Biomedical subjects

Sampsa Vanhatalo

Publications and source records attributed to Sampsa Vanhatalo.

17 recordsLinked to original sources

PubMed2006

Development of neonatal EEG activity: from phenomenology to physiology.

After having been in routine use for about half a century, neonatal EEG is currently facing unprecedented challenges in assessing and monitoring brain function during intensive care of preterm babies. It has therefore become increasingly important to understand the neurophysiological processes underlying EEG activity, as well as to identify those features of brain activity that are essential for brain development. By integrating the existing literature from basic neuroscience to neonatal EEG, the present review proposes a simple, neurophysiologically and neuroanatomically based framework for neonatal EEG interpretation. This is composed of two developmental trajectories: one related to discrete spontaneous activity transients (SAT) and the other to the ongoing, apparently oscillatory EEG activity. This framework can readily be applied to clinical use. It may open novel avenues to automated analysis in EEG monitoring and, moreover, it may facilitate genuine translational research.

Brain↗

PubMed2006

Neonatal SEP - back to bedside with basic science.

Scalp-recorded somatosensory evoked potentials (SEPs) have been successfully used in neonatal assessment for several decades. The current routine SEP paradigm is markedly predictive for future cerebral palsy (CP) or other neurocognitive sequelae in brain-injured babies. Recent advances in basic science have dramatically increased our knowledge about structural-functional development of SEP-related brain mechanisms. It has thereby become apparent that preterm SEP differs from that in more mature counterparts in that it also comprises responses from transient brain structures, and hence being unique to the preterm period. It is now obvious also that several aspects in the current SEP paradigm, ranging from the type of stimulation to the methods of recording and analysis, are suboptimal for preterm babies. Recent progress in recording and analysis techniques have made it possible to combine SEP studies with EEG recordings, as well as to implement advanced analyses (e.g. time-frequency analysis) into routine practice. This review summarizes literature from relevant areas in basic science, and proposes a novel, integrated approach in neonatal SEP studies in order to significantly increase the fidelity of testing somatosensory system.

Cerebral Palsy↗

PubMed2006

Epileptogenic neocortical networks are revealed by abnormal temporal dynamics in seizure-free subdural EEG.

Long-term video electroencephalographic (EEG) recording is currently a routine procedure in the presurgical evaluation of localization-related epilepsies. Cortical epileptogenic zone is usually localized from ictal recordings with intracranial electrodes, causing a significant burden to patients and health care. Growing literature suggests that epileptogenic networks exhibit aberrant dynamics also during seizure-free periods. We examined if neocortical epileptogenic regions can be circumscribed by quantifying local long-range temporal (auto-)correlations (LRTC) with detrended fluctuation analysis of seizure-free ongoing subdural EEG activity in 4 frequency bands in 5 patients. We show here with subdural EEG recordings that the LRTC are abnormally strong near the seizure onset area. This effect was most salient in neocortical oscillations in the beta frequency band (14-30 Hz). Moreover, lorazepam, a widely used antiepileptic drug, exerted contrasting effects on LRTC (n = 2): lorazepam attenuated beta-band LRTC near the epileptic focus, whereas it strengthened LRTC in other cortical areas. Our findings demonstrate that interictal neuronal network activity near the focus of seizure onset has pathologically strong intrinsic temporal correlations. The observed effect by lorazepam on beta-band activity suggests that the antiepileptic mechanism of benzodiazepines may be related to the normalization of LRTC within the epileptic focus. We propose that this method may become a promising candidate for routine invasive and noninvasive presurgical localization of epileptic foci.

Adult↗

PubMed2006

Experimental febrile seizures are precipitated by a hyperthermia-induced respiratory alkalosis.

Febrile seizures are frequent during early childhood, and prolonged (complex) febrile seizures are associated with an increased susceptibility to temporal lobe epilepsy. The pathophysiological consequences of febrile seizures have been extensively studied in rat pups exposed to hyperthermia. The mechanisms that trigger these seizures are unknown, however. A rise in brain pH is known to enhance neuronal excitability. Here we show that hyperthermia causes respiratory alkalosis in the immature brain, with a threshold of 0.2-0.3 pH units for seizure induction. Suppressing alkalosis with 5% ambient CO2 abolished seizures within 20 s. CO2 also prevented two long-term effects of hyperthermic seizures in the hippocampus: the upregulation of the I(h) current and the upregulation of CB1 receptor expression. The effects of hyperthermia were closely mimicked by intraperitoneal injection of bicarbonate. Our work indicates a mechanism for triggering hyperthermic seizures and suggests new strategies in the research and therapy of fever-related epileptic syndromes.

Alkalosis, Respiratory↗

PubMed2006

Fine spatiotemporal structure of phase in human intracranial EEG.

OBJECTIVE: To transfer to the clinic for humans the technology and theory for high-resolution EEG analysis that have been developed in the laboratory with animals. METHODS: EEGs were recorded at high spatial resolution from a 1 x 1 cm 8 x 8 electrode array on the right inferior temporal gyrus of a patient undergoing preoperative monitoring for epilepsy surgery. Cosines were fitted to EEG segments to measure frequency and phase and compute location, size, latency, phase velocity, duration, and recurrence rate of radially symmetric spatial patterns called phase cones. The Hilbert transform was also used to get high temporal resolution. RESULTS: In the awake state, the power spectral density (PSD) showed power-law decrease in log power with log frequency at 1/falpha, alpha approximately 2, but with peaks in the standard empirical ranges. The phase in beta and gamma ranges had spatial gradients in conic form. Resetting of these stable spatial patterns of phase cones was spatially coincident at intermittent discontinuities ('phase slip') recurring at theta rates. Cones had half power diameters from 2 to 50+ mm; their durations had power-law distributions with values ranging from 6 to 300+ ms depending on length of the analysis window. In slow wave sleep PSD decreased at 1/falpha, alpha approximately 3,with loss of beta-gamma spectral peaks and diminished or absent oscillations and spatiotemporal phase structure. CONCLUSIONS: Spatiotemporal structures in awake human and rabbit EEG showed striking similarities. The only clear differences were ascribable to differing scales of measurement. These fine spatiotemporal structures of EEG were diminished or lost in slow wave sleep. SIGNIFICANCE: The fine structure indicates that neocortical stability is sustained at self-organized criticality; that synaptic input in the awake state drives neocortex away from criticality causing beta-gamma oscillations in re-stabilizing 'neural avalanches'; and that diminished input in slow wave sleep allows return toward criticality but with some added risk of instability and seizure.

Adult↗

PubMed2005

Full-band EEG (FbEEG): an emerging standard in electroencephalography.

While enormous resources have been recently invested into the development of a variety of neuroimaging techniques, the bandwidth of the clinical EEG, originally set by trivial technical limitations, has remained practically unaltered for over 50 years. An increasing amount of evidence shows that salient EEG signals are observed beyond the bandwidth of the routine clinical EEG, which is typically around 0.5-50 Hz. Physiological and pathological EEG activity ranges at least from 0.01 Hz to several hundred Hz, as demonstrated in recordings of spontaneous activity in the immature human brain, as well as during epileptic seizures, or various kinds of cognitive tasks and states in the adult brain. In the present paper, we will review several arguments leading to the conclusion that elimination of the lower (infraslow) or higher (ultrafast) bands of the EEG frequency spectrum in routine EEG leads to situations where salient and physiologically meaningful features of brain activity are ignored. Recording the full, physiologically relevant range of frequencies is readily attained with commercially available direct-current (DC) coupled amplifiers, which have a wide dynamic range and a high sampling rate. Such amplifiers, combined with appropriate DC-stable electrode-skin interface, provide a genuine full-band EEG (FbEEG). FbEEG is mandatory for a faithful, non-distorted and non-attenuated recording, and it does not have trade-offs that would favor any frequency band at the expense of another. With the currently available electrode, amplifier and data acquisition technology, FbEEG is likely to become the standard approach for a wide range of applications in both basic science and in the clinic.

Brain↗

PubMed2005

Slow endogenous activity transients and developmental expression of K+-Cl- cotransporter 2 in the immature human cortex.

Spontaneous transients of correlated activity are a characteristic feature of immature brain structures, where they are thought to be crucial for the establishment of precise neuronal connectivity. Studies on experimental animals have shown that this kind of early activity in cortical structures is composed of long-lasting, intermittent network events, which undergo a developmental decline that is closely paralleled by the maturation of GABAergic inhibition. In order to examine whether similar events occur in the immature human cortex, we performed direct current-coupled electroencephalography (EEG) recordings from sleeping preterm babies. We show now that much of the preterm EEG activity is confined to spontaneous, slow activity transients. These transients are characterized by a large voltage deflection that nests prominent oscillatory activity in several frequency bands covering the whole frequency spectrum of the preterm EEG (<0.1-30 Hz). The slow voltage deflections had an amplitude of up to 800 microV. Most of these 'giant' events originated in the temporo-occipital areas, with a maximum rate of about 8/min, and their occurrence as well as amplitude showed a decline by the time of normal birth. In age-matched fetal brain tissue, this decrease in the spontaneous activity transients was associated with a developmental up-regulation of the neuronal chloride extruder K+-Cl- cotransporter 2, a crucial molecule for the generation of inhibitory GABAergic Cl- currents. Our work indicates that slow endogenous activity transients in the immature human neocortex are mostly confined to the prenatal stage and appear to be terminated in parallel with the maturation of functional GABAergic inhibition.

Cerebral Cortex↗

PubMed2005

Full-band EEG (fbEEG): a new standard for clinical electroencephalography.

A variety of neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET) and magnetoencephalography (MEG), have been established during the last few decades, with progressive improvements continuously taking place in the underlying technologies. In contrast to this, the recording bandwidth of the routine clinical EEG (typically around 0.5-50 Hz) that was originally set by trivial technical limitations has remained practically unaltered for over half a decade. An increasing amount of evidence shows that salient EEG signals take place and can be recorded beyond the conventional clinical EEG bandwidth. These physiological and pathological EEG activities range from 0.01 Hz to several hundred Hz, and they have been demonstrated in recordings of spontaneous activity in the preterm human brain, and during epileptic seizures, sleep, as well as in various kinds of cognitive tasks and states in the adult brain. In the present paper, we will describe the practical aspects of recording the full physiological frequency band of the EEG (Full-band EEG; FbEEG), and we review the currently available data on the clinical applications of FbEEG. Recording the FbEEG is readily attained with commercially available direct-current (DC) coupled amplifiers if the recording setup includes electrodes providing a DC-stable electrode-skin interface. FbEEG does not have trade-offs that would favor any frequency band at the expense of another. We present several arguments showing that elimination of the lower (infraslow) or higher (ultrafast) bands of the EEG frequency spectrum in routine EEG has led, and will lead, to situations where salient and physiologically meaningful features of brain activity remain undetected or become seriously attenuated and distorted. With the currently available electrode, amplifier and data acquisition technology, it is to be expected that FbEEG will become the standard approach in both clinical and basic science.

Action Potentials↗

PubMed2004

Nonneuronal origin of CO2-related DC EEG shifts: an in vivo study in the cat.

We studied the mechanisms underlying CO(2)-dependent DC potential shifts, using epicranial, epidural, epicortical, intraventricular, and intraparenchymal (intraneuronal, intraglial, and field) recordings in ketamine-xylazine-anesthetized cats. DC shifts were elicited by changes in artificial ventilation, causing end-tidal CO(2) variations within a 2-5% range. Hypercapnia was consistently associated with negative scalp DC shifts (average shift -284.4 microV/CO(2)%, range -216 to -324 microV/CO(2)%), whereas hypocapnia induced positive scalp DC shifts (average shift 307.8 microV/CO(2)%, range 234 to 342 microV/CO(2)%) in all electrodes referenced versus the nasium bone. The former condition markedly increased intracranial pressure (ICP), whereas the latter only slightly reduced ICP. Breakdown of the blood-brain barrier (BBB) resulted in a positive DC shift and drastically reduced subsequent DC responses to hypo-/hypercapnia. Thiopental and isoflurane also elicited a dose-dependent positive DC shift and, at higher doses, hypo-/hypercapnia responses displayed reverted polarity. As to the possible implication of neurons in the production of DC shifts, no polarity reversal was recorded between scalp, various intracortical layers, and deep brain structures. Moreover, the membrane potential of neurons and glia did not show either significant or systematic variations in association with the scalp-recorded CO(2)-dependent DC shifts. Pathological activities of neurons during spike-wave seizures produced DC shifts of significantly smaller amplitude than those generated by hyper-/hypocapnia. DC shifts were still elicited when neuronal circuits were silent during anesthesia-induced burst-suppression patterns. We suggest that potentials generated by the BBB are the major source of epicortical/cranial DC shifts recorded under conditions affecting brain pH and/or cerebral blood flow.

Anesthesia↗

PubMed2004

Does hyperventilation elicit epileptic seizures?

PURPOSE: Voluntary hyperventilation has been advocated for many decades as an "activating" procedure to provoke clinical seizures and epileptiform discharges in subjects with suspected epilepsy who undergo standard EEG recordings. This study was undertaken to determine the effects of hyperventilation in patients with proven epilepsy. METHODS: We examined the records of 433 consecutive patients with proven epilepsy, as documented by long-term video-EEG studies. The patients underwent 5 min of voluntary hyperventilation during standard EEG recordings. All EEGs were interpreted by board-certified electroencephalographers. The patients ranged in age from 10 to 64 years; 384 (88.7%) had localization-related and 48 (11.3%) generalized epilepsy syndromes. RESULTS: Hyperventilation was associated with a clinical seizure in two (0.46%) of the subjects (partial seizures in both cases). Interictal epileptiform discharges were interpreted as showing in increase in frequency during hyperventilation in 19 (4.4%) patients, when compared with the baseline EEG. CONCLUSIONS: Voluntary hyperventilation in patients with unequivocal epilepsy is rarely associated with either clinical seizures or an increase in frequency of epileptiform discharges.

Adolescent↗

PubMed2003

Bioelectrical behaviour of hypoxic human neocortical tissue under the influence of nimodipine and dimethyl sulfoxide.

Nimodipine and dimethyl sulfoxide (DMSO) have been shown to affect electrophysiological responses in rodent brain tissue in an vitro model of hypoxia. In the present study, the same agents were now examined for their effects on human neocortical brain slices under repeated hypoxic conditions. DMSO (0.4%), with and without addition of nimodipine (40 micromol/l), did not increase the latency of anoxic depolarization (AD). This finding is not in line with our previous observations of DMSO effects, with and without nimodipine, on brain slices of guinea pigs. AD latency was significantly longer in human neocortical brain slices compared with hippocampal slices of rodents even without any pharmacological influence. A possible acute effect of DMSO-nimodipine may therefore be masked by an interspecies difference of hypoxia resistance.

Action Potentials↗

PubMed2003

Vertebral artery insufficiency as a possible mechanism for sudden infant death--in vivo evidence does not support findings from postmortem studies.

Recent postmortem studies have suggested that sudden infant death syndrome (SIDS) might involve an underlying, gradual brain stem injury caused by repeated episodes of transiently compromised brain stem circulation. Autopsy studies have also reported that vertebral artery occlusion due to head rotations, such as occurs, e.g. during prone sleeping, would be a physiological phenomenon of infant atlantooccipital junction. The present study was undertaken to examine whether vertebral artery insufficiency does truly occur in live infants during such head rotations. We studied by transcranial doppler sonography the blood flow velocity of the basilar artery (BA) in 27 infants during head rotation from straight position to maximal rotation in three directions (left, right, dorsiflexion). No significant change in BA blood flow was seen between any head positions. Weight and gestational age, but not arterial pressure or hematocrit, of the infants were correlated with blood flow velocity. Our results suggest that brain stem circulation in live infants may not be compromised due to changing the head position, which is inconsistent with the postmortem findings showing insufficiency of brain stem circulation in both controls and those succumbed to SIDS. We hence propose that the brain stem pathology observed with SIDS is likely caused by other factors (e.g. systemic disturbance) rather than by mechanical obstruction of brain stem circulation.

Autopsy↗

PubMed2003

Spatial spectra of scalp EEG and EMG from awake humans.

OBJECTIVE: Evaluate spectral scaling properties of scalp electroencephalogram (EEG) and electromyogram (EMG), optimal spacing of electrodes, and strategies for mitigating EMG. METHODS: EEG was recorded referentially from 9 subjects with a 64 channel linear array (electrodes 3mm apart) placed parasagittally or transversely on forehead or occiput, at rest with eyes open or closed, or with deliberate EMG. Temporal (PSD(t)) and spatial (PSD(x)) power spectral densities were calculated with one-dimensional fast Fourier transform (FFT) for comparison with earlier analyses of intracranial EEG. RESULTS: Scaling of PSD(t) from scalp resembled that from pia: near-linear decrease in log power with increasing log frequency (1/f(alpha)). Scalp PSD(x) decreased non-linearly and more rapidly than PSD(x) from pia. Peaks in PSD(t) (especially 4-12Hz) and PSD(x) (especially 0.1-0.4 cycles/cm) revealed departures from 1/f(alpha). EMG power in PSD(t) was more "white" than 1/f(alpha). CONCLUSIONS: Smearing by dura-skull-scalp distorts PSD(x) more than PSD(t) of scalp EEG from 1/f(alpha) scaling at the pia. Spatial spectral peaks suggest that optimal scalp electrode spacing might be approximately 1cm to capture non-local EEG components having the texture of gyri. Mitigation of EMG by filtering is unsatisfactory. A criterion for measuring EMG may support biofeedback for training subjects to reduce their EMG. SIGNIFICANCE: High-density recording and log-log spectral display of EEG provide a foundation for holist studies of global human brain function, as an alternative to network approaches that decompose EEG into localized, modular signals for correlation and coherence.

Brain↗

PubMed2003

Vagal nerve stimulation induces intermittent hypocapnia.

PURPOSE: To study whether respiratory alteration caused by vagal nerve stimulation (VNS) can change end-tidal carbon dioxide (EtCO2) levels. METHODS: We performed polygraphic recordings including capnographic monitoring during daytime sleep on adults with VNS therapy. RESULTS: Ten of 13 patients showed VNS-induced alterations in the frequency or amplitude of respiration. Five patients had a consistent increase in respiratory rate with a simultaneous, consistent and significant decrease (p < 0.01; 5-22%) in EtCO2 during VNS. Three subjects showed occasional decreases in EtCO2 during VNS, and two showed no clearly detectable VNS-related EtCO2 changes. CONCLUSIONS: Our findings suggest that VNS may alter brain CO2 levels through changes in respiration. Because carbon dioxide (CO2) has potent effects on various brain functions, it is possible that these transient CO2 changes may have an effect on the state transitions between interictal and preictal states.

Adult↗

PubMed2002

Millivolt-scale DC shifts in the human scalp EEG: evidence for a nonneuronal generator.

Slow shifts in the human scalp-recorded EEG, including those related to changes in brain CO(2) levels, have been generally assumed to result from changes in the level of tonic excitation of apical dendrites of cortical pyramidal neurons. We readdressed this issue using DC-EEG shifts elicited in healthy adult subjects by hypo- or hypercapnia. A 3-min period of hyperventilation resulted in a prompt negative shift with a rate of up to 10 microV/s at the vertex (Cz) and an extremely steep dependence (up to 100 microV/mmHg) on the end-tidal Pco(2). This shift had a maximum of up to -2 mV at Cz versus the temporal derivations (T3/T4). Hyperventilation-like breathing of 5% CO(2)-95% O(2), which does not lead to a significant hypocapnia, resulted in a near-complete block of the negative DC shift at Cz. Hypoventilation, or breathing 5% CO(2) in air at normal respiratory rate, induced a positive shift. The high amplitude of the voltage gradients on the scalp induced by hyperventilation is not consistent with a neuronal origin. Instead, the present data suggest that they are generated by extracortical volume currents driven by a Pco(2)-dependent potential difference across epithelia separating the cerebrospinal fluid and blood. Since changes in respiratory patterns and, hence, in the level of brain Pco(2), are likely to occur under a number of experimental conditions in which slow EEG responses have been reported (e.g., attention shifts, preparatory states, epileptic seizures, and hypoxic episodes), the present results call for a thorough reexamination of the mechanisms underlying scalp-recorded DC-EEG responses.

Adult↗

PubMed2002

DC-EEG discloses prominent, very slow activity patterns during sleep in preterm infants.

OBJECTIVES: The objective of this study is to test the hypothesis that the immature human brain exhibits slow electrical activity that is not detected by conventional (i.e. high-pass filtered) electroencephalography (EEG). METHODS: Six healthy preterm infants (conceptional age 33-37 weeks) were recorded bedside with direct current (DC) EEG during sleep. Epochs with quiet sleep were selected to study the delta frequency bursts during discontinuous EEG patterns (trace discontinu or trace alternant), and we compared the waveforms obtained without filtering (i.e. genuine DC-EEG) to those seen after high pass filtering of the same traces. RESULTS: In all infants, DC-EEG demonstrated that the typical delta frequency bursts are consistently embedded in very large amplitude (200-700 microV) and long lasting (1-5s) occipitally negative transients, which are not seen in conventional EEG. CONCLUSIONS AND SIGNIFICANCE: Our study demonstrates that (i) the most prominent spontaneous EEG activity of a sleeping preterm infant consists of very slow, large amplitude transients, and (ii) the most salient features of these transients are not seen in conventional EEG. Proper recording of this type of brain activity by DC-EEG provides a novel way for non-invasive assessment of neonatal brain function.

Brain↗

PubMed2002

Visual field constriction in 91 Finnish children treated with vigabatrin.

PURPOSE: To study the prevalence and features of visual field constrictions (VFCs) associated with vigabatrin (VGB) in children. METHODS: A systematic collection of all children with any history of VGB treatment in fifteen Finnish neuropediatric units was performed, and children were included after being able to cooperate reliably in repeated visual field tests by Goldmann kinetic perimetry. This inclusion criterion yielded 91 children (45 boys; 46 girls) between ages 5.6 and 17.9 years. Visual field extent <70 degrees in the temporal meridian was considered abnormal VFC. RESULTS: There was a notable variation in visual field extents between successive test sessions and between different individuals. VFCs <70 degrees were found in repeated test sessions in 17 (18.7%) of 91 children. There was no difference in the ages at the study, the ages at the beginning of treatment, the total duration of the treatment, general cognitive performance, or neuroradiologic findings between the patients with normal visual fields and those with VFC, but the patients with VFC had received a higher total dose of VGB. In linear regression analysis, there were statistically significant inverse correlations between the temporal extent of the visual fields and the total dose and the duration of VGB treatment. The shortest duration of VGB treatment associated with VFC was 15 months, and the lowest total dose 914 g. CONCLUSIONS: Because of a wide variation in normal visual-field test results in children, the prevalence figures of VFCs are highly dependent on the definition of normality. Although our results confirm the previous findings that VFC may occur in children treated with VGB, our study points out the need to reevaluate critically any suspected VFC to avoid misdiagnosis. Nevertheless, our study suggests that the prevalence of VFC may be lower in children than in adults, and that the cumulative dose of VGB or length of VGB therapy may add to the personal predisposition for developing VFC.

Adolescent↗