are properly anaesthetized before stimulation by e.g. blockade of the major nerves responsible for the sensation of the stimulus area.
The primary aim of the study was to determine the best electrode positions for EOG signals in vigilance studies. Two-channel recordings were conducted in analogy to the Rechtschaffen and Kales (1968) system. Twenty electrodes (10 electrode pairs) were compared. Both EOG amplitudes and amplitude asymmetries within an electrode pair were studied. The amplitude of the EOG signal is sensitive to relatively small differences in electrode position. This concerns especially distance from the eye, the direction of eye movement and the effect of the upper eye lid movement. Larger and more symmetrical EOG amplitudes were obtained for different eye movements by placing the electrodes more medially than in the conventionally used system. EOG asymmetry in different electrode positions was dependent on the eye movement direction and even on the starting and end points of a movement with equal angular degrees. Most of the data could be explained by a simple monopolar model when combined with the effects of the upper eye lid movements. The most unexpected finding was that the EOG amplitudes of the horizontal and oblique eye movements were significantly larger when the eyes were moving towards an electrode than when they were moving to the opposite direction.
The transcranial magnetic stimulation (TMS) technique makes it possible to stimulate the intracranial part of the facial nerve. In a total of 51 patients with acute Bell's palsy, TMS was performed, and the responses were compared with those elicited by conventional extracranial electric stimulation (EES). Clinical recovery was evaluated at 258-539, mean 410, days from the beginning of the palsy. With both techniques the motor evoked potentials (MEPs) could always be elicited on the healthy side, the mean latency being 4.7 ms with TMS and 3.7 ms with EES. In the acute phase, TMS elicited MEPs on the paralyzed side in 47% of the patients, and EES in 98%. The patients with TMS elicitable MEPs during the first 4 days of the palsy had significantly better recovery than those without response (p less than 0.05). The difference in recovery between patients with or without elicitable TMS responses on days 5-8 and 9-14 was not significant. In EES, the amplitude difference between the two sides within the first 4 days was not significantly (p greater than 0.05) different. On days 9-14 the patients with a less than 80% difference between the two sides recovered significantly (p less than 0.05) better than those with a difference of greater than or equal to 80%, So, TMS may be of help in the early prognosis of Bell's palsy.
Magnetic stimulation provides a method to stimulate the facial nerve transcranially. With this method, the stimulation can be directed to the intracranial part of the facial nerve, whereas conventional electric stimuli are delivered to a more peripheral part of the nerve. In 40 healthy subjects, ipsilateral responses with latencies of 4.5 +/- 0.4 ms were recorded on the nasolabial folds. The latencies were 1.1 ms longer than those elicited at the stylomastoid foramen by electric stimulation. Furthermore, a response with a mean latency of 12 ms (range 10-16 ms) appeared in 6 out of 10 healthy subjects and a polyphasic response with a mean latency of 32 ms in 9 out of 10 of these subjects. Transcranial magnetic stimulation seems to allow the examination of motor conduction through the proximal part of the facial nerve. In addition, the method may give further information concerning the facial activation mechanisms possibly by other central pathways.
Magnetic stimulation provides a new method to stimulate facial nerve transcranially. Stimulation can be directed to the intracranial part of the facial nerve, whereas the conventional electric stimuli are delivered extracranially to a more peripheral part of the nerve. Fourty healthy volunteers were examined to determine the normal responses for transcranial facial nerve stimulation. The center of the inducing coil ring was located so that its center was 3 cm posterior and 6 cm lateral to the vertex. Responses were recorded on the nasolabial fold. Latencies were 4.5 +/- 0.4 ms on both sides, being 1.1 ms longer than those elicited by electric stimulation of the nerve at the stylomastoid foramen. Amplitudes with magnetic stimuli were equal to those obtained with electric stimuli. The transcranial magnetic stimulation seems to be an accurate and promising method to examine the facial nerve.
The EEG of ten elective abdominal surgery patients was studied during halothane anaesthesia. The EEG was analysed by compressed spectral array. The total power and various power bands were analysed. Anaesthesia was induced by mask with halothane in air. EEG analysis was performed from the data collected before induction and during anaesthesia at steady states of 1 MAC, 1.5 MAC, and 2 MAC. The correlation between deepening anaesthesia and power values was strongest in the 10-14 Hz band power and in the 18-32 Hz band power. This study confirms the usefulness of high frequency power in estimating the effect of halothane in patients.
Despite the relatively wide use of flash-type stimuli in VEP studies, no universally accepted standards or methods of measurement for these stimuli are in existence. Several methods have been described for the determination of flash-intensities, however, the majority of these methods are not sufficiently rigorous, or are based on overly optimistic assumptions on the ideal nature of flash-stimulators. We describe here a simple method for the determination of flash-stimulus energies and absolute peak intensities. Our method does not require specialized optometric instrumentation, and should be readily adaptable to any modern laboratory.
This study focuses on three-dimensional (3D) presentations of medical images such as magnetic resonance (MR) images and computed tomography (CT) images. Also multimodal presentations of medical images and signals, including different visualization techniques are considered. A C++ class library together with graphical user interfaces was developed for presenting the results. The implemented software operates in PC/Windows environment. It was tested with various medical images including raw MR and CT data and segmented images, and was applied in a hospital environment. The software operates relatively fast and the quality of resulting pictures is adequate for all tested medical applications. Further applications of 3D presentations in clinical medicine are considered.
A computer model has been designed for the calculation of the electrical fields in the head, based on the finite difference method. This method has not previously been applied for head modelling. The model was validated by using three concentric spheres and comparing it with an analytic model. Three levels of accuracy were tested. The forward solutions show that the finite difference algorithm works correctly and, by selecting the size of the volume elements properly, accurate results are obtained. The model will be applied to accurate and realistic geometries of the human head obtained from magnetic resonance images.