38例网络成瘾青少年脑电图分析

目的:探讨互联网络成瘾(IAD)青少年的脑电信号特点及可能的发生机制.方法:描记符合诊断标准的38例IAD患者和35例健康对照者的脑电图(EEG),进行目测阅图和功率谱组间对比分析,并对异常程度与IAD时间做组内相关性分析.结果:EEG目测阅图结果显示,IAD组EEG异常率明显高于对照组,病变部位主要是额区,两者比较差异有统计学意义(P＜0.05);IAD组EEG异常程度与IAD时间无明显关联性(P＞0.05).EEG相对功率值分析显示,与正常对照组相比,IAD组双侧额、颞区慢波(δ、θ波)功率增高.结论:IAD青少年EEG结果提示额、颞区脑功能处于抑制状态,抑制程度与IAD的时间不相关;推测大脑额、颞区兴奋性降低是导致IAD的可能原因之一.     

儿童良性癫(癎)动态脑电图与临床追踪观察

目的: 探讨儿童期良性中央-颞区棘波灶性癫(癎)(EBCC)的临床发作形式,动态脑电图(AEEG)不同类型的改变,追踪临床、AEEG及预后情况.方法: 对36例不同年龄、不同发作特点、不同发作类型进行清醒、自然睡眠或药物诱导睡眠AEEG描记.结果: 本组36例临床发作表现多为部分型,AEEG特点;其中21例(58%)局限于一侧的中央-颞区,15例(42%)呈双侧基本以一侧为主的中央-颞区为起搏点播散到额顶区,但仍以中央-颞区波幅最高.结论: 本病6～10岁为多发年龄,AEEG浅睡期阳性率最高,并以中央-颞区为主的散发、阵发单个棘、尖波或棘、尖-慢综合波间断或连续为发作特点.另外药物治疗比末治疗预后要好.     

发作间期额及额中线导联棘波的临床意义

目的:探讨发作间期额及额中线导联棘波的临床意义.方法:对2011年7-12月脑电图(EEG)表现为发作间期额及额中线导联棘波放电的85例(期间共计2302例患者进行长程脑电监测)患者的临床资料及EEG进行分析.研究发作间期额及额中线棘波的出现频次、出现的时间、棘波的波形、棘波或棘慢波的波幅、棘波放电的侧别在临床癫(痫)及非癫(痫)疾病的诊断价值.结果:25(25/30)例癫(痫)患者额及额中线导联棘波出现频次大于10;所有患者额及额中线导联棘波均出现在NREM的Ⅰ-Ⅱ期,其中23(23/30)例癫(痫)患者同时有清醒期额及额中线导联棘波,12(12/55)例非癫(痫)患者合并清醒期额及额中线导联棘波;26(26/30)例癫(痫)患者额及额中线导联棘波波幅大于或等于100 μV,6(6/55)例非癫(痫)患者额及额中线导联棘波波幅大于或等于100 μV;28(28/30)例癫(痫)患者额及额中线导联棘波波形为棘慢波,35(35/55)例非癫(痫)患者额及额中线导联棘波波形为棘慢波;20(20/30)例癫(痫)患者额及额中线导联棘波恒定于一侧导联,13(13/55)例非癫(痫)患者额及额中线导联棘波恒定于一侧导联.额导联棘波的出现频次、波幅、波形及侧别的恒定与否在癫(痫)和非癫(痫)组均有显著性差异.结论:额及额中线导联棘波可以出现在癫(痫)及非癫(痫)患者.如额及额中线导联棘波出现的频次少,棘慢波的波幅小于100 μV,左右导不恒定或位于双侧额导,仅出现在NREM的Ⅰ-Ⅱ期,则提示该患者可能是癫(痫)或非癫(痫)性疾病,非癫(痫)的可能性大.额及额中线导联棘波,尤其是在清醒期或NREM Ⅰ-Ⅱ期出现,更多见于癫(痫)患者.     

青少年肌阵挛癫痫发作间期EEG-fMRI的研究

采用同步脑电与功能磁共振(Simultaneous electroencephalography-correlated functional magnetic resonance imaging,EEG-fMRI)技术,研究青少年肌阵挛癫痫患者发作间期痫样放电时脑部血氧水平依赖(Blood oxygen level-dependent,BOLD)信号变化。结果发现:双侧大脑半球的激活及失活信号变化普遍对称且各自独立存在,信号由枕顶至额区逐渐减少。阳性激活区有:楔叶、岛叶、额中部内侧、小脑中线两侧及丘脑。阴性激活区有:双侧额前部、顶部及扣带后回。由此推断:以棘慢复合波为表现形式的同步的神经元活动可能反映了丘脑皮层BOLD信号的激活,而失活区域反映了异常放电时的脑功能的静息状态;这类激活在神经元的活动(EEG)与fMRI结果之间有很好的对应关系;EEG-fMRI是研究脑功能状态有效的方式。     

失神发作患儿棘慢波放电的峰频分析

节律性棘慢波放电（ＳＷＤ）功率谱类似＂笙＂形，其最高功率为δ频带的２．５～３．５Ｈｚ区；峰频分析显示同样结果。不同个体在此范围内可有一定的差异，但同一个体在同一状态下δ峰频不变。δ峰频从ＳＷＤ起始到终止呈规律性减慢（由３．５０～３．００到２．７５～２．５０Ｈｚ）。θ、α和β各频段常为多峰频，个体间／内变化较大。多数情况下，θ、α和β峰频与δ主峰频的频率不呈倍数关系。     

EEG、ERP在血管性痴呆诊断中的应用分析

目的:探讨脑电图(EEG)和事件相关电位(ERP)在血管性痴呆(VD)早期诊断中的应用价值。方法:对56例VD患者进行EEG、ERP检测,分析认知功能的变化并与对照组进行比较。结果:56例中有54例EEG异常,表现为α节律变慢、广泛θ活动,局限性慢波(出现在额区、颞区、顶区),其中3例出现痫样放电;与对照组比较,ERP的P300波潜伏期延长,波幅降低。结论:EEG、ERP检测是诊断VD的重要方法之一,尤其是在发病早期。     

中年人听觉选择性注意的老化：来自事件相关电位(ERP)的证据

目的:探讨听觉选择性注意的老化是否出现在中年期。方法:参考Go/NoGo实验范式,采用E-prime2.0编制听觉选择性注意任务(选择和抑制条件),对20名中年和21名配对青年两组人群进行测试,同时用ERP记录脑电数据,最后用MATLAB(R2013b)和SPSS 16.0软件分析任务效应和年龄效应。结果:第一,任务效应显著,即在额区(Fz电极点)选择条件诱发的N1波幅比抑制条件更负更大(F_((2,78))=10.89,η_p~2=0.22,P0.01);抑制条件诱发的P2波幅比选择条件更正更大(F_((1,39))=52.13,η_p~2=0.57,P0.001);第二,年龄效应显著:(1)中年组的N1波幅比青年组更负更大(F_((1,39))=10.91,η_p~2=0.22,P0.01);(2)中年组N1和P2的潜伏期都显著长于青年组(F_((1,39))=8.05,η_p~2=0.17,P0.01;F_((1,39))=79.02,η_p~2=0.67,P0.001);(3)选择和抑制条件上,N1波幅和N1与P2的潜伏期均体现了注意老化,但在抑制上比选择上体现得更多。结论:中年人出现了听觉选择性注意的老化,且主要体现在抑制活动上。     

抑郁症患者脑电地形图改变对认知功能及与疗效的影响

目的:探讨抑郁症患者额颞叶脑电功率改变与认知功能及疗效的关系。方法:对40例抑郁症患者入院1周内行脑电地形图检查,并和32例正常对照组进行对照分析;同时对患者在治疗前后进行汉密尔顿抑郁量表(HAMD)评定。结果:(1)研究组额叶脑波α1(t=2.243,2.968,3.688,3.918),δ(t=3.639,2.517),θ(t=2.519,3.613,3.730)功率明显高于对照组,差异具有统计学意义(P0.05);(2)研究组颞叶脑波α2(t=-2.103,-2.944,-3.200,-4.548),α3(t=-3.102,-2.752,-3.047,-4.094),β(t=-3.015,-2.584,-3.842)功率明显低于对照组,差异具有统计学意义(P0.05);(3)左前额δ波功率与第2周末HAMD减分率有显著负相关(t=-2.429,P0.05);(4)左前额及右前颞β波功率、左前颞δ波功率与第6周末HAMD减分率有显著负相关(t=-2.365,-3.107,-3.979;P0.05);(5)右中颞δ波功率与第6周末HAMD减分率有显著正相关(t=2.248,P0.05)。结论:抑郁症患者存在额颞叶功能损伤影响认知功能;其抗抑郁剂治疗起效时间可能与左前额δ波功率有关;左前额及右前颞β波功率值可作为疗效的观察指标之一。     

儿童良性癫痫脑电图与临床追踪观察

目的：探讨儿童期良性中央—颞区棘波灶性癫痫(EBCC)的临床发作形式，脑电图(EEG)不同类型的改变，追踪临床、EEG及预后情况。方法：对36例不同年龄、不同发作特点、不同发作类型进行清醒自然睡眠或药物诱导睡眠行EEG描记。结果：本组36例临床发作表现多为部分型，EEG特点；其中21例(58％)局限于一侧的中央—颞区，15例(42％)呈双侧基本以一侧为主的中央—颞区为起搏点播散到额顶区，但仍以中央—颞区波幅最高。结论：本病5～10岁为多发年龄，EEG浅睡期阳性率最高。以中央—颞区为主的阵发单个间断或连续棘尖波或棘尖一慢综合波为发作特点。另外用药治疗比未治疗预后要好。     

HCV的核苷酸序列和突变率

有资料表明,HCV基因组在不同个体,甚至在一个体都存在变异。作者检测了同一例HCV慢性感染者相隔13年的两份血清。比较了血清中HCV基因组的核苷酸序列变化。该病人是美国人,1977年感染输血后NANB肝炎。一份血清取自急性感染早期(1977年7月12日)。另一份血清取自1990年8月1日。在此期间病人体内病毒持续复制。在5′非编码区(5′NC)、核心区(C)、外膜区(E)、非结构区(NS)1、2、3、5,共检测了4 923个核苷酸的序列。约占HCV基因组的一半。其中有123个碱基发生了改变,占2.5％。据此估计,该株HCV的突变率为每年每个基因位点约     

Space–time network connectivity and cortical activations preceding spike wave discharges in human absence epilepsy: a MEG study

To describe the spatial and temporal profiles of connectivity networks and sources preceding generalized spike-and-wave discharges (SWDs) in human absence epilepsy. Nonlinear associations of MEG signals and cluster indices obtained within the framework of graph theory were determined, while source localization in the frequency domain was performed in the low frequency bands with dynamic imaging of coherent sources. The results were projected on a three-dimensional surface rendering of the brain using a semi-realistic head model and MRI images obtained for each of the five patients studied. An increase in clustering and a decrease in path length preceding SWD onset and a rhythmic pattern of increasing and decreasing connectivity were seen during SWDs. Beamforming showed a consistent appearance of a low frequency frontal cortical source prior to the first generalized spikes. This source was preceded by a low frequency occipital source. The changes in the connectivity networks with the onset of SWDs suggest a pathologically predisposed state towards synchronous seizure networks with increasing connectivity from interictal to preictal and ictal state, while the occipital and frontal low frequency early preictal sources demonstrate that SWDs are not suddenly arising but gradually build up in a dynamic network.     

T-type Ca2+ channels in absence epilepsy

Absence epilepsy accompanies the paroxysmal oscillations in the thalamocortical circuit referred as spike and wave discharges (SWDs). Low-threshold burst firing mediated by T-type Ca²⁺ channels highly expressed in both inhibitory thalamic reticular nuclei (TRN) and excitatory thalamocortical (TC) neurons has been correlated with the generation of SWDs. A generally accepted view has been that rhythmic burst firing mediated by T-type channels in both TRN and TC neurons are equally critical in the generation of thalamocortical oscillations during sleep rhythms and SWDs. This review examined recent studies on the T-type channels in absence epilepsy which leads to an idea that even though both TRN and TC nuclei are required for thalamocortical oscillations, the contributions of T-type channels to TRN and TC neurons are not equal in the genesis of sleep spindles and SWDs. Accumulating evidence revealed a crucial role of TC T-type channels in SWD generation. However, the role of TRN T-type channels in SWD generation remains controversial. Therefore, a deeper understanding of the functional consequences of modulating each T-type channel subtype could guide the development of therapeutic tools for absence seizures while minimizing side effects on physiological thalamocortical oscillations.     

Hexa-methyl-propylene-amine-oxime (HMPAO) single photon emission computed tomography (SPECT) in epilepsy

Summary Twenty-eight normal volunteers and 74 seizure patients were investigated with hexa-methyl-propylene-amine-oxime (HMPAO) brain single photon emission computed tomography (SPECT). Fifty-four patients suffered from partial seizures and 20 patients had generalized seizures. Indices describing regional tracer distribution (RIs) were calculated in all investigated subjects. Regions whose RI exceeded the mean normal RI +/-3 SD were defined as abnormally perfused. In normals a significant interhemispheric asymmetry of HMPAO deposition was found, with higher RI values in the right frontal, parietal, temporal and occipital regions. In 59.3% of partial seizure patients abnormal RIs were found. Low RIs were detected predominantly in the frontal and temporal cortex, while elevated RIs were observed predominantly in the anterior basal ganglia. Only in 20% of the cases with generalized seizures, abnormal RIs were found. In one patient an ictal and 3 follow-up SPECT studies were obtained. Here SPECT results indicated transient rCBF changes between the ictal and seizure free state. EEG and SPECT foci were ipsilaterally located in 69.2% of the partial seizure cases. The results indicate that HMPAO brain SPECT is valuable for the detection of rCBF abnormalities in seizure patients and that patients with partial seizures have mostly several abnormally perfused areas in their brains.     

成人ADHD患者脑电α功率不对称性与生态执行功能的相关性

目的:探究成人注意缺陷多动障碍(ADHD)患者静息态脑电α绝对功率不对称性与生态执行功能的相关性。方法:选取成人ADHD患者49例及正常对照45例,用执行功能行为评定量表成人版(BRIEF-A)评估生态执行功能,并记录静息态脑电,分析不同脑区α绝对功率不对称性差异并探讨其与生态执行功能的相关性。结果:ADHD患者双侧额部、前额的α绝对功率不对称性低于正常对照(均P<0.05);成人ADHD在BRIEF-A自评问卷的行为管理指数和元认知指数维度得分均高于对照(均P<0.001);在正常对照中双侧额部(r=0.43,P<0.05)、前额(r=0.43,P<0.05)的α绝对功率不对称性与其自我监控评分呈现正相关,但成人ADHD患者未见此相关性(P>0.05)。结论:成人ADHD患者生态执行功能存在缺陷,额部α绝对功率不对称性与自我监控能力关联性的消失可能是其执行功能受损的神经电生理机制。     

Source Generators of Mismatch Negativity to Multiple Deviant Stimulus Types

The purpose of the present study was to investigate auditory stimulus feature processing and how neural generators might differ among the mismatch negativity (MMN) responses to intensity, frequency, and duration deviant stimuli. Data collected from 72 electrodes in twelve adult female subjects were analyzed. For each subject, peak amplitude and latency values at Fz were compared among responses to the three deviant stimulus types presented in individual conditions with a probability of 0.10 and 0.30, and in the multiple deviant condition in which all three deviant types were presented (design based on Deacon et al. 1998). Further, equivalent current dipoles (ECD) for each deviant type, in each condition, and for each subject were calculated in three areas: right hemisphere, left hemisphere, and frontal. Peak amplitude and latency measured at Fz were consistent with previous findings by Deacon et al. (1998) and suggested parallel processing, perhaps by separate neural generators. However, ECD locations were not significantly different among the responses to the different deviant types. Further, the ECD magnitudes did not consistently reflect the differences in amplitude observed at the scalp among responses to the deviant types and conditions. The latter finding may indicate that the procedures were not sensitive enough to identify true differences among the generators. Alternatively, it was suggested that searching for separate neural generators at the cortical level may be too restrictive because the process may begin in subcortical areas, as indicated in animal models.     

Absence seizures are reduced by the enhancement of GABA-ergic inhibition in the hippocampus in WAG/Rij rats

Classical theories on absence epilepsy suggest that spike-wave discharge (SWDs) represent thalamo-cortical oscillations, where an abnormally excitable cortex interacts with thalamus and brain stem reticular formation. The limbic system is generally not included in any theory about the pathogenesis of absence seizures. However, some data demonstrated that the alterations in the limbic system attribute to the expression of absence epileptic phenotype in genetic models of absence epilepsy. The present study investigated whether local intrahippocampal administration of progesterone (a GABA_A-mimetic) and tiagabine (an inhibitor of GABA (re)uptake) might affect the occurrence of SWDs. Male WAG/Rij rats were implanted with permanent electroencephalograph (EEG) electrodes and bilateral cannulas in the CA1-CA3 region of the dorsal hippocampus. Control rats had bilateral cannulas in the cortical area above the hippocampus. Rats received intracerebral injections of progesterone (5 mg/ml), 45% β-cyclodextrin (CD), saline, or tiagabine (2 mg/ml). EEG recordings were made before and after injection. Progesterone, CD, and tiagabine administration to the hippocampus reduced SWDs for 60 min following administration without behavioral or electroencephalographic side-effects. Both progesterone administration into the cortex and saline injection into the hippocampus yielded no changes in the occurrence of SWDs. These data suggest that activation of GABA-ergic transmission in the hippocampus has an inhibitory effect on cortico-thalamo-cortical circuits underlying the generation of SWDs and might be critically involved in the regulation of absence seizures.     

额叶癫痫发作的临床与脑电图特征

目的 :分析额叶癫发作的临床及EEG特征。方法 :经同步录像脑电图 (Video—EEG)监测 ,对 40例癫病人 181次额叶发作的临床表现及EEG进行同步分析。结果 :额叶发作频繁而短暂 ,以睡眠中发作为主。常见的临床表现依次为过度运动、扭转性强直、姿势性强直、发声、假性失神等。发作间期额区棘、尖波稀少且波形不典型 ,发作期额叶限局性或弥漫性的改变与背景活动的差别不明显。结论 :临床和EEG不典型是导致额叶发作临床诊断困难或误诊的主要原因。认识额叶发作的临床特点 ,延长EEG记录时间及发作期临床—EEG同步分析有助于对额叶发作的诊断。     

Effects of repetitive transcranial magnetic stimulation on spike-and-wave discharges

Aim of this study was to evaluate the effect of 5Hz-suprathreshold repetitive transcranial magnetic stimulation (rTMS) on the duration of the spike-and-wave discharges (SWDs) in a patient presenting idiopathic absence seizures. At the moment of the study the patient presented a mild blunting of consciousness due to the high frequency of absences and EEG recordings showed sub-continuous, generalized, symmetrical and synchronous 3c/s SWDs, petit mal status. Trains of 10 stimuli (120% resting motor threshold) were delivered at 5Hz frequency at the beginning of the SWDs. 5Hz-rTMS trains significantly changed the EEG activity by reducing the duration of SWDs without changing the intervals between two consecutive discharges. rTMS had not significant after-effects on the epileptic activity and patient's clinical status. Despite the limitations of a single case report, our neurophysiological findings suggest that 5Hz-suprathreshold rTMS delivered in short trains induces a transitory interference of the ongoing epileptic activity.     

EEG mapping in seasonal affective disorder

Given that the nature of hemispheric dysfunction is different in heterogeneous disorders, in the present investigation EEG power mapping was applied to establish neurophysiological profiles that might potentially discriminate patients with seasonal affective disorder (SAD) among other affective disorders. The baseline resting EEG activity was recorded from 31 depressed SAD patients and 30 controls. Power in the delta, theta-1, theta-2, alpha, beta-1 and beta-2 frequency bands was extracted by Fourier transformation. Patients were found to have a lower delta (in central, parietal, occipital, temporal, posterior-temporal areas), theta-1 (in central and parietal), theta-2 (in anterior-frontal, parietal, occipital) and alpha activity (in anterior-frontal, midfrontal, central, parietal and occipital areas) than controls. SAD subjects showed, compared to controls, an asymmetrical distribution of delta, theta-1, theta-2 and alpha activity in parietal and temporal regions due to an increase of EEG power over the right electrode sites, and beta activity in the lateral frontal region due to an increase of beta power over the right electrode site. It is assumed that differential hemispheric contributions of EEG spectra may discriminate between the varieties of depression or different depressive states.     

额叶癫癎发作的临床特征及脑电图分析

目的：探讨额叶癫癎发作的临床特征、脑电图（EEG）特点及临床意义.方法：回顾性分析30例经手术证实发作起源于额叶的药物难治性额叶癫癎患者87次临床发作症状、发作期及发作间期的头皮EEG特点.结果：额叶癫癎发作形式复杂多样,常见的发作形式有姿势性强直发作、过度运动性自动症、扭转性强直、阵挛性发作、发声、失神等,有时出现发作性情绪改变或自主神经症状等少见症状.额叶癫癎常见以下发作特点：发作频繁,常成簇出现,发作起止突然,持续时间短暂,发作后意识恢复快,以睡眠中发作为主.额叶癫癎发作间期EEG阳性率较低,额区棘波、尖波出现率相对较低,且波形不典型,发作期额叶限局性或弥漫性的改变与背景活动的差别不明显.结论：额叶癫癎临床和EEG不典型是导致额叶癫癎发作临床诊断困难的主要原因,认识额叶癫癎发作的临床特点,延长EEG记录时间,认真分析发作症候学、发作期同步EEG有助于明确诊断.