Recently, blink-related delta oscillations (delta BROs) have been observed in healthy subjects during spontaneous blinking at rest. Delta BROs have been linked with continuous gathering of information from the surrounding environment, which is classically attributed to the precuneus. Furthermore, fMRI studies have shown that precuneal activity is reduced or missing when consciousness is low or absent. We therefore hypothesized that the source of delta BROs in healthy subjects could be located in the precuneus and that delta BROs could be absent or reduced in patients with disorders of consciousness (DOC). To test these hypotheses, electroencephalographic (EEG) activity at rest was recorded in 12 healthy controls and nine patients with DOC (four vegetative states, and five minimally conscious states). Three-second-lasting EEG epochs centred on each blink instance were analyzed in both time- (BROs) and frequency domains (event-related spectral perturbation or ERSP and intertrial coherence or ITC). Cortical sources of the maximum blink-related delta power, corresponding to the positive peak of the delta BROs, were estimated by standardized Low Resolution Electromagnetic Tomography. In control subjects, as expected, the source of delta BROs was located in the precuneus, whereas in DOC patients, delta BROs were not recognizable and no precuneal localization was possible. Furthermore, we observed a direct relationship between spectral indexes and levels of cognitive functioning in all subjects participating in the study. This reinforces the hypothesis that delta BROs reflect neural processes linked with awareness of the self and of the environment.
This prospective study was planned to assess whether quantitative EEG (qEEG) can give an estimate of the timing of achievement of three endpoints (loss of activities of daily living, incontinence, and death) in 72 consecutive patients (53 females, 19 males; mean age, 70.8) affected with probable Alzheimer's disease, as defined according to the NINCDS-ADRDA criteria. Power-weighted, log-transformed relative values of the four conventional EEG bands were considered in a central-posterior temporal region for each hemisphere. The hypothesis was tested by the lifereg procedure of the Statistical Analysis System package (first significance level accepted, P < or = 0.01). Because patients were in different stages of the disease, the statistical analysis was performed in the entire group as well as in the subgroup of 41 patients (mean age, 69.6) with mild dementia (scoring 3 or 4 on the global deterioration scale). In the whole group, the loss of activities of daily living was predicted by delta power in either side (P = 0.01), incontinence was predicted by alpha power in the right side (P < 0.01), whereas the statistical significance was not reached for death (P < 0.05). In the subgroup of mild demented patients, the loss of activities of daily living was predicted by delta power in the left side (P = 0.01), incontinence by both delta (P < 0.01) and alpha (P < 0.001) power in the right side, and death was not significantly predicted (P = 0.08). Quantitative EEG is a low-cost, discomfort-free technique which may be used to obtain information on the timing of disease evolution. The results showed in mild Alzheimer's disease appear especially interesting to attempt a prediction of the future time course of the disease from its beginning.
Oscillatory mass responses centered at about 20-35 Hz or 100-120 Hz occur (after contrast or luminance visual stimulation, respectively) in the retina and cortex of animals and man and are recorded by electrical or magnetic methods. These oscillatory events reflect stimulus-related uni/multicellular oscillations of the firing rate/membrane potential and result from synchronization of neuronal assemblies selectively responding to the stimulus characteristics. Methodological problems in the study of these events derive from the contiguity in frequency between the ERG or VEP and the oscillatory responses and from the need to reliably define oscillatory events in time and frequency. Two methods (time-frequency analysis by matching pursuit and locking index) have been implemented to approach this issue. Theory and application are reviewed.
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