Electroencephalographic assessment in patients with Rett syndrome during cognitive stimulation by means of eye tracking technology and alternative and augmentative communication systems.

Rett syndrome (RTT) is considered a rare disease despite being the leading genetic disorder to cause severe intellectual disability in women. There is no cure for RTT, so the treatment is symptomatic and supporting, requiring a multidisciplinary approach. Occupational therapy can help girls and their families to improve communication, being one of the main concerns when verbal language and intentional hand movement are impaired or lost. This paper presents a pilot study of cognitive training through the combined use of eye-tracking technology (ETT) and augmentative and alternative communication (AAC) using the Peabody Picture Vocabulary Test (PPVT-IV). The objective was to evaluate brain activation by means of electroencephalography (EEG) during the stimulation of non-verbal communication. EEG data were recorded during an eyes-open resting state (EO-RS) period and during cognitive stimulation via AAC activity. To assess their effect, both signals were compared at the spectral level, focusing on frequency, brain symmetry and connectivity. During the task, a redistribution of power towards fast frequency bands was observed, as well as an improvement in the brain symmetry index (BSI) and functional synchronicity through increased coherence. Therefore, the results of the spectral analysis showed a possible deviation from the pathological pattern, manifesting a positive effect in the use of non-verbal cognitive stimulation activities. In conclusion, it was observed that it is possible to establish a cognitive training system that produces brain activation and favors communication and learning despite intentional language loss.Clinical Relevance- This manifests a method of cognitive training that would induce brain activation in RTT patients with absence of intentional communication. The evaluation system through spectral analysis could complement the standardized protocols to asses communication that are based on verbal and motor production.

Influence of ocular filtering in EEG data on the assessment of drug-induced effects on the brain.

Ocular artifacts in EEG signals affect the interpretation of clinical study results. The aim of this study was to assess the influence of automatic ocular filtering procedures in the conclusions drawn from a pharmaco-EEG trial. Regression analysis, gold standard, and blind source separation (BSS), Second Order Blind Identification algorithm, ocular filtering procedures were compared using time, frequency, topographic and tomographic brain mapping approaches and pharmacokinetic-pharmacodynamic (PK-PD) relationships. Data consisted of EEGs obtained from 20 volunteers who received single oral doses of haloperidol 3 mg, risperidone 1 mg, olanzapine 5 mg and placebo in a randomized cross-over double-blind design. Although the BSS-based technique preserved brain activity more than regression analysis in anterior leads, in general, topographic significance probability maps globally showed similar results with both methods for most spectral variables. However, different results were obtained when using whole multi-channel information for studying drug effects in the brain: (i) higher correlations between PK and PD time courses showing that BSS allowed estimation of spectral variables more accurately related to drug effects and (ii) larger and more symmetric drug related tomographic LORETA maps showing that BSS led to results that were more neurophysiopharmacologically sound. Definitely, the BSS-based procedure is an effective and efficient preprocessing method to remove ocular artifacts from EEG data. The selection of the ocular filtering procedure could determine different results whose impact depends on the evaluating tool applied to analyze the pharmaco-EEG data.