Combining and optimizing NIRS and EEG to study interictal epileptic discharges

We describe our ongoing application of NIRS-EEG to the study of inter-ictal discharges in adult epilepsy. We discuss optimizing NIRS-EEG data acquisition and analysis and we present preliminary NIRS-EEG results for an epileptic patient. © 2012 OSA

Seizure Detection, Seizure Prediction, and Closed-Loop Warning Systems in Epilepsy

Nearly one-third of patients with epilepsy continue to have seizures despite optimal medication management. Systems employed to detect seizures may have the potential to improve outcomes in these patients by allowing more tailored therapies and might, additionally, have a role in accident and SUDEP prevention. Automated seizure detection and prediction require algorithms which employ feature computation and subsequent classification. Over the last few decades, methods have been developed to detect seizures utilizing scalp and intracranial EEG, electrocardiography, accelerometry and motion sensors, electrodermal activity, and audio/video captures. To date, it is unclear which combination of detection technologies yields the best results, and approaches may ultimately need to be individualized. This review presents an overview of seizure detection and related prediction methods and discusses their potential uses in closed-loop warning systems in epilepsy

Sports psychiatry and medical views on mild traumatic brain injury in competitive sport: a current review and recommendations

Head injuries are common in competitive and recreational sport. Nomenclature, though inconsistent, identifies mild traumatic brain injury (mTBI) based on acute diagnostic criteria, whereas a sport-related concussion (SRC) is event-related and specific to mTBI experienced while participating in athletic activity. The effects of SRC are often neurological, neuropsychological and/or psychiatric with a variety of symptoms. Different organizations categorize these symptoms differently and this variance demonstrates that no uniform clinical classification system has been agreed upon. Diagnosis of SRC is based on clinical examination. Numerous symptom checklists and assessments are available for clinical diagnosis, but their validity is somewhat limited. There is increasing awareness regarding the psychiatric deficits associated with SRC and the potential for developing post-concussion syndrome (PCS). In addition to complex, causal SRC-associated symptoms, reactive psychological complaints may also occur, as well as social mistreatment on recovery from SRC. Pre-existing mental health conditions are associated with an increased risk for developing PCS. This often necessitates the implementation of psychiatric or psychotherapeutic care after SRC. As with mTBI and SRC, no standardized classification has been established for PCS. Multi-stage rehabilitation strategies can help injured athletes navigate a successful recovery and prevent premature return to play. Further research on the utility of psychotherapy, psychopharmacotherapy, and exercise therapy of PCS is needed. Key Words: Concussion, Mental Health, Post-Concussion Syndrome, Interdisciplinarit

Sportorthopädie

Background: There is some evidence that regular physical activity has protective effects on cognitive functions in elderly people. The optimal dose of physical activity remains to be elucidated. We conducted a systematic literature research to detect a dose-response-relationship with quantitative measures between physical activity and cognitive performance.Method: We searched PubMed and Ovid for randomized controlled trials. Intensity and total numberof minutes of exercise per week were converted into metabolic equivalent (MET) values per week. Standardized Mean Differences were calculated to determine the effect of the physical intervention on executive functions, attention, processing speed, verbal memory, short- and long-term memory. Methodological quality was assessed by risk of bias with the Cochrane Collaboration tool.Results: 13 studies were analyzed. Eight studies reached two and three points in the quality assessment, five studies reached between four and six points. Low, moderate and high MET/week values were related to marginal, small, medium and high effect sizes for each health status. Indications were found for a linear dose-response relationship between executive functions and MET/week for the MCI population, but not for healthy elderly and AD patients. Conclusion: A dose-response-relationship superior to other intensities was not found for any group. Consensus on cognitive outcomes and the exploration of the effects of different types of exercise in healthy elderly, MCI- and AD-patients might help to elucidate the optimal dose of physical activity on age- and AD-affected cognitive functions.KEY WORDS: Dose-Response-Relationship, Cognitive Performance, Physical Activity, Metabolic Equivalent, Dementi

Source connectivity patterns in the default mode network differ between elderly golf-novices and non-golfers

Abstract Learning to play golf has high demands on attention and therefore may counteract age-related changes of functional brain networks. This cross-sectional study compared source connectivity in the Default Mode Network (DMN) between elderly golf novices and non-golfers. Four-minute resting-state electroencephalography (128 channels) from 22 elderly people (mean age 67 ± 4.3 years, 55% females) were recorded after completing a 22-week golf learning program or after having continued with normal life. Source connectivity was assessed after co-registration of EEG data with native MRI within pre-defined portions of the DMN in the beta band (14–25 Hz). Non-golfers had significantly higher source connectivity values in the anterior DMN compared to non-golfers. Exploratory correlation analyses did not indicate an association to cognitive performance in either group. Inverse correlations between a marker of external attention with source connectivity of the anterior DMN may suggest a trend in the golf group only, but have to be replicated in future studies. Clinical relevance of these findings remains to be elucidated, but the observed difference in the anterior DMN may provide a starting point to further investigate if and how learning golf may have an impact on physiological age-related cognitive changes

Electroconvulsive therapy resolves cortical inhibition and manneristic omissions in a chronic catatonic patient

We investigated a patient with severe catatonic schizophrenia (manneristic catatonia according to Karl Leonhard) treated with electroconvulsive therapy (ECT) after pharmacological approaches did not result in any clinical improvement. Before and after nine ECT sessions a double-pulse transcranial magnetic stimulation (TMS) paradigm was used to measure intracortical inhibition (ICI) which has been shown to be reduced in a significant proportion of patients with schizophrenia. Although the patient showed no remission regarding some psychomotor aspects after ECT, we found an increase in ICI and a remarkable clinical improvement of catatonic omissions which might be due to changes in the GABAergic system