“Distressed aging”: the differences in brain activity between early- and late-onset tinnitus

Recent findings regarding different characteristics according to the age of tinnitus onset prompted us to conduct a study on the differences in tinnitus-related neural correlates between late-onset tinnitus (LOT; mean onset age, 60.4 years) and early-onset tinnitus (EOT; mean onset age, 29.7 years) groups. Hence, we collected quantitative electroencephalography findings of 29 participants with LOT and 30 with EOT, and from 59 controls. We then compared the results between the 2 groups and between the tinnitus groups and age- and sex-matched control groups using resting state electroencephalography source-localized activity and connectivity analyses. Compared with the EOT and older control groups, the LOT group demonstrated increased localized activity and functional connectivity in components of previously described tinnitus distress networks, and the default mode and intrinsic alertness networks, such as the prefrontal cortices, dorsal anterior cingulate cortex, and insula. The current findings of intrinsic differences in tinnitus-related neural activity between the LOT and EOT groups might be applicable for planning individualized treatment modalities according to age of onset. Moreover, differences with regard to the age of tinnitus onset might be a milestone for future studies on onset-related differences in other similar pathologies, such as pain or depression.     

生物反馈结合线索暴露治疗降低海洛因依赖者药物线索反应

目的:了解生物反馈结合线索暴露治疗是否降低海洛因依赖者环境线索诱发渴求及心理生理反应.方法:采用前瞻性的队列研究将60例环境线索诱发心理渴求增高的康复期海洛因依赖者分成实验组(n=36)与对照组(n=24),对照组只进行劳教场所的常规帮教,实验组除帮教外进行12次生物反馈结合线索暴露治疗,评估治疗前后环境线索诱发心理渴求与心理生理反应情况.结果:两组治疗结束后,实验组环境诱发前、后的心理渴求,肌电和皮导得分均低于对照组[诱发前:心理渴求(3.06±7.26)mm vs.(22.32±20.26)mm、肌电(8.52±4.23)μV vs.(12.06±5.17)μV、皮导(2.14±1.43)μS vs.(4.61±2.24)μS;诱发后:心理渴求(6.97±10.30)vs.(33.14±25.40)mm、肌电(8.72±4.31)vs.(14.79±5.86)μV、皮导(2.15±1.33)vs.(4.49±2.59)μS,P≤0.01].结论:生物反馈结合线索暴露治疗可降低康复期海洛因依赖者渴求及环境诱发心理生理反应.     

ERP denoising in multichannel EEG data using contrasts between signal and noise subspaces

In this paper, a new method intended for ERP denoising in multichannel EEG data is discussed. The denoising is done by separating ERP/noise subspaces in multidimensional EEG data by a linear transformation and the following dimension reduction by ignoring noise components during inverse transformation. The separation matrix is found based on the assumption that ERP sources are deterministic for all repetitions of the same type of stimulus within the experiment, while the other noise sources do not obey the determinancy property. A detailed derivation of the technique is given together with the analysis of the results of its application to a real high-density EEG data set. The interpretation of the results and the performance of the proposed method under conditions, when the basic assumptions are violated – e.g. the problem is underdetermined – are also discussed.Moreover, we study how the factors of the number of channels and trials used by the method influence the effectiveness of ERP/noise subspaces separation. In addition, we explore also the impact of different data resampling strategies on the performance of the considered algorithm. The results can help in determining the optimal parameters of the equipment/methods used to elicit and reliably estimate ERPs.     

眼睑肌阵挛失神综合征的临床与脑电图特征

目的：探讨眼睑肌阵挛失神综合征（EMA）的临床、脑电图（EEG）特点及治疗。方法：回顾我院诊治的2例EMA患者的临床资料,并结合文献分析。结果：2例均为儿童期起病,表现为反复的眼睑肌阵挛,伴或不伴短暂失神,EEG特征为泛化性的、双侧基本对称的2．5～4Hz棘慢波或多棘慢波发放。结论：EMA由于症状复杂,常被漏诊。EEG对EMA的诊断是必需的。     

液压脑损伤大鼠行为学和脑电图的研究

目的 通过液压脑损伤大鼠行为学和脑电图的研究以探讨其在外伤后癫痫中的研究价值.方法 建立液压脑损伤动物模型并进行为期3个月大鼠行为学和脑电图的观察、记录.结果 液压脑损伤后50只大鼠死亡19只,存活的31只中有11只出现癫痫.癫痫的发作形式主要表现为面肌痉挛、点头样运动,其次为四肢抽搐、翻转跳起等.液压脑损伤后第2个月为癫痫发生的高峰期.癫痫发作时同期脑电图可见癫痫样放电.液压脑损伤后部分非癫痫大鼠脑电图表现为1～5导联波幅增高、频率增快.结论 液压脑损伤后癫痫动物模型与临床外伤后癫痫相似,与其他外伤后癫痫动物模型相比,更具有研究价值.     

Inter-hemispheric functional coupling of eyes-closed resting EEG rhythms in adolescents with Down syndrome

ObjectiveWe tested the hypothesis that inter-hemispheric directional functional coupling of eyes-closed resting EEG rhythms is abnormal in adolescents with Down syndrome (DS).MethodsEyes-closed resting EEG data were recorded in 38 DS adolescents (18.7 years ±0.67 SE, IQ = 49 ± 1.9 SE) and in 17 matched normal control subjects (NYoung = 19.1 years ±0.39 SE). The EEG data were recorded from 8 electrodes (Fp1, Fp2, C3, C4, T3, T4, O1, O2) referenced to vertex. EEG rhythms of interest were delta (2–4 Hz), theta (4–8 Hz), alpha 1 (8–10.5 Hz), alpha 2 (10.5–13 Hz), beta 1 (13–20 Hz), and beta 2 (20–30 Hz). Power of EEG rhythms was evaluated by FFT for control purposes, whereas inter-hemispheric directional EEG functional coupling was computed by directed transfer function (DTF).ResultsAs expected, alpha, beta, and gamma power was widely higher in NYoung than DS subjects, whereas the opposite was true for delta power. As a novelty, DTF (directionality) values globally prevailed from right to left occipital areas in NYoung subjects and in the opposite direction in DS patients. A control experiment showed that this DTF difference could not be observed in the comparison between DS adults with mild cognitive impairment and normal age-matched adults.ConclusionsThese results indicate a peculiar abnormal directional inter-hemispheric interplay in visual occipital areas of DS adolescents.SignificanceDirection of inter-hemispheric EEG functional coupling unveils a new abnormal brain network feature in DS adolescents.     

Paramedical treatment in primary dystonia: A systematic review

Dystonia is a disabling movement disorder with a significant impact on quality of life. The current therapeutic armamentarium includes various drugs, botulinum toxin injections, and occasionally (neuro)surgery. In addition, many patients are referred for paramedical (including allied health care) interventions. An enormous variation in the paramedical treatment is provided, largely because evidence‐based, accepted treatment regimes are not available. We have conducted a systematic review of studies that explored the effect of various paramedical interventions in primary dystonia. Only studies that have used clinical outcome measures were included. There were no class A1 or A2 studies and therefore, level 1 or 2 practice recommendations for a specific intervention could not be deducted. Many papers were case reports, mostly with a very limited number of patients and a clear publication bias for beneficial effects of a particular paramedical intervention. Some potentially interesting interventions come from class B studies, which include physical therapy in addition to botulinum toxin injections (BoNT‐A) in cervical dystonia; sensorimotor training and transcutaneous electrical nerve stimulation (TENS) in writer's cramp; and speech therapy added to BoNT‐A injections in laryngeal dystonia. Good quality clinical studies are therefore warranted, which should have the aim to be generally applicable. A design in which the paramedical intervention is added to a current gold standard, for example, BoNT‐A injections in cervical dystonia, is recommended. © 2009 Movement Disorder Society     

中老年复杂部分性发作癫痫持续状态的临床特征及误诊分析

目的 分析中老年复杂部分性发作癫痫持续状态(CPSE)的临床特点及误诊原因.方法 收集广州医学院第二附属医院神经内科自2008年1月至12月收治、曾被外院误诊的中老年CPSE患者的临床资料,进行视频脑电图(EEG)、头颅MR、生化检查,根据国际抗癫痫联盟的CPSE诊断标准进行诊断,并随访3个月以上. 结果 本组患者7例,均为女性,其中额叶癫痫(FLE)2例,颞叶癫痫(TLE)5例;CPSE患者临床症状和视频EEG表现多样化;经抗癫痫药物(AEDs)治疗后3例至少3个月无发作,3例仍有CPSE发作,1例仍有反复CPSE. 结论 由于CPSE患者临床症状和EEG表现欠典型,常合并其他系统疾病和社会因素的影响易被误诊,应及早做视频EEG检查以明确诊断;口服AEDs治疗可取得良好效果.     

Educational problems related to quantitative EEG changes in benign childhood epilepsy with centrotemporal spikes

The relationship between educational problems and clinical/electroencephalographic aspects was assessed in 38 children with benign childhood epilepsy with centrotemporal spikes (BECTS). Children were assessed using the School Performance Test; questionnaires on learning difficulties administered to parents and teachers; the Wechsler Intelligence Scale for Children, Third Edition; and EEGs. Absolute and relative amplitudes in the classic bands (quantitative EEG) and characteristics of epileptiform activity on the EEG were examined. Educational problems were observed in 7 (18.4%) children with BECTS. In this subgroup, relative alpha amplitudes at the central and parietal electrodes were lower as compared with those of the BECTS subgroup with normal educational performance and a control group matched for age, gender, and socioeconomic status. The data indicated a possible relationship between alterations in background brain electrical activity and the tendency toward inferior educational performance in children with BECTS. This study suggested that quantitative EEGs are a possible physiological tool in the assessment of cognitive aspects in children with BECTS.     

脑电趋势图监护在神经重症监护病房对癫痫及亚临床癫痫的诊断意义

目的 通过连续和动态监护神经重症监护病房(N-ICU)患者的脑电图(EEG)变化,观察脑趋势图改变与癫痫的关系,探讨脑电趋势图对癫痫以及亚临床癫痫的诊断意义. 方法N-ICU 15例癫痫患者,其中癫痫持续状态(SE)10例,予以脑电监护,采用10-20标准电极安装法,8导参考电极导联法(Fp1-A1、C3-A1、T3-A1、01-A1、Fp2-A2、C4-A2、T4-A2、O2-A2)采集脑电趋势图数据,包括振幅整合脑电图(aEEG)、样本包络、波段功率(BP).对同一患者的癫痫发作期和间期的数值分别求出平均值,进行对比分析.采用ROC分析评价3种趋势图对癫痫诊断能力. 结果癫痫在N-ICU的发生率为15/122,15例癫痫患者中癫痫持续状态(SE)10例,全面性惊厥性癫痫持续状态(GCSE)8例,非惊厥性癫痫持续状态(NCSE)7例,GCSE发作后继之NCSE 5例.癫痫发作时aEEG上界和下界分别上升了27.90%和33.53%,形成一明显"波峰",与未发作时比较,差异均有统计学意义(P<0.05).参考电极导联样本包络波幅上升了124.09%,与未发作时比较,差异有统计学意义(P<0.05).α和β波段的绝对波段功率(ABP)明显增高,与未发作时比较,差异均有统计学意义(P<0.05). 结论癫痫及亚临床癫痫在N-ICU发生率较高,3种趋势图对癫痫发作的诊断都有价值,aEEG诊断能力强于样本包络,BP结果可提供参考.