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J M Guérit

Publications and source records attributed to J M Guérit.

At least 19 recordsLinked to original sources
PubMed2006

Analysis of EEG tracings in frequency and time domain in hepatic encephalopathy.

Spectral EEG analysis in hepatic encephalopathy (HE) is usually performed disregarding the effect of epoch length, statistical errors and equipment noise. A study on these items was carried out. In addition, spectral analysis and a new analysis, performed in time domain, were compared in the assessment of HE. The EEG tracings of 73 cirrhotic patients with HE were analyzed. Artifact-free periods of about 1 min were selected. Equipment noise was measured by short-circuiting all the electrodes. The equipment noise was notable below 1.5 Hz; the best epoch length was 4s and the statistical errors were minimal for the band with the highest relative power. Nineteen per cent of the tracings were unstable. The spectral values were found to be related to liver function and to the degree of HE, whereas the relationship with psychometric variables was poor. The indexes computed by time-domain analysis were found to be better related to psychometric findings. We have provided information on the optimisation of spectral EEG analysis and presented a time-domain analysis giving results related to psychometric tests and liver function.

Aged↗
PubMed2005

Microsurgical results with large vestibular schwannomas with preservation of facial and cochlear nerve function as the primary aim.

OBJECTIVE: To evaluate our microsurgical results in dealing with vestibular schwannomas (VS) greater than or equal to 30 mm when preservation of cranial nerve function was considered more important than total tumour removal. METHODS: Sixteen consecutive cases were operated on by the same neurosurgeon according to a prospective protocol using intraoperative neuro-monitoring (IONM) based on electromyographic and brain stem auditory evoked potential recordings. Facial nerve function was evaluated on the House-Brackmann Scale and cochlear nerve function on the Gardner-Robertson Scale. Someone not involved in the clinical management of our patients collected all data. RESULTS: Fifteen patients showed facial nerve (FN) function of House-Brackmann grade (HBG) I or II at one year postoperatively and one kept the HBG IV she had preoperatively. Two patients of four maintained a cochlear nerve function of Gardner-Robertson grade (GRG) II. The tumour excision rates were: total, 68.7%; near total, 6.3%; subtotal, 18.7%, and partial, 6.3%. The average follow-up was 55 months (1-106). Three patients underwent radiotherapy later with growth stabilisation and no additional morbidity. CONCLUSION: When dealing with VS greater than or equal to 30 mm, microsurgery guided by IONM, with a rate of total or near-total tumour excision of about 75%, can retain socially acceptable facial nerve function (HBG I or II) in all cases and serviceable hearing (GRG I or II) in two cases out of four. Maintaining serviceable cranial nerve function should take precedence over total tumour excision.

Adult↗
PubMed2005

Automatic evaluation of the exteroceptive suppression of the temporalis muscle activity.

AIM: To set up a reliable automated method of allowing to identify the ES1 and ES2 periods of exteroceptive suppression of the temporal muscle (EST), thereby reducing their intra- and inter-individual variability. MATERIALS AND METHODS: Analyses were performed in 79 healthy subjects with strict inclusion and exclusion criteria. Each individual underwent two separate examinations 1 week apart. Activity of the left and right temporal muscles was recorded in response to unilateral stimulation of the left and right labial commissures. Wave forms were successively rectified, averaged, and filtered; the intersections of the resulting curve with values corresponding to 50%, 60%, 70%, 75%, and 80% of the control period (20 ms preanalysis time) were automatically determined. RESULTS: All subjects reached a 80% level of attenuation for ES2. The values of ES2 durations were normally distributed. The mean ES1 and ES2 durations didn't vary between the two recording session, and there was a good individual reproducibility from one session to the other. Though relatively high, the inter-individual variability was slightly lower in the second than in the first session. CONCLUSIONS: Computed analysis of EST may contribute to decrease inter- and intra-individual test variability. Letting patient habituate through a first recording session could increase test sensitivity, too. The obtained values for ES2 duration are normally distributed and well-reproducible at both the population and individual level. We suggest taking into account both ES2 duration and level of attenuation.

Adult↗
PubMed2005

Event-related potentials (ERPs) in ecstasy (MDMA) users during a visual oddball task.

Ecstasy is the common name for a drug mainly containing a substance identified as 3,4-methylenedioxymethamphetamine (MDMA). It has become popular with participants in "raves", because it enhances energy, endurance and sexual arousal, together with the widespread belief that MDMA is a safe drug [Byard, R.W., Gilbert, J., James, R., Lokan, R.J., 1998. Amphetamine derivative fatalities in South Australia. Is "ecstasy" the culprit? Am. J. Forensic Med. Pathol. 19, 261-265]. However, it is suggested that this drug causes a neurotoxicity to the serotonergic system that could lead to permanent physical and cognitive problems. In order to investigate this issue, and during an ERP recording with 32 channels, we used a visual oddball design, in which subjects (14 MDMA abusers and 14 paired normal controls) saw frequent stimuli (neutral faces) while they had to detect as quickly as possible rare stimuli with happy or fearful expression. At a behavioral level, MDMA users imply longer latencies than normal controls to detect rare stimuli. At the neurophysiological level, ERP data suggest as main result that the N200 component, which is involved in attention orienting associated to the detection of stimulus novelty (e.g. [Campanella, S., Gaspard, C., Debatisse, D., Bruyer, R., Crommelinck, M., Guerit, J.M., 2002. Discrimination of emotional facial expression in a visual oddball task: an ERP study. Biol. Psychol. 59, 171-186]), shows shorter latencies for fearful rare stimuli (as compared to happy ones), but only for normal controls. This absence of delay was interpreted as an attentional deficit due to MDMA consumption.

Adult↗
PubMed2004

Human gender differences in an emotional visual oddball task: an event-related potentials study.

Pictures from the Ekman and Friesen series were used in an event-related potentials study to define the timing of occurrence of gender differences in the processing of positive (happy) and negative (fear) facial expressions. Ten male and 10 female volunteers were confronted with a visual oddball design, in which they had to detect, as quickly as possible, deviant happy or fearful faces amongst a train of standard stimuli (neutral faces). Behavioral results suggest that men and women detected fearful faces more quickly than happy ones. The main result is that the N2b component, functionally considered as an attentional orienting mechanism, was delayed in men for happy stimuli as compared with fearful ones. Gender differences observed in the processing of emotional stimuli could then originate at the attentional level of the information processing system.

Adult↗
PubMed2004

Refractoriness cannot explain why C-fiber laser-evoked brain potentials are recorded only if concomitant Adelta-fiber activation is avoided.

Co-activation of Adelta- and C-fiber nociceptors by brief cutaneous laser heat stimuli may induce a dual sensation composed of first and second pain but evokes only a single, Adelta-fiber related, late laser-evoked potential (LEP). Yet, when concomitant activation of Adelta-nociceptors is avoided, C-nociceptor activation evokes an ultra-late LEP. As cumulating evidence indicates that late and ultra-late LEPs may share common generators, investigators have hypothesized that when Adelta-fibers trigger a late LEP, the later arriving C-fiber afferent volley cannot trigger an ultra-late LEP because underlying generators are in a 'refractory state'. Better understanding of these interactions could have important consequences regarding the functional significance of LEPs. Therefore, this hypothesis was tested by applying two consecutive laser stimuli to the hand dorsum such as to produce a second Adelta-nociceptor afferent volley arriving at generators during their expected 'refractory period'. Results showed that late LEPs evoked by the second stimulus were not altered and consequently that this hypothesis does not hold. In addition, when stimuli ended the sensory detection task, an ample P600 component was recorded. Studies have shown that this component is probably related to the P3b component described in other sensory modalities. This result provides support to the 'context closure' model hypothesizing that this component reflects the closure of information processing occurring when expectations are terminated. Altogether, these results suggest that late and ultra-late LEPs reflect very general processes, which are mainly related to detection and orientation and constitute only a fraction of the central processing of both nociceptive inputs.

Adult↗
PubMed2003

Non-phase locked electroencephalogram (EEG) responses to CO2 laser skin stimulations may reflect central interactions between A partial partial differential- and C-fibre afferent volleys.

OBJECTIVE: By co-activating A partial partial differential- and C-fibre nociceptors, intense CO2 laser heat stimuli produce a dual sensation, composed of first and second pain, but induce only a single A partial partial differential-fibre related late laser evoked potential (LEP). However, when avoiding concomitant activation of A partial partial differential-fibres, C-fibre related ultra-late LEPs are recorded. This poorly understood phenomenon was re-investigated using a method which, unlike time-domain averaging, reveals electroencephalogram (EEG) changes whether or not phase-locked to stimulus onset. METHODS: CO2 laser stimuli were applied to the dorsum of the hand. Reaction-time was used to discriminate between A partial partial differential- and C-fibre mediated detections. Analyses were performed using a method based on the time-frequency wavelet transform of EEG epochs. RESULTS: This study revealed: (1) a novel non-phase-locked component related to the activation of A partial partial differential-fibres occurring at similar latencies as the late LEP; and (2) a widespread post-stimulus event-related desynchronization (ERD) induced by both A partial partial differential- and C-fibres. CONCLUSIONS: A partial partial differential- and C-fibre related LEPs could be electrophysiological correlates of similar brain processes, which, when already engaged by A partial partial differential-fibres, cannot or do not need to be reactivated by the later arriving C-fibre afferent volley. A partial partial differential-fibre related ERD could reflect a transient change of state of brain structures generating these responses.

Adult↗
PubMed2001

No evidence of auditory dysfunction in guinea pigs immunized with myelin P0 protein.

Recent data have focused on the peripheral nerve myelin glycoprotein P0 as a putative autoantigen involved in the autoimmune etiology of some cases of Meniere's disease, idiopathic sensorineural hearing loss and sudden deafness. To determine whether antibodies to myelin P0 can alter cochlear function, 13 healthy guinea pigs were immunized with purified porcine myelin P0 while 10 controls were injected with saline water. The animals were then evaluated for evidence of evolving inner ear disease using immunological, electrophysiological and morphological methods. Twenty-six experimental ears were tested weekly with a brainstem auditory evoked potential technique for a period of 4 months and were compared to 20 control ears. Uniformly, all P0-sensitized guinea pigs showed antibodies to myelin protein P0 as evidenced by ELISA. Clinical signs of inflammatory demyelination were not discernible in P0-sensitized guinea pigs and all the animals were qualitatively normal. No significant increase of evoked potential thresholds was found in the P0-sensitized animals when compared to controls (P>0.05). Peak latencies of waves I, II, III, IV and V and inter-peak latencies in P0-sensitized guinea pigs did not significantly differ from those of controls (P>0.05). Histological sections of inner ear and peripheral nerves were free of disease in both groups. These findings indicate that the sole presence of antibodies to myelin P0 in the sera of guinea pigs or patients suspected of having autoimmune inner ear diseases is unlikely to elicit auditory abnormalities and that additional factors are necessary for the pathogenic development of these disorders.

Animals↗
PubMed2000

Early extrastriate activity without primary visual cortex in humans.

Damage to the primary visual cortex (V1) destroys the major source of anatomical input to extrastriate cortical areas (V2, V3, V4 and V5) and produces cortical blindness--an absence of any sensation of light and colour--in the visual field contralateral to the side of the lesion. Neuroimaging studies, nevertheless, have recently demonstrated dorsal and ventral extrastriate activation for stationary stimuli presented to the blind visual field in the absence of V1 activity in human subjects. To clarify the moment in time that visual information reaches extrastriate areas, by means of event-related potentials (ERPs) we tracked the temporal course of responses to complex visual stimuli (faces) presented in the blind field of a hemianopic patient. Stimulation of the normal visual field elicited a positive occipital deflection (P1) at 140 ms. A P1 response was also observed with stimulation of the blind field, although slightly delayed (20 ms) and reduced. Its topography and timing demonstrate that early neural activity for stationary stimuli takes place within extrastriate regions despite V1 denervation.

Adult↗
PubMed2000

Intra- and postoperative factors determining neurological complications after surgery under deep hypothermic circulatory arrest: a retrospective somatosensory evoked potential study.

OBJECTIVES: Intraoperative median nerve SEP monitoring uses the disappearance of cortical and brain stem activities as the criterion to determine that brain cooling is sufficient in deep hypothermic circulatory arrest (CA) surgery. This study presents the results of a retrospective SEP analysis of intraoperative events that engendered neurological complications. METHODS: Median nerve SEP monitoring was performed on 58 consecutive patients who underwent surgery under deep hypothermic CA. The monitoring was retrospectively analyzed and compared with intraoperative events, and postoperative symptoms. RESULTS: Intraoperative SEP abnormalities were observed in 9 out of the 16 patients who presented neurological complications. Among the 7 others, the abnormalities either were present preoperatively (n = 2), occurred postoperatively (n = 3) or only involved the lower limbs (n = 2). Although the mere inspection of the intraoperative SEPs was insufficient to determine the origin of the alterations, their comparison with intraoperative events facilitated the identification of hemodynamic factors in 7 cases and embolism in two cases. There were no patients in whom CA per se caused neurological complications. CONCLUSIONS: Intraoperative SEP monitoring helps identify intraoperative events responsible for neurological complications and prevent these in subsequent procedures. However, the neurological complications of deep hypothermic CA can also be due to pre- or postoperative factors that escape the domain of intraoperative monitoring.

Adolescent↗
PubMed2000

Right N170 modulation in a face discrimination task: an account for categorical perception of familiar faces.

Behavioral studies have shown that two different morphed faces belonging to the same identity are harder to discriminate than two faces stemming from two different identities. The temporal course of this categorical perception effect has been explored through event-related potentials. Three kinds of pairs were presented in a matching task: (1) two different morphed faces representing the same identity (within), (2) two other faces representing two different identities (between), and (3) two identical morphed faces (same). Following the second face onset in the pair, the amplitude of the right occipitotemporal negativity (N170) was reduced for within and same pairs as compared with between pairs, suggesting an identity priming effect. We also observed a modulation of the P3b wave, as the amplitude of the responses for within pairs was higher than for between and same pairs, suggesting a higher complexity of the task for within pairs. These results indicate that categorical perception of human faces has a perceptual origin in the right occipitotemporal hemisphere.

Adult↗
PubMed2000

The usefulness of EEG, exogenous evoked potentials, and cognitive evoked potentials in the acute stage of post-anoxic and post-traumatic coma.

Three-modality evoked potentials (TMEPs) have been used for several years in association with the EEG as a diagnostic and prognostic tool in acute anoxic or traumatic coma. Cognitive EPs have been recently introduced. EEG and cognitive EPs provide functional assessment of the cerebral cortex. TMEP parameters can be described by two indices: the index of global cortical function (IGCF) and the index of brainstem conduction (IBSC). Although it remains a unique tool for epilepsy assessment, the value of EEG is largely limited by its high sensitivity to the electrical environmental noise, its dependence on sedative drugs, and its inability to test the brainstem. Major TMEP alterations (absence of cortical activities more than 24 hours after the onset of post-anoxic coma, major pontine involvement in head trauma) are associated in all cases with an ominous prognosis (death or vegetative state). However, even if mild TMEP changes are associated with a good prognosis in 65% (post-anoxic coma) to 90% (head trauma) of cases, some patients never recover despite exogenous TMEPs that are only mildly altered in the acute stage. Thus, cognitive EPs can usefully complement exogenous EPs as a prognostic tool in coma. Indeed, even if the absence of cognitive EPs in comatose patients does not have any prognostic value, their presence implies a very high (more than 90%) probability of consciousness recovery. The major technical challenge for the future will be the development of reliable tools for continuous EEG and TMEP monitoring.

Acute Disease↗
PubMed1999

Spatio-temporal localization of the face inversion effect: an event-related potentials study.

Event-related potentials (ERPs) from 58 electrodes at standard EEG sites were recorded while 14 subjects performed a delayed-matching task on normal and inverted faces. A large and single difference between normal and inverted face processing was observed at occipito-temporal sites about 160 ms following stimulus onset, mainly in the right hemisphere (RH). Although the topographies indicate that similar areas are involved at this latency in processing the two types of stimuli, the electrophysiological activity, which corresponds to the previously described N170, was larger and delayed for inverted as compared to normal face processing. These results complement and specify, at a neural level, previous behavioral and divided visual field studies which have suggested that the loss of configural face information by inversion may slow down and increase the difficulty of face processing, particularly in the RH.

Adult↗
PubMed1999

Medical technology assessment EEG and evoked potentials in the intensive care unit.

We review the principal aspects of EEG and evoked potential (EP) neuromonitoring in the intensive care unit. The electrophysiological methods allow functional assessment of comatose patients and can be used (a) as a help to diagnose the origin of coma, (b) as a means to predict outcome, and (c) for monitoring purposes. The combination of the EEG and long-, middle-, and short-latency EPs allows widespread assessment of the cerebral cortex, the brain-stem, and the spinal cord. The EEG and the EP interpretation first requires taking into account non-neurological factors that may interfere with the recorded activities (sensory pathologies, toxic or metabolic problems, body temperature). The sensitivity and the specificity of any neurophysiological technique depend on the etiology of coma. Anoxic comas are associated with a predominantly cortical involvement, while the cortical and brain-stem functions are to be taken into account to interpret the EEG and the EPs in head trauma. The EEG and the EPs can be used to differentiate the comas due to structural lesions from those of metabolic origin, to confirm brain death and help to diagnose psychogenic unresponsiveness or a de-efferented state. While the prognostic value of the EEG is markedly hampered by the widespread use of sedative drugs, it has been possible to design efficient systems based on early- and middle-latency multimodality evoked potentials in anoxic and traumatic comas and, more generally, in all comas associated with an increase of the intracranial pressure. Continuous neuromonitoring techniques are currently under development. They have already been proven useful for the early detection and for the prevention of subclinical seizures, transtentorial herniation, vasospasm, and other causes of brain or spinal-cord ischemia.

Critical Care↗
PubMed1999

[A comparison between group-average and individual evoked potential analysis].

PURPOSE: Event-related potentials (ERPs) studies in human subjects have shown inter-individual response variations, probably linked to anatomical and functional brain disparities. The present study was conducted to compare the results obtained by a standard grand-average method and a single subject analysis of VEPs to faces. MATERIAL AND METHOD: Fifty-eight channel ERPs (analysis time: 1,024 ms) were recorded in 13 normal volunteers during gender or familiarity judgements on unknown and known faces, as well as on a control task using meaningless patterns. Data were then submitted to individual and group averages. RESULTS AND CONCLUSION: Three activities were identified by both procedures: a P1/N1 complex, a vertex positive potential (P2 or VPP) associated with a temporal negativity, and a N2 negativity. These peaks displayed a marked inter-individual topographical variability. Regarding the outcome of statistical analyses, a certain number of differences were found: on P1, in which individual analyses revealed a strong effect of experimental conditions, while the grand-average method did not; on VPP, in which grand-average analyses suggested an interaction between experimental conditions, face familiarity and cerebral lateralization, while individual analyses did not; and on N2, in which grand-average data showed a clear lateralization effect, while individual analyses did not. A P3 component (Pz, 250 ms) was also defined in grand-average data, but could not be clearly described in individual data. Statistical analyses on this P3 component were thus only performed on group data and revealed a right lateralization and an interaction between face familiarity and experimental conditions. These findings confirmed the existence of a marked topographical variability of ERPs to face and, therefore, question the validity of grand-average studies. Moreover, these results suggest a better efficiency of individual analyses for studying short and middle-latency peaks, while grand-averages appear to be better suited for studying late components.

Adult↗
PubMed1999

ERPs obtained with the auditory oddball paradigm in coma and altered states of consciousness: clinical relationships, prognostic value, and origin of components.

OBJECTIVE: To study the event related potentials (ERPs) in coma and altered states of consciousness, their relationship with the clinical status and coma outcome. METHODS: ERPs were recorded with a passive auditory oddball paradigm in 103 patients. Their probability of occurrence and the peak latencies and amplitudes were studied as a function of the Glasgow Coma Score (GCS). Their relationship with outcome was studied in a subset of 83 patients examined within the first 4 days, and expressed in terms of sensitivity, specificity, and negative or positive prognostic values. RESULTS: When present, the ERPs to rare stimuli consisted of a fronto-central negativity (N(endog), mean latency: 330 ms) and a fronto-central positivity (P(endog), mean latency: 431 ms) following the exogenous N100-P200 complex. Both their probability of occurrence and their latencies and amplitudes were related with the GCS in anoxic and traumatic comas. The N(endog) and P(endog) had high sensitivity with a negative predictive value of 70% and 100%, respectively, but a low specificity, with a positive predictive value of 44% and 41%, respectively. CONCLUSIONS: ERPs can be recorded in some comatose patients and are likely to reflect implicit orienting processes rather than preserved consciousness. Their presence implies a good prognosis but no conclusion can be drawn from their absence.

Acoustic Stimulation↗
PubMed1999

Spectral versus visual EEG analysis in mild hepatic encephalopathy.

OBJECTIVE: Spectral EEG analysis has been claimed to reduce subjective variability in EEG assessment of hepatic encephalopathy and to allow the detection of mild encephalopathy. METHOD: To test such assumptions, 43 digital EEG were recorded in 32 cirrhotics without overt encephalopathy or with grade 1 overt encephalopathy; 7 patients were re-tested (2-5 times) in their follow up. All patients underwent psychometric assessment. Nineteen controls were considered. EEG were blindly evaluated by two electroencephalographers and by spectral EEG analysis performed according to 3 different techniques. RESULTS: The reliability of the classification based on spectral analysis (biparietal technique) was higher than that based on a three-degree qualitative visual reading (concordance/discordance = 58/4 versus 46/16 P < 0.01) and comparable with that of semiquantitative visual assessment based on posterior basic rhythm (concordance/discordance = 55/7 P = 0.5). The accuracy of spectral EEG analysis was higher than that of qualitative visual EEG readings alone (90 versus 75%) and comparable to semi-quantitative visual assessment (87%), however, statistical significance was not reached. In the follow-up, the variations of theta and delta relative power were found to be significantly correlated with psychometric variations. CONCLUSIONS: In conclusion, spectral EEG analysis may improve the assessment of mild hepatic encephalopathy by decreasing inter-operator variability and providing reliable parameters correlated with mental status.

Adult↗