Electroencephalographic Spectra and Reaction Time in Disorders of Higher Nervous Function

Stevens, Janice R.; B, Lonsbury; Goel, Sachin S.

doi:10.1126/science.176.4041.1346

Cited by 15 publications

(4 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Tuvo (1958), Prechtl et al (1961), Sellden (1971 and Hutt et al (1977) found no evidence of TCI during discharges variously described as unilateral, focal or localized. An association of increased reaction time with localized increase in low frequency components of EEG power spectra has been demonstrated, however, by Stevens et al (1972), and these 'ramp spectra' in turn were associated with spiking at depth electrodes.…”

Section: Discussionmentioning

confidence: 99%

Selective Cognitive Impairment During Focal and Generalized Epileptiform Eeg Activity

Aarts¹,

Binnie²,

Smit³

et al. 1984

Brain

499

325

View full text Add to dashboard Cite

It is well established that generalized epileptiform EEG discharges unaccompanied by overt clinical change may nevertheless be associated with transitory cognitive impairment (TCI) detectable by appropriate psychological testing. However, the tests employed in most research studies of this phenomenon are of little use for routine clinical application. They are suitable for administration only over short periods of time and are therefore applicable only to patients with a high discharge rate, a serious limitation, as the discharges are generally depressed by the tests themselves. We have developed two short-term memory tasks, one using verbal, the other nonverbal material presented in the form of television games which patients are generally prepared to perform for up to an hour or longer. Forty-six patients with subclinical EEG discharges have been studied. They were screened by video monitoring before and during testing to exclude any with overt clinical changes during the discharges. Despite this rigorous selection, in 50 per cent TCI was demonstrable with a confidence level (within the individual patient) of 10 per cent. Discharges during stimulus presentation were most disruptive of performance and those confined to the period when the patient was responding were without demonstrable effect. A significant association was found between the laterality of focal or asymmetrical generalized discharges and impairment of one or other task, left-sided discharges being associated with errors in the verbal task and right-sided with impairment of the nonverbal test. Two case histories are cited illustrating patients who were clearly handicapped by TCI and whose functioning improved when the subclinical discharges were suppressed by medication. To determine how many patients suffer such disabilities or can be helped by appropriate medication, further prospective studies are required.

show abstract

Section: Discussionmentioning

confidence: 99%

Selective Cognitive Impairment During Focal and Generalized Epileptiform Eeg Activity

Aarts¹,

Binnie²,

Smit³

et al. 1984

Brain

499

325

View full text Add to dashboard Cite

show abstract

“…Longer duration increased the probability for an IED-induced deficit. 14 , 32 Other determinants may include IED amplitude 18 , 32 and increased EEG power during epileptiform discharges (called ramp configuration of EEG spectrum 33 ). 18 IEDs were, however, variable within EEG recordings.…”

Section: Discussionmentioning

confidence: 99%

Predictive Power of Interictal Epileptiform Discharges in Fitness-to-Drive Evaluation

Krestel,

Schreier,

Sakiri

et al. 2023

Neurology

View full text Add to dashboard Cite

Background:This study aimed to evaluate and predict the effects of interictal epileptiform discharges (IEDs) on driving ability using simple reaction tests and a driving simulator.Methods:Patients with various epilepsies were evaluated with simultaneous EEGs during their response to visual stimuli in a single-flash test, a car-driving videogame, and a realistic driving simulator. Reaction times (RT) and missed reactions or crashes (miss/crash) during normal EEG and IEDs were measured. IEDs, as considered here, were a series of epileptiform potentials (>1 potential) and were classified as generalized typical, generalized atypical, or focal. RT and miss/crash in relation to IED type, duration, and test type were analyzed. RT-prolongation, miss/crash probability, and odds ratio of miss/crash due to IEDs were calculated.Results:Generalized typical IEDs prolonged RT by 164ms, compared to generalized atypical IEDs (77.0ms) and focal IEDs (48.0ms) (p<0.01). Generalized typical IEDs had a session miss/crash probability of 14.7% compared to a zero median for focal and generalized atypical IEDs (p<0.01). Long repetitive bursts of focal IEDs lasting >2s had a 2.6% miss/crash probabilityIED. Cumulated miss/crash probability could be predicted from RT-prolongation: 90.3ms yielded a 20% miss/crash probability. All tests were non-superior to each other in detecting miss/crash probabilitiesIED(zero median for all three tests) or RT-prolongations (flash test: 56.4ms, car-driving videogame: 75.5ms, simulator 86.6ms). IEDs increased the odds ratio (OR) of miss/crash in the simulator by 4.9-fold compared to normal EEG. A table of expected RT-prolongations and miss/crash probabilities for IEDs of a given type and duration was created.Conclusion:IED-associated miss/crash probability and RT-prolongation were comparably well detected by all tests. Long focal IED-bursts carry a low risk, while generalized typical IEDs are the primary cause of miss/crash. We propose a cumulative 20% miss/crash risk at a RT-prolongation of 90.3ms as a clinically relevant IED effect. The IED-associated odds ratio in the simulator approximates the effects of sleepiness or low blood-alcohol level while driving on real roads. A decision aid for fitness-to-drive evaluation was created by providing the expected RT-prolongations and misses/crashes when IEDs of a certain type and duration are detected in routine EEG.

show abstract

“…Kontro/lt: dt:5 Koukkou und Lehmann, 1968;Stevens et al, 1972;Lehmann und Koukkou, 1974;Nunn und Osselton, 1974;Shimizu et al, 1977 (Lynn, 1966).…”

Section: Der Begriffdes Funktionellen Zustandes Desunclassified

Psychophysiologie des Träumens und der Neurosentherapie: Das Zustands-Wechsel-Modell, eine Synopsis

Koukkou¹,

Lehmann²

1980

Fortschr Neurol Psychiatr

View full text Add to dashboard Cite

Electroencephalographic Spectra and Reaction Time in Disorders of Higher Nervous Function

Cited by 15 publications

References 13 publications

Selective Cognitive Impairment During Focal and Generalized Epileptiform Eeg Activity

Selective Cognitive Impairment During Focal and Generalized Epileptiform Eeg Activity

Predictive Power of Interictal Epileptiform Discharges in Fitness-to-Drive Evaluation

Psychophysiologie des Träumens und der Neurosentherapie: Das Zustands-Wechsel-Modell, eine Synopsis

Contact Info

Product

Resources

About