Trigger Factors in Childhood Migraine: A Prospective Clinic-Based Study From North of France.

The objective was to study the prevalence and characterization of pediatric migraine triggers and to compare results to this retrospective study. A total of 101 pediatric patients with ICHD-II migraine with and/or without aura were instructed to prospectively complete a diary dealing with attacks triggers for a 3-month period. Each subject reported at least 1 trigger (range: 1-14) with a total number of 532 attacks and a median per subject of 3. Lack of sleep (51.4%), stress (44.6%), warm climate (41.9%), noise (32.4%), and excitation (29.7%) were the most frequently reported. The delay between trigger exposure and attack onset was between 0 and 3 hours in 67.6% of attacks. This prospective study confirmed the findings of the authors' previous study, with the exception that number of triggers was smaller, probably due to recall bias. The 4 most frequent triggers (lack of sleep, stress, hot weather, and noise) were identical in both studies.

Evaluation of automatic feature detection algorithms in EEG: application to interburst intervals.

In this paper, we present a new method to compare and improve algorithms for feature detection in neonatal EEG. The method is based on the algorithm׳s ability to compute accurate statistics to predict the results of EEG visual analysis. This method is implemented inside a Java software called EEGDiag, as part of an e-health Web portal dedicated to neonatal EEG. EEGDiag encapsulates a component-based implementation of the detection algorithms called analyzers. Each analyzer is defined by a list of modules executed sequentially. As the libraries of modules are intended to be enriched by its users, we developed a process to evaluate the performance of new modules and analyzers using a database of expertized and categorized EEGs. The evaluation is based on the Davies-Bouldin index (DBI) which measures the quality of cluster separation, so that it will ease the building of classifiers on risk categories. For the first application we tested this method on the detection of interburst intervals (IBI) using a database of 394 EEG acquired on premature newborns. We have defined a class of IBI detectors based on a threshold of the standard deviation on contiguous short time windows, inspired by previous work. Then we determine which detector and what threshold values are the best regarding DBI, as well as the robustness of this choice. This method allows us to make counter-intuitive choices, such as removing the 50 Hz filter (power supply) to save time.

The effect of video-guidance on passive movement in patients with cerebral palsy: fMRI study.

In patients with cerebral palsy (CP), neuroimaging studies have demonstrated that passive movement and action-observation tasks have in common to share neuronal activation in all or part of areas involved in motor system. Action observation with simultaneous congruent passive movements may have additional effects in the recruitment of brain motor areas. The aim of this functional magnetic resonance imaging (fMRI) study was to examine brain activation in patients with unilateral CP during passive movement with and without simultaneous observation of simple hand movement. Eighteen patients with unilateral CP (fourteen male, mean age 14 years and 2 months) participated in the study. Using fMRI block design, brain activation following passive simple opening-closing hand movement of either the paretic or nonparetic hand with and without simultaneous observation of a similar movement performed by either the left or right hand of an actor was compared. Passive movement of the paretic hand performed simultaneously to the observation of congruent movement activated more "higher motor areas" including contralesional pre-supplementary motor area, superior frontal gyrus (extending to premotor cortex), and superior and inferior parietal regions than nonvideo-guided passive movement of the paretic hand. Passive movement of the paretic hand recruited more ipsilesional sensorimotor areas compared to passive movement of the nonparetic hand. Our study showed that the combination of observation of congruent hand movement simultaneously to passive movement of the paretic hand recruits more motor areas, giving neuronal substrate to propose video-guided passive movement of paretic hand in CP rehabilitation.

Neurodevelopmental and perinatal correlates of simple brain metrics in very preterm infants.

OBJECTIVE: To explore perinatal correlates of 3 simple measures of brain size, known as metrics, in very preterm infants at term-equivalent age and their relationship to 2-year neurodevelopmental outcomes. DESIGN: Prospective cohort study of preterm infants born at a gestational age of less than 30 weeks or a weight of less than 1250 g between April 1, 2001, and December 31, 2003, and followed up at 2 years of corrected age. SETTING: The Royal Women's Hospital and the magnetic resonance imaging unit at the Royal Children's Hospital. PATIENTS: Two hundred thirty-six preterm infants. INTERVENTIONS: Brain metrics--biparietal, bifrontal, and transverse cerebellar diameters--on magnetic resonance imaging for preterm infants at term-equivalent age and neurodevelopmental assessments at 2 years of corrected age. MAIN OUTCOME MEASURES: Mental Development Index and the Psychomotor Development Index of the Bayley Scales of Infant Development-Revised. RESULTS: Higher birth weight z score, shorter duration of assisted ventilation, and postmenstrual age at magnetic resonance imaging were independently associated with increases in the 3 brain metrics, and male sex was associated with larger bifrontal and biparietal diameters. Only the biparietal diameter was predictive of cognitive and motor indices after adjustment for perinatal variables and social risk. CONCLUSION: This study provides further evidence of altered brain growth in preterm infants, relating to growth restriction and severity of illness, that in turn relate to neurodevelopmental outcome.

Respiratory evoked potentials and occlusion elicited sympathetic skin response.

INTRODUCTION: Neurophysiological study of respiratory structures usually relies upon diaphragm electromyography and phrenic nerve conduction study, which do not assess the afferent sensory pathways. OBJECTIVE: To assess the feasibility of respiratory evoked potentials (REPs) and sympathetic skin responses (SSRs) elicited by inspiratory occlusion. METHODS: REPs and SSRs were studied in 12 healthy adults. REPs were elicited by inspiratory occlusions triggered by the physician within 1 s after the onset of a respiratory effort. They were recorded from C3, C4 and Cz needle electrodes (referenced to Fz). Each individual trial consisted of two superimposed 30-sweep averaged responses to inspiratory occlusions. SSRs were recorded from surface electrodes placed on the subject's hand and elicited by similar inspiratory occlusions. RESULTS: Reproducible REPs and SSRs were obtained in all subjects. Mean latencies of initial P1 and N1 cortical responses were 41 and 72 ms, respectively. SSRs were similar to those usually elicited by peripheral nerve electrical stimulation. CONCLUSION: Brief occlusion of inspiration induces cortical and sympathetic activation, both are easily recordable. Since REPs are considered to be the neurophysiological substrate of certain types of respiratory sensations and are altered in different chronic respiratory diseases, they, in addition to SSR, represent attractive new techniques that may provide better understanding of respiratory dysfunction.