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T65. EEG in hypothermia in term neonates with HIE
Abstracts / Clinical Neurophysiology 129 (2018) e1–e65
T65. EEG in hypothermia in term neonates with HIE—Emilie Bourel Ponchel, Marie-Dominique Lamblin *, Florence Flamein, Ghida Ghostine-Ramadan, Fabrice Wallois (France) ⇑
Presenting author.
Introduction: HIE, Hypoxo-ischemic encephalopathy is by far the most frequent etiology in neonatal encephalopathy (Lee et al., 2013). It is an important cause of neonatal mortality and long term neurosensorial and cognitive impairment (Ahearne et al., 2016). Therapeutic hypothermia is nowadays the only therapeutic neuroprotective mean to decrease second state lesions within 6 h after hypoxo-ischemia with an effect on mortality and morbidity rates as well as on seizures. Apart from biological, obstetrical and clinical evaluation, EEG is an important tool for early cerebral evaluation before starting hypothermia and during 72 h hypothermia. The aim of our study was to precise EEG criteria in starting hypothermia decision and in prognosis evaluation with at least 2 years clinical followup. Methods: We analyzed around 120 newborns admitted, between January 2013 and February 2015, in the neonatal intensive care for suspicion of HIE. First EEG was done before 6 h of life, it was surveyed continuously and analyzed twice a day during 72 H hypothermia and in 12 h following rewarming. Three grades classification were used according to French classification for EEG. EEG characteristics were analyzed for the decision of hypothermia and to determine the prognosis in hours following warming and compared to the neurodevelopment evaluation at 2 years old using standardized scales. Results: The evolution of infants with initial grades 0 or 1 EEG was characterized by normal or mild neurodevelopment impairment. Infants with initial grade 3 on EEG, without improvement within the first 48 h were always associated with severe outcome (severe neurological impairment or death). For the other initial grade 3, who improve within the first 48 h under hypothermia, as well as the initial grade 2, a variable outcome, between normal to severe neurological sequelae, were noted. Conclusion: Our results confirmed that Conventional EEG remains the gold standard for hypothermia decision and in prognostic evaluation. However, prospective longitudinal studies in large cohort are necessary to better clarify grade 2 EEG abnormalities in order to improve the prognosis evaluation; specially background and specific EEG pattern. doi:10.1016/j.clinph.2018.04.066
T66. Reinstating electrophysiology into global brain projects via CBRAIN and LORIS—Pedro Valdes Sosa (China)
Introduction: Electrophysiology provides functional data with time a resolution data that is crucial to study brain functions and disorders. It is also THE translational bridge to population health in all economic settings. In spite of this it is an imaging modality sadly neglected in current Global Brain Projects. Methods: We intend to remedy this situation as part of the C-C-C collaboration by integrating electrophysiology (EEG and MEG) into the CBRAIN portal. Towards this end we are: incorporating the tomographic quantitative EEG (qEEGt) toolbox developed by CNEURO into CBRAIN. qEEGt is Statistical Parametric Mapping for EEG source spectra (Bosch-Bayard et al., 2001). Adopting the BIDS-EEG format for storing data into the LORIS framework Releasing, as part of the data repositories, the data from the Cuban Human Brain Project. This is the only large national effort to integrate EEG with other
e27
imaging modalities (Bosch-Bayard et al., 2001) Creating conditions for linking to other datasets and other data repositories (BoschBayard et al., 2001). Results: We will illustrate the usefulness of multimodal imaging studies to discover EEG biomarkers with examples from the Barbados Nutrition Study and population based study of hypertension in Havana in which an EEG version of source mutivoxel pattern analysis allows accurate classification of subjects. Conclusion: Bosch-Bayard et al. (2001), Hernandez-Gonzalez et al. (2011), and Vogelstein et al. (2016). References Bosch-Bayard J et al. 3D Statistical parametric mapping of EEG source spectra by means of variable resolution electromagnetictomography (VARETA). Clin Electroencephalogr 2001;32:47–61. Hernandez-Gonzalez G et al. Multimodal quantitative neuroimaging databases and methods: the Cuban Human Brain Mapping Project. Clin EEG Neurosci 2011;42:149–59. Vogelstein JT et al. To the Cloud! A grassroots proposal to accelerate brain science discovery. Neuron 2016;92:622–7. doi:10.1016/j.clinph.2018.04.067
T67. Electroencephalogram utility in early detection of dementia—Elisa A. Laconich (Paraguay)
Introduction: The brain and its neurons are continuously active, this activity occurs spontaneously as well as in response to external stimulation, the computerized electroencephalogram collects the information of brain activity and its importance is that provides sufficiently reliable information about if there a normal or pathological brain function, in addition through this method it is possible to follow closely the dynamics of these processes making possible the characterization and control of the disease process. Regarding the usefulness of the EEG in dementia according to the findings of a study, it is as accurate as the clinical examination in the diagnosis of Alzheimer’s dementia (about 90% according to Cummings et al., 1998) and others affirm that the diagnostic relevance is comparable with other more complex and less accessible exams such as PET positron emission tomography (Szelies and Grond, 1992; Dierks and Jelic, 2000). According to the characterization, Stigsby et al. (1981) found greater diffuse activity of theta and delta, and lower alpha and beta, as well as the frontal deceleration, more prominent to Silvio’s fissure. Another study about prediction revealed the value of the EEG as a predictor with the 95% of accuracy in identifying those, in the study participants, who would suffer from neurocognitive decline, and those who not (Prichep et al., 2005). Methods: A qualitative cross - sectional descriptive methodology was proposed with the objective of knowing the brain activity, prior to treatment, in five patients with Dementia. The study was performed in awake state and activation using two methods: opening/closing the eyes and hyperventilation. Exclusion criteria were: presence of comorbidity psychiatric, history of brain damage and consumption of psychoactive substances, considering that these conditions may influence the results of the CEEG. Results: I was detected some heterogeneous data such as presences of theta waves in the left frontal lobe (in 1 of 5 patients), linked to diffuse corticosubcortical dysfunction and generalized low voltage (1 of 5 patients), related to cortical hypofunction suggestive of loss of nerve cells and therefore of functionality, nevertheless, it is important to emphasize the absence of alpha waves in all of them (5 of 5 patients) which is related to alterations in the synchronicity of the corticocortical connections.
T65. EEG in hypothermia in term neonates with HIE—Emilie Bourel Ponchel, Marie-Dominique Lamblin *, Florence Flamein, Ghida Ghostine-Ramadan, Fabrice Wallois (France) ⇑
Presenting author.
Introduction: HIE, Hypoxo-ischemic encephalopathy is by far the most frequent etiology in neonatal encephalopathy (Lee et al., 2013). It is an important cause of neonatal mortality and long term neurosensorial and cognitive impairment (Ahearne et al., 2016). Therapeutic hypothermia is nowadays the only therapeutic neuroprotective mean to decrease second state lesions within 6 h after hypoxo-ischemia with an effect on mortality and morbidity rates as well as on seizures. Apart from biological, obstetrical and clinical evaluation, EEG is an important tool for early cerebral evaluation before starting hypothermia and during 72 h hypothermia. The aim of our study was to precise EEG criteria in starting hypothermia decision and in prognosis evaluation with at least 2 years clinical followup. Methods: We analyzed around 120 newborns admitted, between January 2013 and February 2015, in the neonatal intensive care for suspicion of HIE. First EEG was done before 6 h of life, it was surveyed continuously and analyzed twice a day during 72 H hypothermia and in 12 h following rewarming. Three grades classification were used according to French classification for EEG. EEG characteristics were analyzed for the decision of hypothermia and to determine the prognosis in hours following warming and compared to the neurodevelopment evaluation at 2 years old using standardized scales. Results: The evolution of infants with initial grades 0 or 1 EEG was characterized by normal or mild neurodevelopment impairment. Infants with initial grade 3 on EEG, without improvement within the first 48 h were always associated with severe outcome (severe neurological impairment or death). For the other initial grade 3, who improve within the first 48 h under hypothermia, as well as the initial grade 2, a variable outcome, between normal to severe neurological sequelae, were noted. Conclusion: Our results confirmed that Conventional EEG remains the gold standard for hypothermia decision and in prognostic evaluation. However, prospective longitudinal studies in large cohort are necessary to better clarify grade 2 EEG abnormalities in order to improve the prognosis evaluation; specially background and specific EEG pattern. doi:10.1016/j.clinph.2018.04.066
T66. Reinstating electrophysiology into global brain projects via CBRAIN and LORIS—Pedro Valdes Sosa (China)
Introduction: Electrophysiology provides functional data with time a resolution data that is crucial to study brain functions and disorders. It is also THE translational bridge to population health in all economic settings. In spite of this it is an imaging modality sadly neglected in current Global Brain Projects. Methods: We intend to remedy this situation as part of the C-C-C collaboration by integrating electrophysiology (EEG and MEG) into the CBRAIN portal. Towards this end we are: incorporating the tomographic quantitative EEG (qEEGt) toolbox developed by CNEURO into CBRAIN. qEEGt is Statistical Parametric Mapping for EEG source spectra (Bosch-Bayard et al., 2001). Adopting the BIDS-EEG format for storing data into the LORIS framework Releasing, as part of the data repositories, the data from the Cuban Human Brain Project. This is the only large national effort to integrate EEG with other
e27
imaging modalities (Bosch-Bayard et al., 2001) Creating conditions for linking to other datasets and other data repositories (BoschBayard et al., 2001). Results: We will illustrate the usefulness of multimodal imaging studies to discover EEG biomarkers with examples from the Barbados Nutrition Study and population based study of hypertension in Havana in which an EEG version of source mutivoxel pattern analysis allows accurate classification of subjects. Conclusion: Bosch-Bayard et al. (2001), Hernandez-Gonzalez et al. (2011), and Vogelstein et al. (2016). References Bosch-Bayard J et al. 3D Statistical parametric mapping of EEG source spectra by means of variable resolution electromagnetictomography (VARETA). Clin Electroencephalogr 2001;32:47–61. Hernandez-Gonzalez G et al. Multimodal quantitative neuroimaging databases and methods: the Cuban Human Brain Mapping Project. Clin EEG Neurosci 2011;42:149–59. Vogelstein JT et al. To the Cloud! A grassroots proposal to accelerate brain science discovery. Neuron 2016;92:622–7. doi:10.1016/j.clinph.2018.04.067
T67. Electroencephalogram utility in early detection of dementia—Elisa A. Laconich (Paraguay)
Introduction: The brain and its neurons are continuously active, this activity occurs spontaneously as well as in response to external stimulation, the computerized electroencephalogram collects the information of brain activity and its importance is that provides sufficiently reliable information about if there a normal or pathological brain function, in addition through this method it is possible to follow closely the dynamics of these processes making possible the characterization and control of the disease process. Regarding the usefulness of the EEG in dementia according to the findings of a study, it is as accurate as the clinical examination in the diagnosis of Alzheimer’s dementia (about 90% according to Cummings et al., 1998) and others affirm that the diagnostic relevance is comparable with other more complex and less accessible exams such as PET positron emission tomography (Szelies and Grond, 1992; Dierks and Jelic, 2000). According to the characterization, Stigsby et al. (1981) found greater diffuse activity of theta and delta, and lower alpha and beta, as well as the frontal deceleration, more prominent to Silvio’s fissure. Another study about prediction revealed the value of the EEG as a predictor with the 95% of accuracy in identifying those, in the study participants, who would suffer from neurocognitive decline, and those who not (Prichep et al., 2005). Methods: A qualitative cross - sectional descriptive methodology was proposed with the objective of knowing the brain activity, prior to treatment, in five patients with Dementia. The study was performed in awake state and activation using two methods: opening/closing the eyes and hyperventilation. Exclusion criteria were: presence of comorbidity psychiatric, history of brain damage and consumption of psychoactive substances, considering that these conditions may influence the results of the CEEG. Results: I was detected some heterogeneous data such as presences of theta waves in the left frontal lobe (in 1 of 5 patients), linked to diffuse corticosubcortical dysfunction and generalized low voltage (1 of 5 patients), related to cortical hypofunction suggestive of loss of nerve cells and therefore of functionality, nevertheless, it is important to emphasize the absence of alpha waves in all of them (5 of 5 patients) which is related to alterations in the synchronicity of the corticocortical connections.