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Spectral analysis of slow oscillations in cerebral blood flow velocity
s52
Poster Sessions
peer interactions, and memory, 3. complete WISC-R Tests, and 4. Neale tests of reading rate, accuracy and comprehension. Quantitative EEG was also collected from each child prior to treatment. The neurometric approach was used to evaluate the QEEG. Parametric statistics were used to compare QEEG features extracted from individual patients to those obtained from age appropriate norms. individual patient QEEG profiles were produced which express the degree to which each EEG feature deviates from normal in standard deviation units. QEEG features were examined from 19 referential and 8 bipolar derivations. These features included measures of absolute power, relative power, mean frequency, power asymmetry and waveform coherence calculated across the delta, theta, alpha and beta frequency bands. Within this talk we will use statistical procedures to describe the relationships between subgroups of children classified clinically and their corresponding electrophysiological profiles. We will also examine the relationships between subgroups, QEEG subgroups and treatment outcome.
SESSION 15: STUDIES IN CEREBROVASCULAR 15-01
DISEASE 1
Spectral Analysis of Slow Oscillations Blood Flow Velocity
in Cerebral
Rolf R. Diehl, H. Bazner. Krupp Hospita/, Essen We previously reported transcranial Doppler monitoring (TCDM) data from normal subjects demonstrating spontaneous and interhemispherically synchronized blood flow oscillations in three frequency bands: 0.01 to 0.05 Hz (B-waves), 0.05 to 0.15 Hz (X-waves) and 0.15 to 0.35 Hz (R-waves). We assume that these oscillations reflect the influence of the autonomic nervous system on cerebral blood flow. In the present study we investigated changes of these CBF fluctuations in patients with cerebrovascular diseases. A ZO-minute TCDM with synchronous recording from both middle cerebral arteries was performed in 15 control subjects, in 15 patients with TlAsistrokes from obstructive carotid artery disease and in 15 patients with TIAs/strokes from cardiac embolism. Amplitudes and bilateral correlations were calculated for the three frequency bands. Amplitudes and correlations were reduced significantly against the control group in the carotid group. No change was seen in the cardio-embolic group. The most significantly reduced parameter was the B-wave synchronicity (r = 0.29 in carotid artery disease and r = 0.86 in controls; p < 0.001) The decrease in amplitude and correlation was related to the hemodynamic significance of the carotid artery stenosis. We attribute slow wave amplitude decreases in carotid artery disease to reduced central adrenergic input to small brain vessels at the lower end of the autoregulatory curve. A decline in the bilateral synchronicity is probably caused by an interhemispheric “steal” in cases with a collateralization via the anterior communicating artery.
/15-02 1Headaches Caused By Vascular Malformations-TCD Assessment
j
Thyrotropin-Releasing Hormone (TRH) Enhances Correlations Between EEG and Cortical Blood Flow and Metabolism in Spinocerebellar Degeneration
K. Nagata. H. Yuya, M. Nara, Y Kondoh, Y. Watahiki. Y Satoh, Y Hirata, J. Hatazawa. Research Institute for Brain and Blood Vessels, Akita, Japan To elucidate the effect of thyrotropin-releasing hormone (TRH) on the relationship between EEG and cerebral blood flow (CBF) and oxygen metabolism (CMROZ) in spinocerebellar degeneration (SCD), a combined quantitative EEG and PET study was carried out in 8 SCD patients in whom the diagnosis was made based on their clinical course and neuroradiological findings, Their mean age was 63.2 years. All patients underwent intravenous TRH (4mg/day) therapy for 28 days. Together with quantitative EEG analysis, CBF and CMR02 were measured with PET during resting state before, during and after the TRH therapy From 16 scalp EEG electrodes, relative power was calculated in 4 frequency categories: delta (‘2.0-3.8Hz), theta (4.0-78Hz), alpha (8.0-13.8Hz) and beta (13.0-29.8Hz) bands. Using a linear regression analysis, EEG power data was correlated with the local CBF and CMROZ at the cortical areas corresponding to the scalp EEG electrodes, In the baseline study, alpha activity correlated with CMROZ positively whereas beta activity correlated with CBF negatively (p < 0.01). Delta and Theta activities failed to correlate with either CBF or CMROZ. During TRH therapy, all patients showed some clinical improvement, and theta activity and CMROZ increased significantly. Delta, theta and beta activities correlated with CBF negatively and alpha activity correlated positively, whereas delta activity correlated with CMR02 negatively and alpha activity correlated positively (p < 0.01). The results may reflect an activation of brain function by the intravenous TRH therapy.
) 15-04
1 Cerebral Blood Flow Velocity in Patients with Moyamoya Disease
S. Sanada. M. Sato, T. Terasaki, H. Inoue, E. Oka. S. Ohtahara. Departmenf Child Neurology Okayama University Medical School, Okayama, Japan
of
Rebuild-up phenomenon on EEG by hyperventilation (HV) is a characteristic findings of Moyamoya disease. This is considered to be the evidence of cerebral ischemia, however, hemodynamics of this phenomenon is not yet understood. Blood flow velocity (BFV) of the middle cerebral artery and the internal carotid artery was examined by transcranial Doppler flowmeter (EME TC2-64) in 5 cases with Moyamoya disease, and the changes in BFV by HV were investigated with simultaneous EEG recordings. The resuhs were as follows: 1) In all he 5 cases, duration of BFV decrease by HV was prolonged compared w :h that of normal control. 2) In a case of favorable prognosis after surgical treatment with encephalo-d ro-arterio-synangiosis (EDAS), duration of BFV decrease by WV was shorten d. 3) Simultaneous recordings of BFV and EEG revealed a close relationship between decreased BFV and high voltage slow waves on EEG induced by HV This method could be applicable for elucidation of the pathophysiology and evaluation of the effect of treatment on Moyamoya disease.
S. Karakaneva, L. Petrov, St. Stojanov, J. Jotova. I? Popov. MMA, Dept. of Neurosurge/y “G. Sofiiski” 3, 7606 Sofia, Bulgaria We investigated 10 patients - mean age 37 years, 6 female and 4 male. Eight of them were with arterial brain aneurysm and two with A-V malformation. In all of them headache was the only/3 ptsior the first symptom/7 pts/. All patients underwent TCD preoperatively and postoperatively. In all of them we found changes in the configuration of the circle of Willis which were determined by using common carotid artery compression tests. Blood flow velocities were higher on the side of the malformation and we observed such phenomena as polysystolitic peaks, muscle murmurs and signs of turbulens. Postoperatively all those changes were not found. The study suggests that TCD as a noninvasive method can be used for evaluation of vascular malformations and patients who suffer from headache should undergo Doppler sonography in order to prevent complications as ruptures and hemorrhage.
15-05
Carotid Endarterectomy:
A Three Months Follow-Up
Study A.C. Van Huffelen, E.M. Vriens, G.H. Wieneke, F Touwotten, University Hospital Utrecht, The Netherlands
B.C. Eikelboom.
Carotid endarterectomy (CEA) aims at the prevention of stroke, without causing perioperative cerebral complications. However, there may be an improvement in cerebral function and circulation as well, due to the effects of CEA on the hemodynamic condition. This study aimed both at the assessment of the complication rate and of the functional improvement of cerebral function and circulation. Fifty patients were examined one day prior to CEA and at a follow-up visit after three months, when the complication rate could reliably be assessed. In all patients 16 channel EEGs were recorded. Power spectra from both examinations were compared by means of the subtraction technique. Changes in small power bands, alpha peak frequencies and reactivity were studied. Transcranial Doppler Sonography results from both examinations were compared, concerning mean flow velocity and pulsatility index of the
Poster Sessions
peer interactions, and memory, 3. complete WISC-R Tests, and 4. Neale tests of reading rate, accuracy and comprehension. Quantitative EEG was also collected from each child prior to treatment. The neurometric approach was used to evaluate the QEEG. Parametric statistics were used to compare QEEG features extracted from individual patients to those obtained from age appropriate norms. individual patient QEEG profiles were produced which express the degree to which each EEG feature deviates from normal in standard deviation units. QEEG features were examined from 19 referential and 8 bipolar derivations. These features included measures of absolute power, relative power, mean frequency, power asymmetry and waveform coherence calculated across the delta, theta, alpha and beta frequency bands. Within this talk we will use statistical procedures to describe the relationships between subgroups of children classified clinically and their corresponding electrophysiological profiles. We will also examine the relationships between subgroups, QEEG subgroups and treatment outcome.
SESSION 15: STUDIES IN CEREBROVASCULAR 15-01
DISEASE 1
Spectral Analysis of Slow Oscillations Blood Flow Velocity
in Cerebral
Rolf R. Diehl, H. Bazner. Krupp Hospita/, Essen We previously reported transcranial Doppler monitoring (TCDM) data from normal subjects demonstrating spontaneous and interhemispherically synchronized blood flow oscillations in three frequency bands: 0.01 to 0.05 Hz (B-waves), 0.05 to 0.15 Hz (X-waves) and 0.15 to 0.35 Hz (R-waves). We assume that these oscillations reflect the influence of the autonomic nervous system on cerebral blood flow. In the present study we investigated changes of these CBF fluctuations in patients with cerebrovascular diseases. A ZO-minute TCDM with synchronous recording from both middle cerebral arteries was performed in 15 control subjects, in 15 patients with TlAsistrokes from obstructive carotid artery disease and in 15 patients with TIAs/strokes from cardiac embolism. Amplitudes and bilateral correlations were calculated for the three frequency bands. Amplitudes and correlations were reduced significantly against the control group in the carotid group. No change was seen in the cardio-embolic group. The most significantly reduced parameter was the B-wave synchronicity (r = 0.29 in carotid artery disease and r = 0.86 in controls; p < 0.001) The decrease in amplitude and correlation was related to the hemodynamic significance of the carotid artery stenosis. We attribute slow wave amplitude decreases in carotid artery disease to reduced central adrenergic input to small brain vessels at the lower end of the autoregulatory curve. A decline in the bilateral synchronicity is probably caused by an interhemispheric “steal” in cases with a collateralization via the anterior communicating artery.
/15-02 1Headaches Caused By Vascular Malformations-TCD Assessment
j
Thyrotropin-Releasing Hormone (TRH) Enhances Correlations Between EEG and Cortical Blood Flow and Metabolism in Spinocerebellar Degeneration
K. Nagata. H. Yuya, M. Nara, Y Kondoh, Y. Watahiki. Y Satoh, Y Hirata, J. Hatazawa. Research Institute for Brain and Blood Vessels, Akita, Japan To elucidate the effect of thyrotropin-releasing hormone (TRH) on the relationship between EEG and cerebral blood flow (CBF) and oxygen metabolism (CMROZ) in spinocerebellar degeneration (SCD), a combined quantitative EEG and PET study was carried out in 8 SCD patients in whom the diagnosis was made based on their clinical course and neuroradiological findings, Their mean age was 63.2 years. All patients underwent intravenous TRH (4mg/day) therapy for 28 days. Together with quantitative EEG analysis, CBF and CMR02 were measured with PET during resting state before, during and after the TRH therapy From 16 scalp EEG electrodes, relative power was calculated in 4 frequency categories: delta (‘2.0-3.8Hz), theta (4.0-78Hz), alpha (8.0-13.8Hz) and beta (13.0-29.8Hz) bands. Using a linear regression analysis, EEG power data was correlated with the local CBF and CMROZ at the cortical areas corresponding to the scalp EEG electrodes, In the baseline study, alpha activity correlated with CMROZ positively whereas beta activity correlated with CBF negatively (p < 0.01). Delta and Theta activities failed to correlate with either CBF or CMROZ. During TRH therapy, all patients showed some clinical improvement, and theta activity and CMROZ increased significantly. Delta, theta and beta activities correlated with CBF negatively and alpha activity correlated positively, whereas delta activity correlated with CMR02 negatively and alpha activity correlated positively (p < 0.01). The results may reflect an activation of brain function by the intravenous TRH therapy.
) 15-04
1 Cerebral Blood Flow Velocity in Patients with Moyamoya Disease
S. Sanada. M. Sato, T. Terasaki, H. Inoue, E. Oka. S. Ohtahara. Departmenf Child Neurology Okayama University Medical School, Okayama, Japan
of
Rebuild-up phenomenon on EEG by hyperventilation (HV) is a characteristic findings of Moyamoya disease. This is considered to be the evidence of cerebral ischemia, however, hemodynamics of this phenomenon is not yet understood. Blood flow velocity (BFV) of the middle cerebral artery and the internal carotid artery was examined by transcranial Doppler flowmeter (EME TC2-64) in 5 cases with Moyamoya disease, and the changes in BFV by HV were investigated with simultaneous EEG recordings. The resuhs were as follows: 1) In all he 5 cases, duration of BFV decrease by HV was prolonged compared w :h that of normal control. 2) In a case of favorable prognosis after surgical treatment with encephalo-d ro-arterio-synangiosis (EDAS), duration of BFV decrease by WV was shorten d. 3) Simultaneous recordings of BFV and EEG revealed a close relationship between decreased BFV and high voltage slow waves on EEG induced by HV This method could be applicable for elucidation of the pathophysiology and evaluation of the effect of treatment on Moyamoya disease.
S. Karakaneva, L. Petrov, St. Stojanov, J. Jotova. I? Popov. MMA, Dept. of Neurosurge/y “G. Sofiiski” 3, 7606 Sofia, Bulgaria We investigated 10 patients - mean age 37 years, 6 female and 4 male. Eight of them were with arterial brain aneurysm and two with A-V malformation. In all of them headache was the only/3 ptsior the first symptom/7 pts/. All patients underwent TCD preoperatively and postoperatively. In all of them we found changes in the configuration of the circle of Willis which were determined by using common carotid artery compression tests. Blood flow velocities were higher on the side of the malformation and we observed such phenomena as polysystolitic peaks, muscle murmurs and signs of turbulens. Postoperatively all those changes were not found. The study suggests that TCD as a noninvasive method can be used for evaluation of vascular malformations and patients who suffer from headache should undergo Doppler sonography in order to prevent complications as ruptures and hemorrhage.
15-05
Carotid Endarterectomy:
A Three Months Follow-Up
Study A.C. Van Huffelen, E.M. Vriens, G.H. Wieneke, F Touwotten, University Hospital Utrecht, The Netherlands
B.C. Eikelboom.
Carotid endarterectomy (CEA) aims at the prevention of stroke, without causing perioperative cerebral complications. However, there may be an improvement in cerebral function and circulation as well, due to the effects of CEA on the hemodynamic condition. This study aimed both at the assessment of the complication rate and of the functional improvement of cerebral function and circulation. Fifty patients were examined one day prior to CEA and at a follow-up visit after three months, when the complication rate could reliably be assessed. In all patients 16 channel EEGs were recorded. Power spectra from both examinations were compared by means of the subtraction technique. Changes in small power bands, alpha peak frequencies and reactivity were studied. Transcranial Doppler Sonography results from both examinations were compared, concerning mean flow velocity and pulsatility index of the