Dynamics of autonomic responses during voluntary control of the alpha-rhythm.
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OBJECTIVES: Besides preventing stroke, carotid endarterectomy (CEA) is reported to improve cerebral circulation and brain function. We tested whether this improvement is reflected by changes in the qEEG. METHODS: qEEG changes in 166 patients with a >70% stenosis of the internal carotid artery (ICA) were assessed after subtraction of the preoperative and postoperative spectra (eyes closed condition) before and 3 months after CEA. The mean frequency of the alpha band (MFA), the peak frequency of the alpha band (F alpha), and bands with limits relative to each patient's F alpha were studied in relation to neurological symptoms, patency or occlusion of the contralateral ICA, shunt requirement, and side of surgery. RESULTS: MFA and F alpha significantly increased over both hemispheres. After alignment on F alpha, a decrease of spectral band power was seen below F alpha, and a band power increase above F alpha. The group of patients with a contralateral ICA occlusion showed significantly more improvement than the group without. The group of patients with neurological deficits showed a tendency for improvement. No differences were found concerning shunt requirement or the side of surgery. CONCLUSIONS: After CEA the alpha rhythm frequency increases. In general, patients with a contralateral ICA occlusion improve more than other patients, in agreement with data from the literature on cerebral circulation and brain function.
Luria used the term habituation for the phenomenon that the so-called orientation reflex to a certain stimulus is lost when the stimulus is repeated. In the present investigation habituation was tested by opening the eyes during conventional EEG. During the examination the patient was asked twelve times to open and close the eyes. Thus 730 patients aged 4 to 65 years were examined. Habituation developed in 542 patients and was absent in 188. Most frequently it developed between the 7th and 10th opening of the eyes, most frequently after the ninth. It seems thus that habituation of the alpha rhythm after this repetition is a normal bioelektrcical phenomenon and earlier, later or absent habituation is a deviation from the bioelectric norm.
Dipole sources were investigated in 22 normal subjects with a variety of strategies available through the BESA program. When all the data were summed one regional source, located near the midline in the basal portions of the occipital lobe, explained 92% of the variance. Two regional sources, initially constrained for symmetry but subsequently freed from constraint placed them also in the occipital regions near the midline and reduced the residual variance to 4%. Pooled data obscure, however, the marked individual differences especially in regard to lateralization. In the individual case the major source was also always in one occipital area but its location, especially the degree of separation from the midline depended upon alpha distribution and the strategy used in the workup of the data. The orientation of the major components of the regional sources was usually in the posterior-anterior direction, fairly parallel to the midline and while the other one pointed to the upper convexity. Because of the considerable variability of the alpha rhythm in given subjects and even within the same individual a model which requires symmetry constraints is not optimal for all instances, even when constraints are lifted thereafter. The study demonstrated the feasibility of distinguishing predominantly mesial sources from those which are bihemipheric with more lateral origins but several different models may have to be used to reach the most realistic conclusions.
SUMMARY: A young man, in whom narcolepsy was subsequently diagnosed, had the simultaneous onset of quadriparesis and a rapid eye movement (REM)-sleep polysomnographic pattern. During this REM-sleep pattern, a waking alpha EEG rhythm, appearing when he was asked to close his eyes, immediately attenuated when he was instructed to open his eyes, after which the REM-sleep pattern persisted. The juxtaposition of REM sleep patterns and reactive alpha rhythms are likely unique to sleep paralysis and may prove valuable in diagnosing narcolepsy.
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