Prognostic value of early EEG abnormalities in severe stroke patients requiring mechanical ventilation: a pre-planned analysis of the SPICE prospective multicenter study.

INTRODUCTION: Prognostication of outcome in severe stroke patients necessitating invasive mechanical ventilation poses significant challenges. The objective of this study was to assess the prognostic significance and prevalence of early electroencephalogram (EEG) abnormalities in adult stroke patients receiving mechanical ventilation. METHODS: This study is a pre-planned ancillary investigation within the prospective multicenter SPICE cohort study (2017-2019), conducted in 33 intensive care units (ICUs) in the Paris area, France. We included adult stroke patients requiring invasive mechanical ventilation, who underwent at least one intermittent EEG examination during their ICU stay. The primary endpoint was the functional neurological outcome at one year, determined using the modified Rankin scale (mRS), and dichotomized as unfavorable (mRS 4-6, indicating severe disability or death) or favorable (mRS 0-3). Multivariable regression analyses were employed to identify EEG abnormalities associated with functional outcomes. RESULTS: Of the 364 patients enrolled in the SPICE study, 153 patients (49 ischemic strokes, 52 intracranial hemorrhages, and 52 subarachnoid hemorrhages) underwent at least one EEG at a median time of 4 (interquartile range 2-7) days post-stroke. Rates of diffuse slowing (70% vs. 63%, p = 0.37), focal slowing (38% vs. 32%, p = 0.15), periodic discharges (2.3% vs. 3.7%, p = 0.9), and electrographic seizures (4.5% vs. 3.7%, p = 0.4) were comparable between patients with unfavorable and favorable outcomes. Following adjustment for potential confounders, an unreactive EEG background to auditory and pain stimulations (OR 6.02, 95% CI 2.27-15.99) was independently associated with unfavorable outcomes. An unreactive EEG predicted unfavorable outcome with a specificity of 48% (95% CI 40-56), sensitivity of 79% (95% CI 72-85), and positive predictive value (PPV) of 74% (95% CI 67-81). Conversely, a benign EEG (defined as continuous and reactive background activity without seizure, periodic discharges, triphasic waves, or burst suppression) predicted favorable outcome with a specificity of 89% (95% CI 84-94), and a sensitivity of 37% (95% CI 30-45). CONCLUSION: The absence of EEG reactivity independently predicts unfavorable outcomes at one year in severe stroke patients requiring mechanical ventilation in the ICU, although its prognostic value remains limited. Conversely, a benign EEG pattern was associated with a favorable outcome.

Testing conditional quantile independence with functional covariate.

We propose a new non-parametric conditional independence test for a scalar response and a functional covariate over a continuum of quantile levels. We build a Cramer-von Mises type test statistic based on an empirical process indexed by random projections of the functional covariate, effectively avoiding the "curse of dimensionality" under the projected hypothesis, which is almost surely equivalent to the null hypothesis. The asymptotic null distribution of the proposed test statistic is obtained under some mild assumptions. The asymptotic global and local power properties of our test statistic are then investigated. We specifically demonstrate that the statistic is able to detect a broad class of local alternatives converging to the null at the parametric rate. Additionally, we recommend a simple multiplier bootstrap approach for estimating the critical values. The finite-sample performance of our statistic is examined through several Monte Carlo simulation experiments. Finally, an analysis of an EEG data set is used to show the utility and versatility of our proposed test statistic.

EEG recording latency in critically ill patients: Impact on outcome. An analysis of a randomized controlled trial (CERTA).

OBJECTIVE: To assess, in adults with acute consciousness impairment, the impact of latency between hospital admission and EEG recording start, and their outcome. METHODS: We reviewed data of the CERTA trial (NCT03129438) and explored correlations between EEG recording latency and mortality, Cerebral Performance Categories (CPC), and modified Rankin Scale (mRS) at 6 months, considering other variables, using uni- and multivariable analyses. RESULTS: In univariable analysis of 364 adults, median latency between admission and EEG recordings was comparable between surviving (61.1 h; IQR: 24.3-137.7) and deceased patients (57.5 h; IQR: 22.3-141.1); p = 0.727. This did not change after adjusting for potential confounders, such as lower Glasgow Coma Score on enrolment (p < 0.001) and seizure or status epilepticus detection (p < 0.001). There was neither any correlation between EEG latency and mRS (rho 0.087, p 0.236), nor with CPC (rho = 0.027, p = 0.603). CONCLUSION: This analysis shows no correlation between delays of EEG recordings and mortality or functional outcomes at 6 months in critically ill adults. SIGNIFICANCE: These findings might suggest that in critically ill adults mortality correlates with underlying brain injury rather than EEG delay.

Epileptic Seizure Detection with Hybrid Time-Frequency EEG Input: A Deep Learning Approach.

The precise detection of epileptic seizure helps to prevent the serious consequences of seizures. As the electroencephalogram (EEG) reflects the brain activity of patients effectively, it has been widely used in epileptic seizure detection in the past decades. Recently, deep learning-based detection methods which automatically learn features from the EEG signals have attracted much attention. However, with deep learning-based detection methods, different input formats of EEG signals will lead to different detection performances. In this paper, we propose a deep learning-based epileptic seizure detection method with hybrid input formats of EEG signals, i.e., original EEG, Fourier transform of EEG, short-time Fourier transform of EEG, and wavelet transform of EEG. Convolutional neural networks (CNNs) are designed for extracting latent features from these inputs. A feature fusion mechanism is applied to integrate the learned features to generate a more stable syncretic feature for seizure detection. The experimental results show that our proposed hybrid method is effective to improve the seizure detection performance in few-shot scenarios.

An EEG Classification-Based Method for Single-Trial N170 Latency Detection and Estimation.

Event-related potentials (ERPs) can reflect the high-level thinking activities of the brain. In ERP analysis, the superposition and averaging method is often used to estimate ERPs. However, the single-trial ERP estimation can provide researchers with more information on cognitive activities. In recent years, more and more researchers try to find an effective method to extract single-trial ERPs, because most of the existing methods have poor generalization ability or suffer from strong assumptions about the characteristics of ERPs, resulting in unsatisfactory results under the condition of a very low signal-to-noise ratio. In this paper, an EEG classification-based method for single-trial ERP detection and estimation was proposed. This study used a linear generated EEG model containing templates of ERP local descriptors which include amplitude and latency, and this model can avoid the invalid assumption about ERPs taken by other methods. The purpose of this method is not to recover the whole ERP waveform but to model the amplitude and latency of ERP components. This method afterwards examined the three machine learning models including logistic regression, neural network, and support vector machine in the EEG signal classification for ERP detection and selected the best performed MLPNN model for detection. To get the utmost out of information produced in the classification process, this study also used extra information to propose a new optimization model, with which outperformed detection results were obtained. Performance of the proposed method is evaluated on simulated N170 and real P50 data sets, and the results show that the model is more effective than the Woody filter and the SingleTrialEM algorithm. These results are also consistent with the conclusion of sensory gating, which demonstrated good generalization ability.

Propofol Anesthesia Depth Monitoring Based on Self-Attention and Residual Structure Convolutional Neural Network.

METHODS: We compare nine index values, select CNN+EEG, which has good correlation with BIS index, as an anesthesia state observation index to identify the parameters of the model, and establish a model based on self-attention and dual resistructure convolutional neural network. The data of 93 groups of patients were selected and randomly grouped into three parts: training set, validation set, and test set, and compared the best and worst results predicted by BIS. RESULT: The best result is that the model's accuracy of predicting BLS on the test set has an overall upward trend, eventually reaching more than 90%. The overall error shows a gradual decrease and eventually approaches zero. The worst result is that the model's accuracy of predicting BIS on the test set has an overall upward trend. The accuracy rate is relatively stable without major fluctuations, but the final accuracy rate is above 70%. CONCLUSION: The prediction of BIS indicators by the deep learning method CNN algorithm shows good results in statistics.

Intelligent Algorithm-Based Quantitative Electroencephalography in Evaluating Cerebral Small Vessel Disease Complicated by Cognitive Impairment.

To analyze the application value of artificial intelligence model based on Visual Geometry Group- (VGG-) 16 combined with quantitative electroencephalography (QEEG) in cerebral small vessel disease (CSVD) with cognitive impairment, 72 patients with CSVD complicated by cognitive impairment were selected as the research subjects. As per Diagnostic and Statistical Manual (5th Edition), they were divided into the vascular dementia (VD) group of 34 cases and vascular cognitive impairment with no dementia (VCIND) group of 38 cases. The two groups were analyzed for the clinical information, neuropsychological test results, and monitoring results of QEEG based on intelligent algorithms for more than 2 hours. The accuracy rate of VGG was 84.27% and Kappa value was 0.7, while that of modified VGG (nVGG) was 88.76% and Kappa value was 0.78. The improved VGG algorithm obviously had higher accuracy. The test results found that the QEEG identified 8 normal, 19 mild, 10 moderate, and 0 severe cases in the VCIND group, while in the VD group, the corresponding numbers were 4, 13, 11, and 7; in the VCIND group, 7 cases had the normal QEEG, 11 cases had background changes, 9 cases had abnormal waves, and 11 cases had in both background changes and abnormal waves, and in the VD group, the corresponding numbers were 5, 2, 5, and 22, respectively; in the VCIND group, QEEG of 18 patients had no abnormal waves, QEEG of 11 patients had a few abnormal waves, and QEEG of 9 patients had many abnormal waves, and QEEG of 0 people had a large number of abnormal waves, and in the VD group, the corresponding numbers were 7, 6, 12, and 9. The above data were statistically different between the two groups (P < 0.05). Hence, QEEG based on intelligent algorithms can make a good assessment of CSVD with cognitive impairment, which had good clinical application value.

Resting-state electroencephalography based deep-learning for the detection of Parkinson's disease.

Parkinson's disease (PD) is one of the most serious and challenging neurodegenerative disorders to diagnose. Clinical diagnosis on observing motor symptoms is the gold standard, yet by this point nerve cells are degenerated resulting in a lower efficacy of therapeutic treatments. In this study, we introduce a deep-learning approach based on a recently-proposed 20-Layer Convolutional Neural Network (CNN) applied on the visual realization of the Wavelet domain of a resting-state EEG. The proposed approach was able to efficiently and accurately detect PD as well as distinguish subjects with PD on medications from subjects who are off medication. The gradient-weighted class activation mapping (Grad-CAM) was used to visualize the features based on which the approach provided the predictions. A significantly high accuracy, sensitivity, specificity, AUC, and Weighted Kappa Score up to 99.9% were achieved and the visualization of the regions in the Wavelet images that contributed to the deep-learning approach decisions was provided. The proposed framework can then serve as an effective computer-aided diagnostic tool that will support physicians and scientists in further understanding the nature of PD and providing an objective and confident opinion regarding the clinical diagnosis of the disease.

Review on Epileptic Seizure Prediction: Machine Learning and Deep Learning Approaches.

Epileptic seizures occur due to brain abnormalities that can indirectly affect patient's health. It occurs abruptly without any symptoms and thus increases the mortality rate of humans. Almost 1% of world's population suffers from epileptic seizures. Prediction of seizures before the beginning of onset is beneficial for preventing seizures by medication. Nowadays, modern computational tools, machine learning, and deep learning methods have been used to predict seizures using EEG. However, EEG signals may get corrupted with background noise, and artifacts such as eye blinks and physical movements of muscles may lead to "pops" in the signal, resulting in electrical interference, which is cumbersome to detect through visual inspection for longer duration recordings. These limitations in automatic detection of interictal spikes and epileptic seizures are preferred, which is an essential tool for examining and scrutinizing the EEG recording more precisely. These restrictions bring our attention to present a review of automated schemes that will help neurologists categorize epileptic and nonepileptic signals. While preparing this review paper, it is observed that feature selection and classification are the main challenges in epilepsy prediction algorithms. This paper presents various techniques depending on various features and classifiers over the last few years. The methods presented will give a detailed understanding and ideas about seizure prediction and future research directions.

A Survey of Neuromonitoring Practices in North American Pediatric Intensive Care Units.

BACKGROUND: Neuromonitoring is the use of continuous measures of brain physiology to detect clinically important events in real-time. Neuromonitoring devices can be invasive or non-invasive and are typically used on patients with acute brain injury or at high risk for brain injury. The goal of this study was to characterize neuromonitoring infrastructure and practices in North American pediatric intensive care units (PICUs). METHODS: An electronic, web-based survey was distributed to 70 North American institutions participating in the Pediatric Neurocritical Care Research Group. Questions related to the clinical use of neuromonitoring devices, integrative multimodality neuromonitoring capabilities, and neuromonitoring infrastructure were included. Survey results were presented using descriptive statistics. RESULTS: The survey was completed by faculty at 74% (52 of 70) of institutions. All 52 institutions measure intracranial pressure and have electroencephalography capability, whereas 87% (45 of 52) use near-infrared spectroscopy and 40% (21/52) use transcranial Doppler. Individual patient monitoring decisions were driven by institutional protocols and collaboration between critical care, neurology, and neurosurgery attendings. Reported device utilization varied by brain injury etiology. Only 15% (eight of 52) of institutions utilized a multimodality neuromonitoring platform to integrate and synchronize data from multiple devices. A database of neuromonitoring patients was maintained at 35% (18 of 52) of institutions. Funding for neuromonitoring programs was variable with contributions from hospitals (19%, 10 of 52), private donations (12%, six of 52), and research funds (12%, six of 52), although 73% (40 of 52) have no dedicated funds. CONCLUSIONS: Neuromonitoring indications, devices, and infrastructure vary by institution in North American pediatric critical care units. Noninvasive modalities were utilized more liberally, although not uniformly, than invasive monitoring. Further studies are needed to standardize the acquisition, interpretation, and reporting of clinical neuromonitoring data, and to determine whether neuromonitoring systems impact neurological outcomes.

Continuous Versus Routine Standardized Electroencephalogram for Outcome Prediction in Critically Ill Adults: Analysis From a Randomized Trial.

OBJECTIVES: To investigate electroencephalogram (EEG) features' relation with mortality or functional outcome after disorder of consciousness, stratifying patients between continuous EEG and routine EEG. DESIGN: Retrospective analysis of data from a randomized controlled trial. SETTING: Multiple adult ICUs. PATIENTS: Data from 364 adults with acute disorder of consciousness, randomized to continuous EEG (30-48 hr; n = 182) or repeated 20-minute routine electroencephalogram (n = 182). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Correlations between electrographic features and mortality and modified Rankin scale at 6 months (good 0-2) were assessed. Background continuity, higher frequency, and reactivity correlated with survival and good modified Rankin scale. Rhythmic and periodic patterns carried dual prognostic information: lateralized periodic discharges were associated with mortality and bad modified Rankin scale. Generalized rhythmic delta activity correlated with survival, good modified Rankin scale, and lower occurrence of status epilepticus. Presence of sleep-spindles and continuous EEG background was associated with good outcome in the continuous EEG subgroup. In the routine EEG group, a model combining background frequency, continuity, reactivity, sleep-spindles, and lateralized periodic discharges was associated with mortality at 70.91% (95% CI, 59.62-80.10%) positive predictive value and 63.93% (95% CI, 58.67-68.89%) negative predictive value. In the continuous EEG group, a model combining background continuity, reactivity, generalized rhythmic delta activity, and lateralized periodic discharges was associated with mortality at 84.62% (95%CI, 75.02-90.97) positive predictive value and 74.77% (95% CI, 68.50-80.16) negative predictive value. CONCLUSIONS: Standardized EEG interpretation provides reliable prognostic information. Continuous EEG provides more information than routine EEG.

Research on Night Light Comfort of Pedestrian Space in Urban Park.

The outdoor light environment significantly affects aspects of public psychological and physiological health. This study conducted experiments to quantify the effects of the light environment on visitor light comfort in urban park pedestrian space. Nine sets of lighting conditions with different average horizontal illuminance (2 lx, 6 lx, 10 lx) and colour temperatures (5600 K, 4300 K, 3000 K) were established virtual reality scenarios. Subjective light comfort was evaluated, and electroencephalogram (EEG) was measured on 18 subjects to comprehensively study the effects of different light environments on human light comfort. The results of the comprehensive evaluation showed that colour temperature had a very significant impact on subjective light comfort, with warm light being generally more favourable than cool light in enhancing human subjective light comfort. The results of the EEG analysis show that the average horizontal illuminance is an important factor in the level of physiological fatigue, and that physiological fatigue can be maintained in a superior state at an appropriate level of illuminance. Based on the results of both subjective and objective factors, a comprehensive analysis was carried out to propose a range of average horizontal illuminance (4.08 lx, 6.99 lx) and a range of colour temperature (3126 K, 4498 K) for the comprehensive light comfort zone in urban park pedestrian space.

Using electronic health data to explore effectiveness of ICU EEG and anti-seizure treatment.

OBJECTIVES: The purpose of this study was to examine critical care continuous electroencephalography (cEEG) utilization and downstream anti-seizure treatment patterns, their association with outcomes, and generate hypotheses for larger comparative effectiveness studies of cEEG-guided interventions. METHODS: Single-center retrospective study of critically ill patients (n = 14,523, age ≥18 years). Exposure defined as ≥24 h of cEEG and subsequent anti-seizure medication (ASM) escalation, with or without concomitant anesthetic. Exposure window was the first 7 days of admission. Primary outcome was in-hospital mortality. Multivariable analysis was performed using penalized logistic regression. RESULTS: One thousand and seventy-three patients underwent ≥24 h of cEEG within 7 days of admission. After adjusting for disease severity, ≥24 h of cEEG followed by ASM escalation in patients not on anesthetics (n = 239) was associated with lower in-hospital mortality (OR 0.76 [0.53-1.07]), though the finding did not reach significance. ASM escalation with concomitant anesthetic use (n = 484) showed higher odds for mortality (OR 1.41 [1.03-1.94]). In the seizures/status epilepticus subgroup, post cEEG ASM escalation without anesthetics showed lower odds for mortality (OR 0.43 [0.23-0.74]). Within the same subgroup, ASM escalation with concomitant anesthetic use showed higher odds for mortality (OR 1.34 [0.92-1.91]) though not significant. INTERPRETATION: Based on our findings we propose the following hypotheses for larger comparative effectiveness studies investigating the direct causal effect of cEEG-guided treatment on outcomes: (1) cEEG-guided ASM escalation may improve outcomes in critically ill patients with seizures; (2) cEEG-guided treatment with combination of ASMs and anesthetics may not improve outcomes in all critically ill patients.

A Deep Learning-Based Classification Method for Different Frequency EEG Data.

In recent years, the research on electroencephalography (EEG) has focused on the feature extraction of EEG signals. The development of convenient and simple EEG acquisition devices has produced a variety of EEG signal sources and the diversity of the EEG data. Thus, the adaptability of EEG classification methods has become significant. This study proposed a deep network model for autonomous learning and classification of EEG signals, which could self-adaptively classify EEG signals with different sampling frequencies and lengths. The artificial design feature extraction methods could not obtain stable classification results when analyzing EEG data with different sampling frequencies. However, the proposed depth network model showed considerably better universality and classification accuracy, particularly for EEG signals with short length, which was validated by two datasets.

Monitoring of Anesthesia by Bispectral Analysis of EEG Signals.

BACKGROUND: In intensive care, monitoring the depth of anesthesia during surgical procedures is a key element in the success of the medical operation and postoperative recovery. However, despite the development of anesthesia thanks to technological and pharmacological advances, its side effects such as underdose or overdose of hypnotics remain a major problem. Observation and monitoring must combine clinical observations (loss of consciousness and reactivity) with tools for real-time measurement of changes in the depth of anesthesia. Methodology. In this work, we will develop a noninvasive method for calculating, monitoring, and controlling the depth of general anesthesia during surgery. The objective is to reduce the effects of pharmacological usage of hypnotics and to ensure better quality recovery. Thanks to the overall activity of sets of neurons in the brain, we have developed a BIS technique based on bispectral analysis of the electroencephalographic signal EEG. Discussion. By collecting the electrical voltages from the brain, we distinguish light sleep from deep sleep according to the values of the BIS indicator (ranging from 0 : sleep to 100 : wake) and also control it by acting on the dosage of propofol and sevoflurane. We showed that the BIS value must be maintained during the operation and the anesthesia at a value greater than 60. CONCLUSION: This study showed that the BIS technology led to an optimization of the anesthetic management, the adequacy of the hypnotic dosage, and a better postoperative recovery.

Emotion Recognition Based on EEG Using Generative Adversarial Nets and Convolutional Neural Network.

Emotion recognition plays an important role in the field of human-computer interaction (HCI). Automatic emotion recognition based on EEG is an important topic in brain-computer interface (BCI) applications. Currently, deep learning has been widely used in the field of EEG emotion recognition and has achieved remarkable results. However, due to the cost of data collection, most EEG datasets have only a small amount of EEG data, and the sample categories are unbalanced in these datasets. These problems will make it difficult for the deep learning model to predict the emotional state. In this paper, we propose a new sample generation method using generative adversarial networks to solve the problem of EEG sample shortage and sample category imbalance. In experiments, we explore the performance of emotion recognition with the frequency band correlation and frequency band separation computational models before and after data augmentation on standard EEG-based emotion datasets. Our experimental results show that the method of generative adversarial networks for data augmentation can effectively improve the performance of emotion recognition based on the deep learning model. And we find that the frequency band correlation deep learning model is more conducive to emotion recognition.

Envelope reconstruction of speech and music highlights stronger tracking of speech at low frequencies.

The human brain tracks amplitude fluctuations of both speech and music, which reflects acoustic processing in addition to the encoding of higher-order features and one's cognitive state. Comparing neural tracking of speech and music envelopes can elucidate stimulus-general mechanisms, but direct comparisons are confounded by differences in their envelope spectra. Here, we use a novel method of frequency-constrained reconstruction of stimulus envelopes using EEG recorded during passive listening. We expected to see music reconstruction match speech in a narrow range of frequencies, but instead we found that speech was reconstructed better than music for all frequencies we examined. Additionally, models trained on all stimulus types performed as well or better than the stimulus-specific models at higher modulation frequencies, suggesting a common neural mechanism for tracking speech and music. However, speech envelope tracking at low frequencies, below 1 Hz, was associated with increased weighting over parietal channels, which was not present for the other stimuli. Our results highlight the importance of low-frequency speech tracking and suggest an origin from speech-specific processing in the brain.

Dynamic Electrode-to-Image (DETI) mapping reveals the human brain's spatiotemporal code of visual information.

A number of neuroimaging techniques have been employed to understand how visual information is transformed along the visual pathway. Although each technique has spatial and temporal limitations, they can each provide important insights into the visual code. While the BOLD signal of fMRI can be quite informative, the visual code is not static and this can be obscured by fMRI's poor temporal resolution. In this study, we leveraged the high temporal resolution of EEG to develop an encoding technique based on the distribution of responses generated by a population of real-world scenes. This approach maps neural signals to each pixel within a given image and reveals location-specific transformations of the visual code, providing a spatiotemporal signature for the image at each electrode. Our analyses of the mapping results revealed that scenes undergo a series of nonuniform transformations that prioritize different spatial frequencies at different regions of scenes over time. This mapping technique offers a potential avenue for future studies to explore how dynamic feedforward and recurrent processes inform and refine high-level representations of our visual world.

A large-scale brain network mechanism for increased seizure propensity in Alzheimer's disease.

People with Alzheimer's disease (AD) are 6-10 times more likely to develop seizures than the healthy aging population. Leading hypotheses largely consider hyperexcitability of local cortical tissue as primarily responsible for increased seizure prevalence in AD. However, in the general population of people with epilepsy, large-scale brain network organization additionally plays a role in determining seizure likelihood and phenotype. Here, we propose that alterations to large-scale brain network organization seen in AD may contribute to increased seizure likelihood. To test this hypothesis, we combine computational modelling with electrophysiological data using an approach that has proved informative in clinical epilepsy cohorts without AD. EEG was recorded from 21 people with probable AD and 26 healthy controls. At the time of EEG acquisition, all participants were free from seizures. Whole brain functional connectivity derived from source-reconstructed EEG recordings was used to build subject-specific brain network models of seizure transitions. As cortical tissue excitability was increased in the simulations, AD simulations were more likely to transition into seizures than simulations from healthy controls, suggesting an increased group-level probability of developing seizures at a future time for AD participants. We subsequently used the model to assess seizure propensity of different regions across the cortex. We found the most important regions for seizure generation were those typically burdened by amyloid-beta at the early stages of AD, as previously reported by in-vivo and post-mortem staging of amyloid plaques. Analysis of these spatial distributions also give potential insight into mechanisms of increased susceptibility to generalized (as opposed to focal) seizures in AD vs controls. This research suggests avenues for future studies testing patients with seizures, e.g. co-morbid AD/epilepsy patients, and comparisons with PET and MRI scans to relate regional seizure propensity with AD pathologies.

Electroencephalographic evidence of gray matter lesions among multiple sclerosis patients: A case-control study.

ABSTRACT: This study aimed to investigate evidence of gray matter brain lesions in multiple sclerosis (MS) patients by evaluating the resting state alpha rhythm of brain electrical activity.The study included 50 patients diagnosed with MS recruited from the MS clinic with 50 age and gender-matched control participants. The study investigated parameters of posterior dominant rhythm (PDR) in the electroencephalography (EEG) recordings including wave frequency and amplitude. Functional disability among the patients was evaluated according to the expanded disability status scale. Univariate statistical analysis was completed using one-way analysis of variance and t test with a P value of less than .05 to indicate statistical significance.Patients with MS had significantly lower PDR frequency and amplitude values compared to the controls (P value < .01) and 34% of the MS patients had a PDR frequency of less than 8.5 Hz. The PDR frequency was negatively associated with the level of functional disability among the patients (P value <.001) and 4% of the patients had abnormal epileptiform discharges.Background slowing of resting alpha rhythms and epileptiform discharges are suggestive of gray matter degeneration and may help in the prediction and follow-up of cortical damage and functional disabilities among MS patients. Therefore, electroencephalography monitoring of the PDR spectrum may serve as an alternative or complementary tool with other imaging techniques to detect and monitor cerebral cortical lesions.