Mutual information analysis of the EEG in patients with Alzheimer's disease.

OBJECTIVE: Mutual information provides a measure of both the linear and nonlinear statistical dependencies between two time series. Cross-mutual information (CMI) is used to quantify the information transmitted from one time series to another, while auto mutual information (AMI) in a time series estimates how much on average the value of the time series can be predicted from values of the time series at preceding points. The aim of this study is to assess information transmission between different cortical areas in Alzheimer's disease (AD) patients by estimating the average CMI between EEG electrodes. METHODS: We recorded the EEG from 16 scale electrodes in 15 AD patients and 15 age-matched normal controls, and estimated the local, distant, and interhemispheric CMIs of the EEG in both groups. The rate of decrease (with increasing delay) of the AMI of the EEG was also measured to evaluate the complexity of the EEG in AD patients. RESULTS: The local CMI in AD subjects was lower than that in normal controls, especially over frontal and antero-temporal regions. A prominent decrease in information transmission between distant electrodes in the right hemisphere and between corresponding interhemispheric electrodes was detected in the AD patients. In addition, the AMIs throughout the cerebrums of the AD patients decreased significantly more slowly with delay than did the AMIs of normal controls. CONCLUSIONS: These results are consistent with previous findings that suggest the association of EEG abnormalities in AD patients with functional impairment of information transmission in long cortico-cortical connections.     

Focal EEG abnormalities might reflect neuropathological characteristics of pervasive developmental disorder and attention-deficit/hyperactivity disorder

Neurophysiological characteristics in electroencephalograms (EEG) were investigated for patients with pervasive developmental disorder (PDD) and for patients with attention-deficit/hyperactivity disorder (AD/HD). This study examined 64 PDD children and 22 AD/HD children with no history of epilepsy or progressive neurological or psychiatric disorder. We used multivariate analysis to compare EEG abnormalities, clinical symptoms, and intelligence levels between PDD and AD/AD patient groups. Paroxysmal discharges at the frontopolar-frontal (Fp-F) brain regions and background EEG abnormalities tended to be detected preferentially in the PDD group, although paroxysmal discharges at central-temporal (C-T) regions tended to be detected preferentially in the AD/HD group. The paroxysmal discharges observed in patients expressing persistence and impulsivity are apparently localized respectively in the Fp-F and C-T regions. A combination of EEG abnormalities, including background EEG abnormalities and paroxysmal discharges at Fp-F and C-T regions, might be useful diagnostic hallmarks to distinguish PDD with AD/HD from AD/HD alone using a logistic regression model. The dysfunction of specific brain areas associated with EEG abnormalities might explain characteristics of clinical symptoms observed in PDD and AD/HD patients.     

Cerebral blood flow and metabolism in late-life depression and dementia

Late-life depression (LLD) is characterized by abnormalities in cerebral blood flow (CBF) and cerebral metabolic rate (CMR) for glucose. Unlike younger adults with major depression, global cortical CBF and CMR reductions have been reported in LLD. Patients with LLD are also characterized by topographic abnormalities, most commonly involving selective prefrontal, superior temporal, and anterior parietal cortex. The fate of these abnormalities with response to antidepressant treatment is highly uncertain, and heterogeneous findings have been reported in younger samples with major depression. The limited data in LLD suggest that response to electroconvulsive therapy or antidepressant medications does not involve reversal of baseline abnormalities but rather accentuation of prefrontal deficits. At minimum, these paradoxical findings suggest that abnormalities in CBF and CMR may be persistent in LLD and a trait characteristic. Characteristic profiles of CBF and CMR abnormalities have also been demonstrated in samples with Alzheimer's disease (AD) and other types of dementia. Functional imaging has shown sensitivity to disease severity and progression. Nonetheless, there is limited information regarding the sensitivity and specificity of the functional imaging modalities in the differential diagnosis of dementias. At present, the evidence does not support the use of functional imaging in isolation as a diagnostic tool. Rather, these imaging modalities may be considered as an adjunct to careful clinical assessment, either to improve diagnosis in early cases or to assist in subtyping difficult cases.     

Global dynamical analysis of the EEG in Alzheimer's disease: frequency-specific changes of functional interactions.

OBJECTIVE: EEG coherence is decreased in Alzheimer's disease (AD), suggesting decreased interaction between brain areas. Nonlinear EEG analysis in AD points to decreased complexity of brain dynamics, implicating increased interaction. To clarify these apparently paradoxical findings from linear and nonlinear analysis, we calculated global coherence and global correlation dimension (D2), a nonlinear measure, in the EEG of patients with probable AD and controls. Our hypothesis is that these measures are related to each other when calculated in a comparable way. METHODS: From 15 patients with probable AD (mean age 63.1 years; SD 6.3) and 21 age-matched controls with subjective memory complaints (mean age 62.8; SD 12.0), band filtered EEG data were analysed in six frequency bands. For each frequency band average coherence and multichannel D2 were determined. RESULTS: ANOVA for repeated measures showed for D2 an interaction between band and group, but not for coherence. In the beta band and upper alpha band, D2 was higher in patients with probable AD compared to controls, while global coherence tended to be lower in these frequency bands in patients with probable AD. In the frequency range from theta to beta, coherence and D2 were inversely correlated without group differences. CONCLUSIONS: When calculated in comparable ways, global correlation dimension and coherence are related measures. In AD, these measures change especially in the higher frequency ranges, both pointing to decreased functional cortical connectivity. SIGNIFICANCE: Both global coherence and global correlation dimension seem to measure global connectivity, but nonlinear measures may be more sensitive. In AD, connectivity measures are not equally impaired in all frequency ranges, possibly reflecting differentiated affection of the dynamical processes responsible for the different frequency bands.     

Nonlinear EEG analysis in early Alzheimer's disease

Nonlinear EEG analysis attempts to characterize the dynamics of neural networks in the brain. Abnormalities in nonlinear EEG measures have been found repeatedly in Alzheimer's disease (AD). The present study was undertaken to investigate whether these abnormalities could already be found in the early stage of AD. In a representative sample of 49 community-dwelling elderly, Alzheimer's disease was diagnosed in 7 subjects. Correlation dimension (D2) and nonlinear prediction were measured at 16 electrodes and in two different activational states. Also, 10 surrogate data sets were generated for each EEG epoch in order to investigate the presence of nonlinear dynamics. Differences between nonlinear statistics derived from original and from surrogate data sets were expressed as Z-scores. We found lower D2 and higher predictability in the demented subjects compared to the normal subjects. The results obtained with the Z-scores pointed to changed nonlinear dynamics in frontal and temporal areas in demented subjects. However, the major differences between demented and healthy subjects are not due to nonlinearity. From this it appears that linear dynamics change first in the course of AD, followed by changes in nonlinear dynamics.     

The use of EEG in the diagnosis of dementia with Lewy bodies

Although reports on EEG in dementia with Lewy bodies (DLB) are conflicting, the recent diagnostic guidelines define EEG abnormalities as being supportive for the diagnosis. We examined EEG abnormalities in 18 patients with DLB, 34 patients with Alzheimer's disease (AD) and 36 patients with subjective memory complaints (SMC) using the Grand Total EEG (GTE) score. There was a difference in median GTE score of DLB (11.0), AD (4.8) and SMC (2.5) (p<0.001). Patients with DLB had higher scores than patients with AD. ROC analyses revealed that patients with DLB could be distinguished from those with AD with a sensitivity of 72% and a specificity of 85% at a GTE cut-off of 9.5. The association between GTE and DLB was independent of age, gender, Mini Mental State Examination and medication use. Frontal intermittent rhythmic delta activity (FIRDA) was found in 2.9% of the patients with AD and in 33.3% of the patients with DLB. The GTE is a simple EEG scoring method that can be helpful in the differential diagnosis between DLB and AD with good sensitivity and specificity.     

Cerebral structure on MRI, Part II: Specific changes in Alzheimer's and Huntington's diseases

Using magnetic resonance (MR) imaging and morphometric techniques, groups of patients with Alzheimer's disease (AD) and Huntington's disease (HD) were compared with a large group of normal control subjects. Measures of volume loss in specific subcortical nuclei and eight cortical regions as well as an index of white matter abnormality were obtained. Results indicated expected widespread cortical volume reductions in AD, which were especially severe in mesial cortices; but comparable reductions were present in subcortical structures, particularly the thalamus. In HD, the greatest reductions were in striatal structures, but significant abnormalities were also detected in the thalamus and inferior cortical areas, especially in mesial temporal lobe structures. Significant degeneration in white matter was present in both groups, but was more dramatic in the HD patients. The significant diencephalic reduction in AD may make an important contribution to early memory deficits in the disorder, which are usually attributed to hippocampal damage. Similarly, damage to both the thalamus and mesial temporal lobe structures may play a role in the memory deficits of HD.     

Functional connectivity and working memory in schizophrenia: an EEG study

A leading hypothesis suggests that schizophrenic patients suffer from a disconnection syndrome. A failure in functional connectivity curtails the cortical integration and network activation needed to perform working memory tasks. Simulations with neural network models also indicate that connectivity is crucial for simulation of working memory asks. Multichannel EEG correlation-coefficient estimations are considered as a reliable measurement of connectivity patterns among cortical regions. In this study EEG samples are obtained selectively at the delay epochs of a delayed response working memory task. Results of correlation-coefficient estimations indicate a lack of statistically significant changes between non-task and task conditions in frontal, certain parietal, temporal and central channels. These findings propose that schizophrenics probably "fail" to activate the neural networks of the fronto-temporal regions. These are the networks involved in computation of the working memory task. Interestingly also good performers schizophrenics failed to activate these networks suggesting that the connectivity function is more relevant to the disorder than to task performance. If distinct deficits in cortical network activations would correlate with mental disorders it would be relevant to diagnosis and treatment of psychiatric disorders.     

Spatial–temporal graph convolutional network for Alzheimer classification based on brain functional connectivity imaging of electroencephalogram

Functional connectivity of the human brain, representing statistical dependence of information flow between cortical regions, significantly contributes to the study of the intrinsic brain network and its functional mechanism. To fully explore its potential in the early diagnosis of Alzheimer''s disease (AD) using electroencephalogram (EEG) recordings, this article introduces a novel dynamical spatial–temporal graph convolutional neural network (ST‐GCN) for better classification performance. Different from existing studies that are based on either topological brain function characteristics or temporal features of EEG, the proposed ST‐GCN considers both the adjacency matrix of functional connectivity from multiple EEG channels and corresponding dynamics of signal EEG channel simultaneously. Different from the traditional graph convolutional neural networks, the proposed ST‐GCN makes full use of the constrained spatial topology of functional connectivity and the discriminative dynamic temporal information represented by the 1D convolution. We conducted extensive experiments on the clinical EEG data set of AD patients and Healthy Controls. The results demonstrate that the proposed method achieves better classification performance (92.3%) than the state‐of‐the‐art methods. This approach can not only help diagnose AD but also better understand the effect of normal ageing on brain network characteristics before we can accurately diagnose the condition based on resting‐state EEG.     

Brain Proton MRS is Correlated with Financial Abilities in Patients with Alzheimer’s Disease

Persons with Alzheimer’s disease (AD) demonstrate frank impairments in the performance of everyday functional abilities. However, the neuroanatomic and neuro-metabolic correlates of these functional deficits in mild AD are largely unknown. Using 3-Tesla proton magnetic resonance spectroscopy (¹H-MRS) of the posterior cingulate gyrus in 14 patients with mild AD and 14 healthy adult controls, we sought to determine the brain metabolic correlates of financial impairments in mild AD. Both N-acetylaspartate (NAA) and choline-containing compounds (Cho) were found to be abnormal in mild AD. In AD patients, NAA showed a positive correlation with financial abilities, while Cho showed a possible negative correlation with financial abilities. These findings suggest that metabolic abnormalities of posterior cortical paralimbic regions may reflect the underlying neuropathological processes that are instrumental in the degradation of financial abilities in mild AD. Proton MRS could offer a means to track brain changes associated with functional change in mild AD.     

Frontal shift of posterior alpha activity is correlated with cognitive impairment in early Alzheimer's disease: A magnetoencephalography–beamformer study

Background: Induced‐oscillatory activity is considered a key factor for understanding functional processes in the brain. Magnetoencephalography (MEG) can measure oscillatory activity non‐invasively with higher spatial resolution than electroencephalography (EEG). However, MEG has rarely been used to explore functional abnormalities that may represent state markers in patients with Alzheimer's disease (AD). Methods: Thirteen patients with early AD and 14 age‐matched normal controls participated in the present study. Magnetoencephalography activity was acquired during eyes‐open and eyes‐closed states. Alpha event‐related synchronization (ERS) after eye closing was calculated and its cortical sources superimposed on each individual's magnetic resonance imaging (MRI) scan. The resulting functional image was converted into a Talairach‐transformed anatomical brain image and group comparisons were made. We also assessed correlations between cortical ERS sources showing significant between‐group differences in alpha activity and external clinical parameters, especially measures of cognitive function. Results: The averaged alpha ERS after eye closing appeared dominantly in posterior brain regions in both patients with AD and healthy controls. However, there was a significant increase in alpha ERS in frontal regions, maximal over the prefrontal cortex, in patients with AD relative to controls, indicating a frontal shift of the posterior dominant MEG alpha rhythm in AD patients. This frontal ERS source in the alpha band was negatively correlated with Mini‐Mental State Examination scores in the AD patient group. Conclusions: The findings indicate that a frontal shift of alpha ERS elicited by an eyes‐open/eyes‐closed paradigm may be an early brain electromagnetic change in patients with AD, probably representing a physiological state marker of the disease. Furthermore, the results confirm that the beamformer with group comparison analysis is a useful tool with which to explore functional processes in the brain, as indicated by oscillatory activity changes.     

Decreased nonlinear complexity and chaos during sleep in first episode schizophrenia: a preliminary report

Schizophrenia is characterized by disturbed sleep architecture. It has been thought that sleep abnormalities may underlie information processing deficits associated with this disorder. Nonlinear analyses of sleep data can provide valuable information on sleep characteristics that may be relevant to the functions of sleep. This study examined the predictability and nonlinear complexity of sleep EEG time series in two EEG channels (C4 and F4) using measures of nonlinearity, such as symbolic dynamics and the largest Lyapunov exponent (LLE) in schizophrenia. A series of antipsychotic naive patients with first episode of schizophrenia or schizoaffective disorder and age-matched healthy controls were studied during awake period, stage 1/2, slow wave sleep (stage 3/4) and rapid eye movement (REM) sleep. Nonlinearity scores were significantly lower during awake stage in patients compared to controls suggesting that there may be a diminished interplay between various parameters for the genesis of waking EEG. Symbolic dynamics and LLE were significantly lower in patients during REM compared to healthy controls, suggesting decreased nonlinear complexity of the EEG time series and diminished chaos in schizophrenia. Decreased nonlinear complexity was also correlated with neurocognitive deficits as assessed by the Wisconsin card sorting test. Diminished complexity of EEG time series during awake and REM sleep in patients with schizophrenia may underlie the impaired ability to process information in psychotic disorders such as schizophrenia.     

Alzheimer's disease: more than a 'cholinergic disorder' - evidence that cholinergic-monoaminergic interactions contribute to EEG slowing and dementia

The loss of cognitive (particularly mnemonic) abilities constitutes a prominent symptom of Alzheimer's disease (AD). These cognitive symptoms occur in close relation to the slowing of the electroencephalogram (EEG), and it is likely that the inability of cortical circuits to maintain an activated state contributes to the behavioral disorganization in AD. The 'cholinergic hypothesis' of AD suggests that many of the cognitive and EEG symptoms are related to the atrophy of basal forebrain cholinergic neurons, which innervate the neocortex and hippocampus, among others. However, data from behavioral and electrophysiological studies in rats suggest that selective reductions in cholinergic transmission result in relatively small mnemonic impairments, and only a partial reduction in EEG activation. Thus, cholinergic atrophy alone may not be sufficient to cause the marked changes in cognition and cortical activity typical of AD. Cholinergic deficits do, however, make neural circuits susceptible to additional neurodegenerative processes. In rats, lowered serotonergic or noradrenergic activity alone often produces only minor impairments in learning/memory tasks and does not block EEG activation. The same monoaminergic deficits, however, result in severe behavioral impairments, and reduce or abolish EEG activation when they occur in a brain already affected by lowered cholinergic activity. There is an abundance of evidence that monoamines are reduced in AD. These degenerative processes, when occurring in a neural environment compromised by cholinergic atrophy, may then contribute to the disturbances in cortical processing and cognition/behavior in AD. A prediction derived from this theory is that an enhancement of monoaminergic functions may have beneficial effects on behavior and cortical activity. Preliminary experiments support this idea: combined cholinergic-monoaminergic stimulation can be more effective in reversing behavioral (Morris water maze) impairments and EEG slowing in rats with multiple neurotransmitter deficiencies than cholinergic enhancement alone. Thus, a stimulation of monoaminergic activity, in conjunction with cholinergic therapies, may provide an effective treatment option for AD.     

Increased cerebral vascular reactivity in the tau expressing rTg4510 mouse: evidence against the role of tau pathology to impair vascular health in Alzheimer's disease

Vascular abnormalities are a key feature of Alzheimer''s disease (AD). Imaging of cerebral vascular reactivity (CVR) is a powerful tool to investigate vascular health in clinical populations although the cause of reduced CVR in AD patients is not fully understood. We investigated the specific role of tau pathology in CVR derangement in AD using the rTg4510 mouse model. We observed an increase in CVR in cortical regions with tau pathology. These data suggest that tau pathology alone does not produce the clinically observed decreases in CVR and implicates amyloid pathology as the dominant etiology of impaired CVR in AD patients.     

Interaction of synchronized dynamics in cortex and basal ganglia in Parkinson's disease

Parkinson's disease pathophysiology is marked by increased oscillatory and synchronous activity in the beta frequency band in cortical and basal ganglia circuits. This study explores the functional connections between synchronized dynamics of cortical areas and synchronized dynamics of subcortical areas in Parkinson's disease. We simultaneously recorded neuronal units (spikes) and local field potentials (LFP) from subthalamic nucleus (STN) and electroencephalograms (EEGs) from the scalp in parkinsonian patients, and analysed the correlation between the time courses of the spike–LFP synchronization and inter‐electrode EEG synchronization. We found the (non‐invasively obtained) time course of the synchrony strength between EEG electrodes and the (invasively obtained) time course of the synchrony between spiking units and LFP in STN to be weakly, but significantly, correlated with each other. This correlation is largest for the bilateral motor EEG synchronization, followed by bilateral frontal EEG synchronization. Our observations suggest that there may be multiple functional modes by which the cortical and basal ganglia circuits interact with each other in Parkinson's disease: not only may synchronization be observed between some areas in cortex and the basal ganglia, but also synchronization within cortex and within basal ganglia may be related, suggesting potentially a more global functional interaction. More coherent dynamics in one brain region may modulate or activate the dynamics of another brain region in a more powerful way, causing correlations between changes in synchrony strength in the two regions.     

Resting state cortical electroencephalographic rhythms are related to gray matter volume in subjects with mild cognitive impairment and Alzheimer's disease

Cortical gray matter volume and resting state cortical electroencephalographic rhythms are typically abnormal in subjects with amnesic mild cognitive impairment (MCI) and Alzheimer's disease (AD). Here we tested the hypothesis that in amnesic MCI and AD subjects, abnormalities of EEG rhythms are a functional reflection of cortical atrophy across the disease. Eyes‐closed resting state EEG data were recorded in 57 healthy elderly (Nold), 102 amnesic MCI, and 108 AD patients. Cortical gray matter volume was indexed by magnetic resonance imaging recorded in the MCI and AD subjects according to Alzheimer's disease neuroimaging initiative project ( http://www.adni‐info.org/ ). EEG rhythms of interest were delta (2–4 Hz), theta (4–8 Hz), alpha1 (8–10.5 Hz), alpha2 (10.5–13 Hz), beta1 (13–20 Hz), beta2 (20–30 Hz), and gamma (30–40 Hz). These rhythms were indexed by LORETA. Compared with the Nold, the MCI showed a decrease in amplitude of alpha 1 sources. With respect to the Nold and MCI, the AD showed an amplitude increase of delta sources, along with a strong amplitude reduction of alpha 1 sources. In the MCI and AD subjects as a whole group, the lower the cortical gray matter volume, the higher the delta sources, the lower the alpha 1 sources. The better the score to cognitive tests the higher the gray matter volume, the lower the pathological delta sources, and the higher the alpha sources. These results suggest that in amnesic MCI and AD subjects, abnormalities of resting state cortical EEG rhythms are not epiphenomena but are strictly related to neurodegeneration (atrophy of cortical gray matter) and cognition. Hum Brain Mapp, 2013. © 2012 Wiley Periodicals, Inc.     

Asymmetric cortical degenerative syndromes: clinical and radiologic correlations.

Eight patients presented with slowly progressive focal neurologic syndromes that conformed to one of three clinically defined categories: progressive nonfluent aphasia (three patients), progressive perceptual-motor impairment (four patients), and progressive frontal lobe syndrome (one patient). Planar MRI and MRI-based surface or volume renderings demonstrated focal areas of atrophy that correlated well with clinical deficits. Single-photon emission computed tomography (SPECT) showed areas of cortical hypoperfusion that corresponded to focally atrophic regions revealed by MRI, but abnormal areas with SPECT were larger than those suggested by MRI. MRI and SPECT are useful in defining the regional structural and functional cerebral abnormalities that underlie slowly progressive focal neurologic syndromes caused by asymmetric cortical degeneration.     

Dimensional complexity of the EEG in patients with posttraumatic stress disorder

Recent electrophysiological studies have reported evidence of information processing abnormalities in patients with posttraumatic stress disorder (PTSD). The aim of this study is to examine dynamical complexity of the EEG in PTSD patients, which is thought to reflect information processing of the brain. Resting EEG recordings (32,800 data points acquired continuously from 82 s of an EEG record) were obtained in 16 channels of 27 patients with PTSD from a mixed civilian trauma population and 14 healthy subjects. The correlation dimension (D2) of the EEG was used to quantify the complexity of the cortical dynamics underlying the EEG signal. The PTSD patients were found to have lower D2 values than those of the healthy subjects in most channels (Fp1, F8, C4, P4, T3, T4, T5, T6, and O1), indicating that PTSD patients have globally reduced complexity in their EEG waveforms. This study supports the hypotheses that PTSD patients exhibit disturbed cortical information processing, and that non-linear dynamical analysis of the EEG can be a tool for detecting changes in neurodynamics of the brain in PTSD.     

Focal decreases of cortical GABAA receptor binding remote from the primary seizure focus: What do they indicate?

Purpose: To determine the electroclinical significance and histopathological correlates of cortical γ‐aminobutyric acid_A(GABA_A) receptor abnormalities detected in and remote from human neocortical epileptic foci. Methods: Cortical areas with decreased¹¹C‐flumazenil (FMZ) binding were objectively identified on positron emission tomography (PET) images and correlated to intracranial electroencephalography (EEG) findings, clinical seizure variables, histology findings, and surgical outcome in 20 patients (mean age, 9.9 years) with intractable partial epilepsy of neocortical origin and nonlocalizing magnetic resonance imaging (MRI). Results: Focal decrease of cortical FMZ binding was detected in the lobe of seizure onset in 17 (85%) patients. Eleven patients (55%) had 17 remote cortical areas with decreased FMZ binding outside the lobe of seizure onset. Thirteen of those 16 (81%) of the 17 remote cortical regions that were covered by subdural EEG were around cortex showing rapid seizure spread on intracranial EEG. Remote FMZ PET abnormalities were associated with high seizure frequency and, when resected, showed gliosis in all six cases where material was available. Higher number of unresected cortical regions with decreased FMZ binding was associated with poorer surgical outcome. Conclusions: Focal decreases of cortical GABA_A receptor binding on PET may include cortical regions remote from the primary focus, particularly in patients with high seizure frequency, and these regions are commonly involved in rapid seizure propagation. Although these regions may not always need to be resected to achieve seizure freedom, a careful evaluation of cortex with decreased GABA_A receptor binding prior to resection using intracranial EEG may facilitate optimal surgical outcome in patients with intractable neocortical epilepsy.     

Permutation entropy of scalp EEG: A tool to investigate epilepsies: Suggestions from absence epilepsies

ObjectiveWe used permutation entropy (PE) to disclose abnormalities of cerebral activity in patients with typical absences (TAs).MethodsWe evaluated 24 EEG of TA patients and 40 EEG of healthy subjects. PE was estimated channel by channel, with electrodes being divided into high-PE cluster (high randomness), low-PE cluster (low randomness), and neutral cluster. We compared PE between EEG of patients and controls, and between interictal and ictal EEG of patients.ResultsPatients showed a recurrent behavior of PE topography, with anterior brain regions constantly associated to high PE levels and posterior brain regions constantly associated to low PE levels, during both interictal and ictal phases. On the contrary, healthy controls had a random distribution of PE topography.ConclusionsIn patients with TAs, a higher randomness in fronto-temporal areas and a lower randomness in posterior areas occur during both interictal and ictal phases. Such abnormalities are in keeping with evidences from different morphological and functional studies showing multifocal brain changes in TA patients.SignificancePE seems to be a useful tool to disclose abnormalities of cerebral electric activity not revealed by conventional EEG recordings, opening interesting prospective for future studies.