Browsing by Subject "Electroencephalography (EEG)"

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  • Wielaender, F.; James, F. M. K.; Cortez, M. A.; Kluger, G.; Nessler, J. N.; Tipold, A.; Lohi, H.; Fischer, A. (2018)
    Myoclonic epilepsy in Rhodesian Ridgeback (RR) dogs is characterized by myoclonic seizures occurring mainly during relaxation periods, a juvenile age of onset and generalized tonic-clonic seizures in one-third of patients. An 8-month-old female intact RR was presented for myoclonic seizures and staring episodes that both started at 10 weeks of age. Testing for the DIRAS1 variant indicated a homozygous mutant genotype. Unsedated wireless video-electroencephalography (EEG) identified frequent, bilaterally synchronous, generalized 4 Hz spike-and-wave complexes (SWC) during the staring episodes in addition to the characteristic myoclonic seizures with generalized 4-5 Hz SWC or 4-5 Hz slowing. Photic stimulation did not evoke a photoparoxysmal response. Repeat video-EEG 2 months after initiation of levetiracetam treatment disclosed a >95% decrease in frequency of myoclonic seizures, and absence seizures were no longer evident. Absence seizures represent another seizure type in juvenile myoclonic epilepsy (JME) in RR dogs, which reinforces its parallels to JME in humans.
  • Nevalainen, Päivi; Metsäranta, Marjo; Toiviainen-Salo, Sanna; Lönnqvist, Tuula; Vanhatalo, Sampsa; Lauronen, Leena (2019)
    Objective: The unspecific symptoms of neonatal stroke still challenge its bedside diagnosis. We studied the accuracy of routine electroencephalography (EEG) and simultaneously recorded somatosensory evoked potentials (EEG-SEP) for diagnosis and outcome prediction of neonatal stroke. Methods: We evaluated EEG and EEG-SEPs from a hospital cohort of 174 near-term neonates with suspected seizures or encephalopathy, 32 of whom were diagnosed with acute ischemic or hemorrhagic stroke in MRI. EEG was scored for background activity and seizures. SEPs were classified as present or absent. Developmental outcome of stroke survivors was evaluated from medical records at 8- to 18-months age. Results: The combination of continuous EEG and uni- or bilaterally absent SEP (n = 10) was exclusively seen in neonates with a middle cerebral artery (MCA) stroke (specificity 100%). Moreover, 80% of the neonates with this finding developed with cerebral palsy. Bilaterally present SEPs did not exclude stroke, but predicted favorable neuromotor outcome in stroke survivors (positive predictive value 95%). Conclusions: Absent SEP combined with continuous EEG background in near-term neonates indicates an MCA stroke and a high risk for cerebral palsy. Significance: EEG-SEP offers a bedside method for diagnostic screening and a reliable prediction of neuromotor outcome in neonates suspected of having a stroke. (C) 2019 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.
  • Nevalainen, P.; Marchi, V.; Metsäranta, M.; Lönnqvist, T.; Vanhatalo, S.; Lauronen, L. (2018)
    Objective: To evaluate the reliability of recording cortical somatosensory evoked potentials (SEPs) in asphyxiated newborns using the 4-electrode setup applied in routine long-term amplitude-integrated EEG (aEEG) brain monitoring and to assess the number of averages needed for reliably detecting the cortical responses. Methods: We evaluated median nerve SEPs in 50 asphyxiated full-term newborns. The SEP interpretation (present or absent) from the original recordings with 21-electrodes and approximately 600 trials served as the reference. This was compared to SEP classification (absent, present, or unreliable) based on a reduced (300 or 150) number of averages, and to classification based on only four electrodes (F3, P3, F4, P4). Results: Compared to the original classification, cortical SEPs were uniformly interpreted as present or absent in all 50 newborns with the 4-electrode setup and 600 averages. Reducing number of averages to 300 still resulted in correct SEP interpretation in 49/50 newborns with 21-electrode setup, and 46/50 newborns with 4-electrode setup. Conclusions: Evaluation of early cortical neonatal SEPs is reliable from the 4-electrode setup commonly used in aEEG monitoring. SEP is discernible in most newborns with 300 averages. Significance: Adding SEP into routine aEEG monitoring offers an additional tool for early neonatal neurophysiological evaluation. © 2018 International Federation of Clinical Neurophysiology
  • Suppanen, Emma; Winkler, Istvan; Kujala, Teija; Ylinen, Sari (2022)
    Infants are able to extract words from speech early in life. Here we show that the quality of forming longer-term representations for word forms at birth predicts expressive language ability at the age of two years. Seventy-five neonates were familiarized with two spoken disyllabic pseudowords. We then tested whether the neonate brain predicts the second syllable from the first one by presenting a familiarized pseudoword frequently, and occasionally violating the learned syllable combination by different rare pseudowords. Distinct brain responses were elicited by predicted and unpredicted word endings, suggesting that the neonates had learned the familiarized pseudowords. The difference between responses to predicted and unpredicted pseudowords indexing the quality of word-form learning during familiarization significantly correlated with expressive language scores (the mean length of utterance) at 24 months in the same infant. These findings suggest that 1) neonates can memorize disyllabic words so that a learned first syllable generates predictions for the word ending, and 2) early individual differences in the quality of word-form learning correlate with language skills. This relationship helps early identification of infants at risk for language impairment.
  • Virtala, P.; Huotilainen, M.; Partanen, E.; Tervaniemi, Mari (2014)
  • Nevalainen, Päivi; Metsäranta, Marjo; Toiviainen-Salo, Sanna; Marchi, Viviana; Mikkonen, Kirsi; Vanhatalo, Sampsa; Lauronen, Leena (2020)
    Purpose: To evaluate the accuracy of hypoxic ischemic encephalopathy (HIE) grade, and neonatal neurophysiological and neuroimaging measures for predicting development of infantile spasms syndrome (IS) or other postneonatal, infantile onset epilepsy after perinatal HIE. Methods: We examined a population-based cohort of 92 consequent infants with moderate-to-severe HIE. The HIE grade and neonatal neuroimaging (MRI) and neurophysiology (EEG and somatosensory evoked potentials, SEPs) findings were compared to the development of IS or other epilepsy within the first year of life. Results: Out of 74 surviving infants with follow-up information, five developed IS and one developed a focal onset epilepsy. They all had recovered from severe HIE. All survivors with inactive neonatal EEG (recorded within the first few postnatal days, n = 4) or the most severe type of brain injury in MRI (n = 3) developed epilepsy (positive predictive value, PPV 100 %). Bilaterally absent SEPs had 100 % sensitivity and 75 % PPV for epilepsy. A combination of absent SEPs and a poor MRI finding (combined deep and cortical gray matter injury) resulted in higher PPV (86 %) without lowering sensitivity (100 %). Follow-up EEGs showed recurrent epileptiform activity already between 1- and 2-months age in those that developed epilepsy, distinguishing them from those surviving without epilepsy. Conclusions: Poor neonatal neuroimaging and neurophysiological findings provide accurate prediction for development of infantile onset epilepsy after HIE. Of the neonates with severe HIE, the ones with severe neonatal MRI and neurophysiological abnormalities need frequent follow-up, including repeated EEGs, for early detection of IS.
  • Nevalainen, Päivi; Metsäranta, Marjo; Marchi, Viviana; Toiviainen-Salo, Sanna; Vanhatalo, Sampsa; Lauronen, Leena (2021)
    Background: Somatosensory evoked potentials (SEPs) offer an additional bedside tool for outcome prediction after perinatal asphyxia. Aims: To assess the reliability of SEPs recorded with bifrontoparietal amplitude-integrated electroencephalography (aEEG) brain monitoring setup for outcome prediction in asphyxiated newborns undergoing therapeutic hypothermia. Study design: Retrospective observational single-center study. Subjects: 27 consecutive asphyxiated fullor near-term newborns (25 under hypothermia) that underwent median nerve aEEG-SEPs as part of their clinical evaluation at the neonatal intensive care unit of Helsinki University Hospital. Outcome measures: aEEG-SEP classification (present, absent or unreliable) was compared to classification of SEPs recorded with a full EEG montage (EEG-SEP), and outcome determined from medical records at approximately 12-months-age. Unfavorable outcome included death, cerebral palsy, or severe epilepsy. Results: The aEEG-SEP and EEG-SEP classifications were concordant in 21 of the 22 newborns with both recordings available. All five newborns with bilaterally absent aEEG-SEPs had absent EEG-SEPs and the four with outcome information available had an unfavorable outcome (one was lost to follow-up). Of the newborns with aEEG-SEPs present, all with follow-up exams available had bilaterally present EEG-SEPs and a favorable outcome (one was lost to follow-up). One newborn with unilaterally absent aEEG-SEP at 25 h of age had bilaterally present EEG-SEPs on the next day, and a favorable outcome. Conclusions: aEEG-SEPs recorded during therapeutic hypothermia on the first postnatal days are reliable for assessing brain injury severity. Adding SEP into routine aEEG brain monitoring offers an additional tool for very early outcome prediction after birth asphyxia.
  • Tugin, Sergei; Hernandez-Pavon, Julio C.; Ilmoniemi, Risto J.; Nikulin, Vadim V. (2016)
    Objectives: Auditory and visual deviant stimuli evoke mismatch negativity (MMN) responses, which can be recorded with electroencephalography (EEG) and magnetoencephalography (MEG). However, little is known about the role of neuronal oscillations in encoding of rare stimuli. We aimed at verifying the existence of a mechanism for the detection of deviant visual stimuli on the basis of oscillatory responses, so-called visual mismatch oscillatory response (vMOR). Methods: Peripheral visual stimuli in an oddball paradigm, standard vs. deviant (7: 1), were presented to twenty healthy subjects. The oscillatory responses to an infrequent change in the direction of moving peripheral stimuli were recorded with a 60-channel EEG system. In order to enhance the detection of oscillatory responses, we used the common spatial pattern (CSP) algorithm, designed for the optimal extraction of changes in the amplitude of oscillations. Results: Both standard and deviant visual stimuli produced Event-Related Desynchronization (ERD) and Synchronization (ERS) primarily in the occipito-parietal cortical areas. ERD and ERS had overlapping time-courses and peaked at about 500-730 ms. These oscillatory responses, however, were significantly stronger for the deviant than for the standard stimuli. A difference between the oscillatory responses to deviant and standard stimuli thus reflects the presence of vMOR. Conclusions: The present study shows that the detection of visual deviant stimuli can be reflected in both synchronization and desynchronization of neuronal oscillations. This broadens our knowledge about the brain mechanisms encoding deviant sensory stimuli. (C) 2016 Elsevier Inc. All rights reserved.