EEG seizure in bilateral ECT is different between low and high stimulus doses

Melancholic depressive patients referred for ECT were randomized to receive either low dose (n = 20) or high dose (n = 20) stimulus applied bifrontotemporally. The two stimulus groups were comparable on the clinical variables. The EEG seizure was recorded on two channels (right and left frontal), digitized, coded and analyzed offline without knowledge of ECT parameters. EEG seizure was of comparable duration in the two stimulus (high dose and low dose) groups. A new composite measure, Strength-Symmetry-Index (SSI), based on strength and symmetry of seizure EEG was computed using fractal geometry. The SSI of the early-seizure was higher in the high dose than in the low dose ECT group. In a stepwise, logistic regression model, this variable contributed to 65% with correct classification of high dose and low dose ECT seizures.

Signal Characterization using Fractal Dimension

Fractal Dimensions (FD) are popular metrics for characterizing signals. They are used as complexity measuresin signal analysis applications in various fields. However, proper interpretation of such analyses has not been thoroughly addressed. In this paper, we study the effect of various signal properties on FD and interpret results in terms of classical signal processing concepts such as amplitude, frequency,number of harmonics, noise power and signal bandwidth. We have used Higuchi’s method for estimating FDs. This study helps in gaining a better understanding of the FD complexity measure for various signal parameters. Our results indicate that FD is a useful metric in estimating various signal properties. As an application of the FD measure in real world scenario, the FD is used as a feature in discriminating seizures from seizure free intervals in intracranial EEG data recordings and the FD feature has given good discrimination performance.

Strength Symmetry Index: A measure of seizure adequacy in ECT

Seizure electroencephalography (EEG) was recorded from two channels-right (Rt) and left (Lt)-during bilateral electroconvulsive therapy (ECT) (n = 12) and unilateral ECT (n = 12). The EEG was also acquired into a microcomputer and was analyzed without knowledge of the clinical details. EEG recordings of both ECT procedures yielded seizures of comparable duration. The Strength Symmetry Index (SSI) was computed from the early- and midseizure phases using the fractal dimension of the EEG. The seizures of unilateral ECT were characterized by significantly smaller SSI in both phases. More unilateral than bilateral ECT seizures had a smaller than median SSI in both phases. The seizures also differed on other measures as reported in the literature. The findings indicate that SSI may be a potential measure of seizure adequacy that remains to be validated in future research.

l-pGlu-(2-propyl)-l-His-l-ProNH2 attenuates 4-aminopyridine-induced epileptiform activity and sodium current: a possible action of new thyrotropin-releasing hormone analog for its anticonvulsant potential

L-PGlu-(2-proPyl)-L-His-L-ProNH(2) (NP-647) is a CNS active thyrotropin-releasing hormone (TRH) analog with potential application in various CNS disorders including seizures. In the present study, mechanism of action for protective effect of NP-647 was explored by studying role of NP-647 on epileptiform activity and sodium channels by using patch-clamp methods. Epileptiform activity was induced in subicular pyramidal neurons of hippocampal slice of rat by perfusing 4-aminopyridine (4-AP) containing Mg(+2)-free normal artificial cerebrospinal fluid (nACSF). Increase in mean firing frequency was observed after perfusion of 4-AP and zero Mg(+2) (2.10+/-0.47 Hz) as compared with nACSF (0.12+/-0.08 Hz). A significant decrease in mean firing frequency (0.61+/-0.22 Hz), mean frequency of epileptiform events (0.03+/-0.02 Hz vs. 0.22+/-0.05 Hz of 4-AP+0 Mg), and average number of action potentials in paroxysmal depolarization shift-burst (2.54+/-1.21 Hz vs. 8.16+/-0.88 Hz of 4-AP +0 Mg) was observed. A significant reduction in peak dV/dt (246+/-19 mV ms(-1) vs. 297 18 mV ms-1 of 4-AP+0 Mg) and increase (1.332+/-0.018 ms vs. 1.292+/-0.019 ms of 4-AP+0 Mg) in time required to reach maximum depolarization were observed indicating role of sodium channels. Concentration-dependent depression of sodium current was observed after exposure to dorsal root ganglion neurons to NP-647. NP-647 at different concentrations (1, 3, and 10 mu M) depressed sodium current (15+/-0.5%, 50+/-2.6%, and 75+/-0.7%, respectively). However, NP-647 did not show change in the peak sodium current in CNa18 cells. Results of present study demonstrated potential of NP-647 in the inhibition of epileptiform activity by inhibiting sodium channels indirectly. (C) 2011 IBRO. Published by Elsevier Ltd. All rights reserved.

Study of phase synchronization in multichannel seizure EEG using nonlinear recurrence measure

Complex biological systems such as the human brain can be expected to be inherently nonlinear and hence difficult to model. Most of the previous studies on investigations of brain function have either used linear models or parametric nonlinear models. In this paper, we propose a novel application of a nonlinear measure of phase synchronization based on recurrences, correlation between probabilities of recurrence (CPR), to study seizures in the brain. The advantage of this nonparametric method is that it makes very few assumptions thus making it possible to investigate brain functioning in a data-driven way. We have demonstrated the utility of CPR measure for the study of phase synchronization in multichannel seizure EEG recorded from patients with global as well as focal epilepsy. For the case of global epilepsy, brain synchronization using thresholded CPR matrix of multichannel EEG signals showed clear differences in results obtained for epileptic seizure and pre-seizure. Brain headmaps obtained for seizure and preseizure cases provide meaningful insights about synchronization in the brain in those states. The headmap in the case of focal epilepsy clearly enables us to identify the focus of the epilepsy which provides certain diagnostic value. Comparative studies with linear correlation have shown that the nonlinear measure CPR outperforms the linear correlation measure. (C) 2014 Elsevier Ltd. All rights reserved.