Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Functional mapping of the human brain has made tremendous progress in the past years thanks to new technical developments. Imaging methods are now available; they allow to study brain functions with high spatial and temporal resolution. Single photon emission computer tomography (SPECT), positron emission tomography (PET), functional magnetic resonance imaging (fMRI) and high resolution electro- and magnetoencephalography (EEG and MEG) are currently intensively applied techniques to functional studies, each one having specific properties concerning spatial and temporal resolution. The success of these methods in basic neuroscience research has led to the demand for applying them to clinical questions. Diseases of the central nervous system that lead to brain dysfunction can be ideally explored using these techniques. Of particular importance are those diseases in which a focal neuronal dysfunction is the primary cause and where surgical resection of this focus might be the cure. This is often the case for epilepsy, where a discrete primary focus might exist from which pathological rhythms evolve and propagate throughout the brain, leading to seizures that severely handicap the patient. Surgical resection of the primary focus is only possible if the focus can be exactly localized and adequately separated from functionally important areas. This is where these new functional imaging tools become important. The use of SPECT and PET for focus localization has been most extensively studied and their specificity and sensitivity are intensively discussed. In the last few years functional MRI has evolved as a new interesting tool in epileptic focus localization. The most important limitation of these techniques, however, is the temporal resolution. Since epileptic activity can propagate very fast, several hyper- or hypoactive regions are seen in the images and primary areas cannot be distinguished from regions of propagation. The only methods that have sufficient temporal resolution to follow neuronal activity in real time are the electrophysiological measures, i.e. the EEG and the MEG. Localization of the sources in the brain that produced a given surface electromagnetic field has become possible through algorithms that solve the so-called "inverse problem". Several different algorithms exist and many groups begun to apply them to epileptic data with the aim to localize the focus of the pathological electrical discharges. This review article discusses the use of distributed EEG source localization procedures in the presurgical evaluation of patients with intractable focal epilepsy. In contrast to equivalent dipole models, distributed localization methods do not localize one active point in the brain but rather assume extended active areas, which is generally the case in epileptic activity. The methods shown here are based on linear numerical methods and are therefore less prone to errors when working with scattered solution spaces such as the one defined by anatomical constraints. Solutions constraint to the gray matter determined in the individual MRI are shown here. We illustrate three methods to increase the spatial resolution of the source localization procedures: One is to increase the number of recording channels to more than 100, the second to use linear methods of high precision to detect focal sources (EPIFOCUS), and the third to combine EEG source localization with EEG-triggered functional magnetic resonance imaging. The importance of EEG source localization for the interpretation of fMRI data will be particularly discussed in view of the important difference of the temporal resolution by the two methods. The localization methods can be applied to interictal as well as to ictal activity. In case of analysis of ictal EEG we propose to use full scalp frequency analysis to determine the time period of seizure onset and to localize the sources of the initial dominant frequency.
 ...
PMID:Localization of distributed sources and comparison with functional MRI. 1178 Dec

Localizations were compared for the same human seizure between simultaneously measured MEG and iEEG, which were both co-registered to MRI. The whole-cortex neuromagnetometer localized a dipole in a sphere phantom, co-registered to the MEG sensor array, with an error of 1.4 mm. A focal afterdischarge seizure was induced in a patient with partial epilepsy, by stimulation at a subdural electrocorticography (ECoG) electrode with a known location, which was co-registered to the MRI and to the MEG sensor array. The simultaneous MEG and ECoG during the 30-second seizure was measured and analyzed using the single, moving dipole model, which is the localization model used clinically. The dipole localizations from simultaneous whole cortex 68-channel MEG and 64-channel ECoG were then compared for the repetitive spiking at six different times during the seizure. There were two main regions of MEG and ECoG activity. The locations of these regions were confirmed by determining the location clusters of 8,000 dipoles on ECoG at consecutive time points during the seizure. The mean distances between the stimulated electrode location versus the dipole location of the MEG and versus the dipole location of the ECoG were each about one (1) centimeter. The mean distance between the dipole locations of the MEG versus the dipole locations of the ECoG was about 2 cm. These errors were compared to errors of MEG and ECoG reported previously for phantoms and for somatosensory evoked responses (SER) in patients. Comparing the findings from the present study to those from prior studies, there appeared to be the expected stepwise increase in mean localization error progressing from the phantom, to the SER, to the seizure.
 ...
PMID:Dipole localization of human induced focal afterdischarge seizure in simultaneous magnetoencephalography and electrocorticography. 1179 9

The identification of eloquent areas is of utmost importance in the surgery of tumors located near speech-eloquent brain areas, since the classical concept of a constant localization was proven to be untrue and the spatial localization of these areas may show large interindividual differences. Some neurosurgical centers apply intraoperative electrophysiological methods that, however, necessitate the performance of surgery in the awake patient. This might be a severe burden both for the patient and the operating team in a procedure that lasts several hours; in addition, electrical stimulation may generate epileptic seizures. Alternatively, methods of functional brain imaging (e.g., PET, fMRI, MEG) may be applied, which allow individual localization of speech-eloquent areas. Matching of these image data with a conventional 3D-CT or MRI now allows the exact transfer of this information into the surgical field by neuronavigation. Whereas standards concerning electrophysiological stimulation techniques that could prevent a permanent postoperative worsening of language are available, until now it remains unclear whether the resection of regions shown to be active in functional brain imaging will cause a permanent postoperative deficit.
 ...
PMID:Surgery of low-grade gliomas near speech-eloquent regions: brainmapping versus preoperative functional imaging. 1256 1

Photosensitive epilepsy (PSE) is the most common form of human reflex epilepsy, appearing in up to 10% of epileptic children. It also offers a highly reproducible model to investigate whether changes in neuronal activity preceding the transition to an epileptic photoparoxysmal response (PPR) may be detected. We studied 10 patients with idiopathic PSE (eight female, mean age 26 years, range 9-51 years) using magnetoencephalography. In addition, we also studied the responses of five normal controls (mean age 24 years, age range 9-35 years) and three non-photosensitive epileptic patients (mean age 10 years, range 8-11 years). Spectral analysis of the MEG signals recorded during intermittent photic stimulation revealed relevant information in the phase spectrum. To quantify this effect, we introduced a second order response feature of the stimulus-triggered visual response preceding the PPR: the phase clustering index, which measures how close the phases of successive periods are grouped for each frequency component for all periods of the stimuli applied. We recorded a total of 86 PPRs, including several absence seizures, in nine of the 10 patients. We found that an enhancement of phase synchrony in the gamma-band (30-120 Hz), harmonically related to the frequency of stimulation, preceded the stimulation trials that evolved into PPRs, and differed significantly from that encountered in trials not followed by PPR or in control subjects. This novel finding leads us to postulate that a pathological deviation of normally occurring synchronization of gamma oscillations, underlying perceptional processes, mediates the epileptic transition in PSE.
 ...
PMID:Gamma-band phase clustering and photosensitivity: is there an underlying mechanism common to photosensitive epilepsy and visual perception? 1269 55

To evaluate the source location and clinical significance of rhythmic mid-temporal theta discharges (RMTD) by MEG in non-epileptic and epileptic patients, we conducted simultaneous MEG and EEG recordings with a whole-scalp 306-channel neuromagnetometer in three patients: one with right temporal lobe epilepsy (TLE), one with right frontal lobe epilepsy (FLE), and one with tension headache. We visually detected the RMTD activity and interictal spikes, and then localised their generators by MEG source modelling. We repeated MEG measurement 3 months after right anterior temporal lobectomy (ATL) in the TLE patient; 3 months after anticonvulsant medication in the FLE patient. In epileptic patients, RMTD activities were found during drowsiness over the left temporal channels of both MEG and EEG recordings, and their generators were localised to the left posterior inferior temporal region. In the patient with tension headache, RMTD was localised in the right inferior temporal area. When the epileptic patients became seizure free with disappearance of epileptic spikes, RMTD was still found over the left temporal channels. Besides, some bursts of RMTD appeared also in the right temporal channels in our TLE patient after ATL. Our results indicate that the source of RMTD activity is located in the fissural cortex of the posterior inferior temporal region. As a physiologic rhythm related to dampened vigilance, RMTD has no direct relation to epileptogenic activity.
Seizure 2003 Jun
PMID:Magnetoencephalographic study of rhythmic mid-temporal discharges in non-epileptic and epileptic patients. 1276 69

Development of functional neuroimaging is contributed to diagnosis and treatment in epilepsy patients. The dipole analysis of interictal spikes on EEG or MEG provides 3D-localization of the irritable zone. Interictal and ictal CBF-SPECT reveals the local change in CBF associated to epileptic focus. Three-dimensional stereotactic surface projection (3D-SSP) of SPECT is useful to recognize the seizure generation area. Furthermore, Subtraction ictal SPECT coregistration of MRI (SISCOM), that is fusion image of anatomical and functional brain images, is beneficial to understand the localization of seizure-induced hyperperfusion area. During epilepsy surgery, image-guided system makes less-invasive and accurate surgery possible. Functional image-guided surgery for epilepsy will be available in near future.
 ...
PMID:[Three-dimensional neuroimaging in diagnosis and surgical treatment for epilepsy]. 1510 45

The goal of presurgical evaluation of intractable epilepsy is to identify epileptogenic regions in the brain. From our experience of 38 cases of resective epilepsy surgery from the last 3 years, ictal SPECT was considered the most sensitive at detecting focal changes relating to seizures compared to other neuroimaging modalities, such as MRI, FDG-PET, SPECT and MEG. At interictal state, on the other hand, FDG-PET was most sensitive, especially in cases with focal cortical dysplasia, which is often MRI-invisible. In dysplastic tumors, MRI showed the highest concordance rate to clinically verified epileptogenic regions. Activation studies using functional neuroimaging such as PET and fMRI is useful to evaluate brain functions at epileptogenic regions presurgically. The role of functional brain imaging in epilepsy surgery is considered to be: (i). case selection for resective surgery, (ii). case selection for invasive EEG monitoring, and (iii). navigation of electrode placement and cortical resection.
 ...
PMID:Neuroimaging and presurgical evaluation of symptomatic epilepsies. 1514 9

Using high resolution EEG and MEG and a realistic volume conductor model, the authors investigated spatio-temporal aspects of the sources of spikes in children with benign rolandic epilepsy. A 64-channel EEG and simultaneous 151-channel MEG of interictal spike activity in five children all having general and/or focal seizures were recorded. A spatio-temporal multiple signal classification (MUSIC) analysis was performed on the spike data. Sources having a complex spatio-temporal configuration as well as single stationary sources were found. Results for the EEG and MEG were different. In this group of five patients, both high resolution EEG and MEG revealed that in some cases sources well separated in space and time exist, whereas in other cases only single source activity can be resolved. For multiple sources, differences for EEG and MEG in timing and localization of activity suggest that sources are spatio-temporally distributed. Sources can propagate from initial activity in the finger/hand area around the central sulcus down to the mouth/tongue area.
 ...
PMID:High resolution spatio-temporal EEG-MEG analysis of rolandic spikes. 1528 98

The assessment of drug -resistant partial epilepsy by electrophysiological explorations (based on non-invasive EEG) involves two types of analysis: the study of the seizures, primarily by video-EEG exploration, and the study of interictal activities based on visual analysis, and in some centers on techniques of source localization (high resolution EEG and magnetoencephalography, MEG). Seizure recording can be used to confirm the focal nature and the epileptic origin of the seizure as well as other features such as severity (secondary generalization, frequency, falls etc.). In the pre-surgical approach, the video-EEG recordings enable study of the electro-clinical correlations and allow assumptions on the anatomical localization of the epileptogenic zone. Precise analysis of the localization of the interictal activities (especially within the framework of extra-temporal epilepsies) based on source localization methods, makes it possible to put forth assumptions on the localization of the irritative zone.
 ...
PMID:[EEG and video-EEG explorations in refractory partial epilepsy]. 1533 53

Many complex and interesting phenomena in nature are due to nonlinear phenomena. The theory of nonlinear dynamical systems, also called 'chaos theory', has now progressed to a stage, where it becomes possible to study self-organization and pattern formation in the complex neuronal networks of the brain. One approach to nonlinear time series analysis consists of reconstructing, from time series of EEG or MEG, an attractor of the underlying dynamical system, and characterizing it in terms of its dimension (an estimate of the degrees of freedom of the system), or its Lyapunov exponents and entropy (reflecting unpredictability of the dynamics due to the sensitive dependence on initial conditions). More recently developed nonlinear measures characterize other features of local brain dynamics (forecasting, time asymmetry, determinism) or the nonlinear synchronization between recordings from different brain regions. Nonlinear time series has been applied to EEG and MEG of healthy subjects during no-task resting states, perceptual processing, performance of cognitive tasks and different sleep stages. Many pathologic states have been examined as well, ranging from toxic states, seizures, and psychiatric disorders to Alzheimer's, Parkinson's and Cre1utzfeldt-Jakob's disease. Interpretation of these results in terms of 'functional sources' and 'functional networks' allows the identification of three basic patterns of brain dynamics: (i) normal, ongoing dynamics during a no-task, resting state in healthy subjects; this state is characterized by a high dimensional complexity and a relatively low and fluctuating level of synchronization of the neuronal networks; (ii) hypersynchronous, highly nonlinear dynamics of epileptic seizures; (iii) dynamics of degenerative encephalopathies with an abnormally low level of between area synchronization. Only intermediate levels of rapidly fluctuating synchronization, possibly due to critical dynamics near a phase transition, are associated with normal information processing, whereas both hyper-as well as hyposynchronous states result in impaired information processing and disturbed consciousness.
 ...
PMID:Nonlinear dynamical analysis of EEG and MEG: review of an emerging field. 1611 97


<< Previous 1 2 3 4 5 6 7 8 Next >>