[Cerebral blood flow during neurocardiogenic syncopes in children]. / Przeplyw mózgowy krwi w omdleniach neurokardiogennych u dzieci.

BACKGROUND: Neurocardiogenic syncope, the most common episodic event in children results from global cerebral hypoperfusion. Monitoring of the blood flow during head-up tilt-induced syncope resulted in registration of preferential reduction of end-diastolic velocities in middle cerebral arteries (MCA). The significance of those changes was however not explained. The aim of this retrospective research was to establish the significance of visual inspection of spectra changes of cerebral blood flow in MCA during presyncope and syncope in children. MATERIAL AND METHODS: The diagnostic head-up tilt test (TT) was conducted in 276 children with neurocardiogenic syncopes. The group consisted of 211 girls and 65 boys aged 8 to 18 years (mean age 14 years). 30 healthy volunteers were enrolled as a control group. During rest in supine position and during tilting upright to 70 degree at the tilt table, the blood flow was monitored in MCA using Nicolet Companion III in order to perform transcranial Doppler ultrasonography. RESULTS: During passive TT symptoms of syncope were observed in 31 girls and 10 boys after 3 to 30 min (mean 13.7 min) of tilting, and mild presyncopal signs in other 9 children. The most typical change of the blood flow in MCA registered during vasovagal syncope was a preferential decrease of end-diastolic velocities. In one patient two TT were performed, both examinations were positive, however during the second TT wave reflection during early diastole in MCA was registered. In one child from the control group result of TT was false positive, with the same pattern of blood flow spectra, as in children from the syncope group. During hyperventilation the reduction of velocities of the blood flow in MCA was detected, mainly diastolic. CONCLUSIONS: The registration of reduced velocities of the blood flow in middle cerebral arteries during diastole may allow to earlier termination of tilting in order to prevent a loss of consciousness. One of important prophylactic actions related to syncope is to counteract hyperventilation. The pattern of high resistance spectrum of blood flow in MCA, with a backward direction of early diastolic flow during syncope may suggest that wave reflection may play a significant role.

[P300 potential in chldren with psychogenic nonepileptic events and tension headache]. / Potencjal P300 u dzieci z napadami rzekomopadaczkowymi i napieciowymi bólami glowy.

INTRODUCTION: Psychotherapy is being used as the primary treatment in nonepileptic psychogenic seizures and tension headaches in children. Children's intelectual functioning is related to certain endogenous neurophysiological parameters. AIM: The goal of this study was to establish whether the endogenous potential P300 is different in children with nonepileptic psychogenic events and with tension headaches, and whether it changes under the influence of the cognitive-behavioral psychotherapy. MATERIAL AND METHODS: The study included a group of 47 children: 20 with nonepileptic psychogenic seizures (18 girls and 2 boys), aged 11.09-17.11 years, and 27 children with tension headache (25 girls and 2 boys), aged 10.11-17.11 years. The P300 potential was induced using an auditory stimulus. The reaction time, the amount of mistakes and the percentage of attention focus was measured in all children. All children attended 8-10 psychotherapy sessions. The P300 potential was registered before and after the course of therapy, and additionally in both cycles also after a 3 minutes hyperventilation. RESULTS: Medium P300 parameters were closer to normal in the group of children with tension headaches rather than in the group with nonepileptic seizures. The shorter was the reaction time in the first measurement, the higher the attention score and the shorter the reaction time in the second measurement - this was visible in the results of children with nonepileptic seizures, in contrast to children with tension headaches. The use of hyperventilation caused a noticeable extension of the reaction time in the P300 measurement, with other components unchanged (mistake count and percentage of attention focus). CONCLUSION: The endogenous potential P300 does vary, although on a statistically insignificant level, in groups of children with tension headaches and nonepileptic seizures.

[The influence of cognitive-behavioral therapy on the P300 potential in children with psychogenic nonepileptic seizures and tension headache]. / Wplyw terapii poznawczo-behawioralnej na potencjal P300 u dzieci z napadami rzekomopadaczkowymi i napieciowymi bólami glowy.

UNLABELLED: Explaining associations between neurophysiological and neuropsychological parameteres in children and improving the measurement methods would lead to a better understanding of the pathogenesis and course of psychosomatic disease. Goal: clinical assessment of the efficacy of cognitive-behavioral therapy in the treatment of psychogenic no- nepileptic seizures and tension type headaches in children. Determining the influence of cognitive behavioral therapy on the cognitive P300 potential and whether P300 parameters in children correlate with neuropsychological parameters. MATERIAL AND METHODS: 20 children with nonepileptic psychogenic seizures and 30 children with tension type headaches, aged 11.3 - 17.11 years. The final diagnosis was made in the Paediatric Neurology Clinic. The P300 examination was performed before/after therapy, with/without hyperventilation. A fixed structure therapy was implemented (10 sessions, 90 minutes each), during two weeks of hospitalization or in an outpatient clinic (9 children with tension type headache). The psychological assessment comprised of temperament questionnaires, auditory and visual memory trials, executive function and attention trials, and in some cases also intelligence testing. RESULTS: More significant correlations were found in children with psychogenic seizures: attention parameters correlated negatively with reaction time, and this correlation tended to fade in the second examination, after psychotherapy. In children with tension type headache a statistically insignificant tendency was found of a positive correlation between those parameters. Medium P300 parameteres in this group were better. In 17/20 of children with psychogenic seizures a clinical improvement was observed, in 3 children the symptoms persisted in a 6 month follow up, but of a lower frequency. In 11/27 of chil- dren with tension headache the symptoms persisted, also with a lower frequency. CONCLUSION: cognitive-behavioral therapy is effective in the reduction of symptoms in many cases of psychogenic seizures and chronic tension type headache.

[The links between neuropsychology and neurophysiology]. / Zwiazki miedzy neuropsychologia a neurofizjologia.

AIM: The aim of the study was to establish current scope of knowledge regarding associations between neurophysiological functioning, neuropsychology and psychoterapy. MATERIAL AND METHODS: A systematic review was performed including 93 publications from Science Server, which contains the collections of Elsevier, Springer Journals, SCI-Ex/ICM, MEDLINE/PubMed, and SCOPUS. The works have been selected basing on following key words: 'neuropsychology, neurocognitive correlates, electrodermal response, event related potential, EEG, pupillography, electromiography' out of papers published between 2004-2015. RESULTS: Present reports on the use of neurophysiological methods in psychology can be divided into two areas: experimental research and research of the practical use of conditioning techniques and biofeedback in the treatment of somatic disease. Among the experimental research the following have been distinguished: research based on the startle reflex, physiological reaction to novelty, stress, type/amount of cognitive load and physiological correlates of emotion; research on the neurophysiological correlates of mental disorders, mostly mood and anxiety disorders, and neurocognitive correlates: of memory, attention, learning and intelligence. Among papers regarding the use of neurophysiological methods in psychology two types are the most frequent: on the mechanisms of biofeedback, related mainly to neuro- feedback, which is a quickly expanding method of various attention and mental disorders'treatment, and also research of the use of conditioning techniques in the treatment of mental disorders, especially depression and anxiety. A special place among all the above is taken by the research on electrophysiological correlates of psychotherapy, aiming to differentiate between the efficacy of various psychotherapeutic schools (the largest amount of publications regard the efficacy of cognitive-behavioral psychotherapy) in patients of different age groups and different diagnosis.