DC-EEG recording: a paradigm shift in seizure localization?
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Biomedical subjects
Publications and source records attributed to Terrence D Lagerlund.
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Coherence is the degree of time-locked correlation between two signals as a function of frequency. The purpose of this study was to test the following hypotheses: (1) corticomuscular coherence is abnormally increased in those Parkinson's disease (PD) patients with small amplitude cortical myoclonus, and (2) corticomuscular coherence peaks around the time of the myoclonus electromyographic (EMG) discharge. We studied Parkinson's disease patients with and without myoclonus and controls. The data were digitally collected and processed off-line with EMG rectification, creation of 511-msec epochs, Fast-Fourier transform, and coherence analysis. In the 12 to 30 Hz frequency band, but not at 30 to 60 Hz or above, coherence peaks were observed in the PD subjects with myoclonus that were significantly greater than in the control subjects (P < 0.001) and in PD subjects without myoclonus (P < 0.001). The abnormal coherence values are evidence for abnormal rhythmic activity in cortical motor areas in those Parkinson's disease patients with myoclonus. In combination with previous findings on back-averaging, our results show that this myoclonus occurs when neuronal populations are driven to an extreme amount of synchronous activity with higher corticomuscular coherence values. These results have mechanistic implications for cortical dysfunction in Parkinson's disease and for cortical myoclonus in general.
The scalp electroencephalogram (EEG) is the cornerstone in the diagnosis and treatment of seizure disorders. The EEG, with its excellent temporal resolution, provides a direct measurement of cortical electrophysiology, revealing, for example, the presence of interictal epileptiform discharges that identify regions of an epileptogenic brain. We define the EEG characteristics of focal and generalized epileptiform discharges and provide evidence for their varying diagnostic importance in different patient populations. Identification of nonepileptiform EEG transients, such as wicket waves, small sharp spikes,rhythmic temporal theta activity, and 14- and 6-Hz positive bursts, that can be confused for epileptiform transients is emphasized. A final point is that the clinician must interpret EEG findings within the overall clinical context.
The authors developed a general mathematic algorithm to convert any montage (referential, bipolar, or Laplacian) to any other by linear transformation. Input and output montages are described by matrices, and singular value decomposition is used to find the linear transformation. An error signal can be calculated from the input data to monitor remontaging validity. This algorithm also identifies output channels that cannot be obtained from the specified input. The authors tested this algorithm using an instrument that retrieves digitally encoded EEG data from videotape and produces signals in referential or bipolar form. They obtained good agreement when they compared referential and Laplacian data derived from bipolar output with the same montages calculated from referential output for the same EEG segment.