This case study describes a 54-year-old woman with recurrent epithelial ovarian cancer who was undergoing chemotherapy. After her cancer progressed on multiple lines of chemotherapy including paclitaxel/carboplatin and topotecan, she received ifosfamide. She then developed neurological symptoms and an electroencephalogram showed periodic triphasic waves, indicating ifosfamide-induced encephalopathy. Her chemotherapy was stopped but her encephalopathy worsened and she developed kidney damage from the ifosfamide. She ultimately passed away from her complications within a month.
This case study describes a 54-year-old woman with recurrent epithelial ovarian cancer who was undergoing chemotherapy. After her third round of ifosfamide treatment, she developed neurological symptoms. An electroencephalogram (EEG) detected frequent low-frequency periodic waves across both hemispheres, consistent with ifosfamide-induced encephalopathy. Her chemotherapy was stopped but her condition deteriorated further with worsening encephalopathy and acute kidney injury, and she ultimately passed away within a month.
EEG detects brain wave activity through electrodes placed on the scalp. Brain waves fall into different frequency bands such as delta, theta, alpha, beta, and gamma, which correlate with cognitive and mental states. EEG signals are generated by excitatory and inhibitory neuron activity. EEG recordings involve placing electrodes on standardized scalp locations, amplifying and processing the signals, then analyzing them in frequency or time domains. Digital EEG offers advantages over analog systems like high precision timing and non-invasiveness. It provides a relatively inexpensive way to check brain functioning across different areas.
This document provides an overview of auditory and visual evoked potentials. It discusses brainstem auditory evoked potentials (BAEPs) and visual evoked potentials (VEPs). For VEPs, it describes the visual pathway and how VEPs are recorded and analyzed. Common VEP waveforms like P100 are discussed along with factors that influence VEPs. For BAEPs, it outlines the auditory pathway and describes the waves recorded, including waves I-V. It discusses how BAEPs are measured and clinical applications for both VEPs and BAEPs in evaluating diseases that impact the visual and auditory pathways.
1) VEPs are electrophysiological signals extracted from the EEG activity in the visual cortex in response to visual stimulation. They provide an objective measure of visual pathway integrity from the eye to the occipital cortex.
2) VEP waveform and components mature during early childhood, peaking around ages 5-8 years, then stabilize until aging effects begin around age 55. The "P1" component can be seen in infants by 5 weeks of age.
3) Pattern-reversal stimulation with checkerboards is most commonly used clinically. It elicits a reproducible P100 component around 100ms. Hemifield stimulation can localize lesions to the pre- or retrochiasmatic regions.
This document summarizes a study that used EEG and eye tracking to analyze brain responses to marketing stimuli related to cracker choices. Researchers presented participants with 57 choice sets that described crackers varying in shape, flavor, and topping. They collected EEG data from 14 channels to analyze cortical activity patterns in different frequency bands. Their goals were to detect small changes in stimuli that impact marketing efficacy and explain how marketing information presentation affects brain responses. Their findings showed the frontal and occipital brain regions and theta, alpha, and beta frequency bands were most important for emotional processing of preferred versus non-preferred marketing stimuli.
VEP and BAEP testing provide information about the integrity of the visual and auditory pathways.
VEP uses patterned visual stimulation to assess the visual pathway from the retina to the visual cortex. Unpatterned stimulation can also be used when a patient cannot cooperate. Technical factors like luminance, contrast and check size can affect VEP results. Abnormal VEPs may indicate lesions along the visual pathway.
BAEP assesses the auditory brainstem pathways by recording electrical responses to click or tone stimuli. Waves I-V represent activity in successive portions of the brainstem. Technical factors like stimulus intensity, rate and polarity affect BAEP results. Abnormal latencies or absent waves can localize lesions in
The document discusses electroencephalography (EEG), which measures the electrical activity of the brain using electrodes placed on the scalp. It describes brain anatomy, including the cerebrum, cerebellum, and brainstem. It also discusses the 10-20 international system for electrode placement on the scalp and the different types of brain waves that can be measured by EEG, including alpha, beta, theta, delta, and gamma waves. The document provides an overview of how EEG is used to record and analyze brain activity for applications such as epilepsy diagnosis, monitoring anesthesia and brain injury.
This case study describes a 54-year-old woman with recurrent epithelial ovarian cancer who was undergoing chemotherapy. After her cancer progressed on multiple lines of chemotherapy including paclitaxel/carboplatin and topotecan, she received ifosfamide. She then developed neurological symptoms and an electroencephalogram showed periodic triphasic waves, indicating ifosfamide-induced encephalopathy. Her chemotherapy was stopped but her encephalopathy worsened and she developed kidney damage from the ifosfamide. She ultimately passed away from her complications within a month.
This case study describes a 54-year-old woman with recurrent epithelial ovarian cancer who was undergoing chemotherapy. After her third round of ifosfamide treatment, she developed neurological symptoms. An electroencephalogram (EEG) detected frequent low-frequency periodic waves across both hemispheres, consistent with ifosfamide-induced encephalopathy. Her chemotherapy was stopped but her condition deteriorated further with worsening encephalopathy and acute kidney injury, and she ultimately passed away within a month.
EEG detects brain wave activity through electrodes placed on the scalp. Brain waves fall into different frequency bands such as delta, theta, alpha, beta, and gamma, which correlate with cognitive and mental states. EEG signals are generated by excitatory and inhibitory neuron activity. EEG recordings involve placing electrodes on standardized scalp locations, amplifying and processing the signals, then analyzing them in frequency or time domains. Digital EEG offers advantages over analog systems like high precision timing and non-invasiveness. It provides a relatively inexpensive way to check brain functioning across different areas.
This document provides an overview of auditory and visual evoked potentials. It discusses brainstem auditory evoked potentials (BAEPs) and visual evoked potentials (VEPs). For VEPs, it describes the visual pathway and how VEPs are recorded and analyzed. Common VEP waveforms like P100 are discussed along with factors that influence VEPs. For BAEPs, it outlines the auditory pathway and describes the waves recorded, including waves I-V. It discusses how BAEPs are measured and clinical applications for both VEPs and BAEPs in evaluating diseases that impact the visual and auditory pathways.
1) VEPs are electrophysiological signals extracted from the EEG activity in the visual cortex in response to visual stimulation. They provide an objective measure of visual pathway integrity from the eye to the occipital cortex.
2) VEP waveform and components mature during early childhood, peaking around ages 5-8 years, then stabilize until aging effects begin around age 55. The "P1" component can be seen in infants by 5 weeks of age.
3) Pattern-reversal stimulation with checkerboards is most commonly used clinically. It elicits a reproducible P100 component around 100ms. Hemifield stimulation can localize lesions to the pre- or retrochiasmatic regions.
This document summarizes a study that used EEG and eye tracking to analyze brain responses to marketing stimuli related to cracker choices. Researchers presented participants with 57 choice sets that described crackers varying in shape, flavor, and topping. They collected EEG data from 14 channels to analyze cortical activity patterns in different frequency bands. Their goals were to detect small changes in stimuli that impact marketing efficacy and explain how marketing information presentation affects brain responses. Their findings showed the frontal and occipital brain regions and theta, alpha, and beta frequency bands were most important for emotional processing of preferred versus non-preferred marketing stimuli.
VEP and BAEP testing provide information about the integrity of the visual and auditory pathways.
VEP uses patterned visual stimulation to assess the visual pathway from the retina to the visual cortex. Unpatterned stimulation can also be used when a patient cannot cooperate. Technical factors like luminance, contrast and check size can affect VEP results. Abnormal VEPs may indicate lesions along the visual pathway.
BAEP assesses the auditory brainstem pathways by recording electrical responses to click or tone stimuli. Waves I-V represent activity in successive portions of the brainstem. Technical factors like stimulus intensity, rate and polarity affect BAEP results. Abnormal latencies or absent waves can localize lesions in
The document discusses electroencephalography (EEG), which measures the electrical activity of the brain using electrodes placed on the scalp. It describes brain anatomy, including the cerebrum, cerebellum, and brainstem. It also discusses the 10-20 international system for electrode placement on the scalp and the different types of brain waves that can be measured by EEG, including alpha, beta, theta, delta, and gamma waves. The document provides an overview of how EEG is used to record and analyze brain activity for applications such as epilepsy diagnosis, monitoring anesthesia and brain injury.
QoMEX2014 - Analysing the Quality of Experience of Multisensory Media from Me...Jacob Donley
This presentation was given at QoMEX 2014, the 6th International Workshop on Quality of Multimedia Experience.
Abstract:
This paper investigates the Quality of Experience (QoE) of multisensory media by analysing biosignals collected by electroencephalography (EEG) and eye gaze sensors and comparing with subjective ratings. Also investigated is the impact on QoE of various levels of synchronicity between the sensory effect and target video scene. Results confirm findings from previous research that show sensory effects added to videos increases the QoE rating. While there was no statistical difference observed for the QoE ratings for different levels of sensory effect synchronicity, an analysis of raw EEG data showed 25% more activity in the temporal lobe during asynchronous effects and 20-25% more activity in the occipital lobe during synchronous effects. The eye gaze data showed more deviation for a video with synchronous effects and the EEG showed correlating occipital lobe activity for this instance. These differences in physiological responses indicate sensory effect synchronicity may affect QoE despite subjective ratings appearing similar.
Investigation of Sensory Gating Processes in First-Episode Schizophrenia Pati...Erdil Arsoy
1. The document presents research investigating sensory gating processes in first-episode schizophrenia patients, their healthy siblings, and healthy controls using event-related potentials (ERPs).
2. Results found reduced P50, N100, and P200 peak-to-peak amplitudes and S1-S2 differences in first-episode schizophrenia patients compared to healthy siblings and controls, suggesting impaired sensory gating in patients.
3. Baseline-to-peak N100 amplitudes and S1-S2 differences were also reduced in patients compared to the other groups, providing further evidence of sensory gating deficits in first-episode schizophrenia.
Current trends in audiological practices and implications for developing coun...Alexander Decker
- Current audiological practices in developing countries still rely heavily on behavioral audiometric testing which requires active patient participation, while developed countries now emphasize electrophysiological testing that does not require active participation.
- Electrophysiological tests like auditory brainstem response testing and otoacoustic emission testing provide objective measures of hearing. Developed countries also use advanced techniques like cochlear implants.
- To better diagnose and treat hearing loss early, some developed countries implement universal newborn hearing screening before 1 month of age to identify problems, with evaluation by 3 months and early intervention starting by 6 months if needed. Early diagnosis and treatment are important for language development.
High-intensity LEDs are embedded in the flash stimulation pad
The small disc shape and silicone properties of the pad make it both flexible and lightweight
Illuminance can be set up to 20,000 lux, and different light emission times and cycles can be chosen.
A common system for placing electrodes is the “10-20 International System” which is based on measurements of head size (Jasper, 1958).
The mid-occipital electrode location (OZ) is on the midline.
The distance above the inion calculated as 10 % of the distance between the inion and nasion, which is 3-4 cm in most adults
Lateral occipital electrodes are a similar distance off the midline.
To have reliable VEPs, Intraoperatively, the following factors are important
Maintaining normal intraoperative physiological/hemodynamic parameters
Use of TIVA instead of inhalational anesthesia
Better stimulus delivery methods
Recording intraoperative ERG to ensure good retinal stimulation and
Employing optimal recording parameters
This document provides information about EEG recordings and analysis. It discusses topics like the Nyquist theorem, types of EEG recordings, artifacts in EEG like EMG and eye blinks, reviewing EEG characteristics, spectral maps of EEG under different conditions, microstates in EEG, normal and abnormal distributions in EEG data, and life span normative EEG databases.
Introduction, history and neurophysiologic basis of vepkalpanabhandari19
1. VEPs measure the electrical activity in the visual cortex generated by light stimulation of the retina. They provide an objective measure of the functional integrity of the visual pathways.
2. VEPs were initially observed in the 1930s but were refined through the development of signal averaging techniques from the 1950s onward.
3. Standard VEP stimulation includes flash, pattern onset/offset, and pattern reversal, with the latter being the preferred clinical technique. Check size, luminance, and reversal rate are standardized.
The document summarizes the new sleep scoring guidelines from the American Academy of Sleep Medicine (AASM). Key changes include the addition of frontal EEG leads, closer EOG electrode placement, more chin EMG electrodes, and new definitions for sleep stages, arousals, respiratory events, and movements. The AASM guidelines were developed through an evidence-based process and aim to standardize sleep scoring based on advances in neurobiology and technology.
basic of polysomnography presentation.pptxshaitansingh8
Polysomnography is a multi-parameter test used to diagnose sleep disorders. It involves the simultaneous recording of biophysiological changes that occur during sleep including brain waves, eye movements, muscle activity, heart rate, respiration, and oxygen levels. Key components measured include EEG, EOG, EMG, respiratory effort, airflow, oximetry. Together these provide information about sleep stages and identify disorders like sleep apnea, narcolepsy, restless leg syndrome. Polysomnography is performed in a sleep lab with technicians monitoring the patient overnight.
Diagnostic test in neurological disorder and it's nursing managementRakhiYadav53
A diagnostic test is performed to aid in the diagnosis of neurological disorders. There are non-invasive tests like neurological examination, CT scan, PET scan, and evoked potential studies. Invasive tests include cerebral angiography, cerebrospinal fluid analysis, and brain biopsy. Obtaining brain biopsy specimens is often the last diagnostic resort for patients with rapidly deteriorating neurological conditions to determine the cause. A review of brain biopsies performed between 1993-2002 found they provided a diagnosis in many cases and helped identify features that could enable earlier diagnosis in the future.
1. Evoked potentials are electrical potentials recorded from the brain following presentation of a stimulus. There are several types including visual, auditory, and somatosensory evoked potentials.
2. Visual evoked potentials assess the visual pathway by recording electrical activity in the brain in response to visual stimuli. Patterns or flashes of light are used to stimulate the retina.
3. Auditory evoked potentials evaluate the auditory pathway by recording brain activity following auditory clicks or tones. This can help detect lesions in the auditory nerve or brainstem.
Exploring statistical approaches to Auditory Brainstem Response testingMohammad B S Khan
This document summarizes a dissertation exploring statistical approaches to auditory brainstem response (ABR) testing. It begins by introducing ABRs and their current subjective interpretation method. It then discusses the need for objective statistical measures and compares experts' interpretations of ABR waveforms to measure variability. Two objective parameters, Fsp and Autratio, are evaluated using experts' interpretations as the gold standard. Simulated data is also analyzed to propose critical values for the parameters. The dissertation finds high variability between experts and that objective parameters show potential but still have limitations. It concludes by recommending the proposed critical values be explored further to address limitations and improve ABR interpretation objectivity.
Advances in neuro anesthesia monitoringWesam Mousa
The document discusses various techniques for monitoring the brain during anesthesia to prevent neurological insults. It describes electroencephalography (EEG) techniques like raw EEG, bispectral index, and entropy which can detect cerebral ischemia. It also discusses evoked potentials like somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) using electrical stimulation to assess spinal cord and brain function. Additional monitoring methods covered are intracranial pressure (ICP), cerebral blood flow (CBF), brain oxygenation, and electromyography (EMG) for nerve function. The document emphasizes multimodal monitoring as the gold standard to reduce intraoperative neurological injury.
Diagnostic test in neurological disorderRakhiYadav53
A diagnostic test is performed to aid in the diagnosis of neurological disorders. This document discusses various diagnostic tests for neurological disorders including neurological examination, CT scan, PET scan, evoked potential studies, transcranial Doppler, cerebral spinal fluid analysis, biopsy, and cerebral angiography. It also covers the nursing management aspects for these diagnostic tests such as pre-procedure, during procedure, and post-procedure care. Brain biopsy is often used as a last resort diagnostic for rapidly deteriorating neurological conditions or dementia, and this analysis found it to have a high diagnostic sensitivity to identify the underlying cause.
Mai EchoG and OAEs ENT [Recovered].pptxEmanZayed17
This document discusses electrocochleography (ECochG), otoacoustic emissions (OAEs), and their clinical applications. ECochG involves recording stimulus-evoked electrical potentials from the cochlea and auditory nerve, including the cochlear microphonic, summating potential, and action potential. OAEs are sounds generated by the normal cochlea in response to acoustic stimuli that can be measured. Clinical uses of ECochG and OAEs include diagnosing Meniere's disease, auditory neuropathy, and monitoring for ototoxicity or cochlear damage.
Functional Ultrasound Neuroimaging in Awake & Behaving Non-Human PrimatesInsideScientific
To learn more and watch the webinar, go to:
https://insidescientific.com/webinar/functional-ultrasound-neuroimaging-in-awake-behaving-non-human-primates/
While there are many neuroimaging modalities to study the brain, each comes with its own set of benefits and limitations. MRI and EEG can record from the whole brain, but it comes at the price of limited spatiotemporal resolution and low sensitivity. Recently, functional ultrasound (fUS) imaging has made a name for itself, with its ability to image the full depth of the brain and provide a quantitative view of brain activation and connectivity.
In this webinar, Dr. Pierre Pouget discusses the use of fUS imaging to assess local changes in cerebral blood flow in awake, behaving non-human primates. He provides an overview of fUS technology and highlight recent and ongoing research showing how unexpected functions can be tracked in the fronto-medial cortex.
Dr. Serge Picaud discusses the application fUS imaging to study the neural circuits underlying vision in rats and nonhuman primates. He presents recent research using fUS in rats to study activation of the visual system, and in NHPs to map brain activity and to study ocular dominance columns in the visual cortex.
Key topics will include:
Pierre Pouget
- Using fUS to assess brain activity in non-human primates in a single trial, without averaging
- Possibilities when coupling fUS with electrophysiology and pharmacology
- How fUS imaging can be used to track short and long-term variations in brain activation
Serge Picaud
- Studying activation of neuronal circuits with either prosthetics or optogenetic activation
- Procedure to generate retinotopic maps in behaving non-human primates
- Demonstrating the lateral and spatial resolution of fUS by imaging ocular dominance columns
This document discusses an experiment on silent speech recognition using electromyography (EMG) and electrode arrays. The experiment tested four setups using either 16 or 35 EMG channels attached to the face. Results showed that recognition performance was better when using more training sentences, with optimal context widths for feature extraction differing based on the number of channels and training sentences. Principal component analysis preprocessing led to more consistent relative word error rate improvements between 10-18% across setups.
The document summarizes visual evoked potentials (VEPs), including:
- VEPs measure electrophysiological signals from the visual cortex in response to visual stimuli.
- International standards exist for stimulus parameters, recording procedures, and normal values.
- Pattern-reversal VEPs eliciting the P100 wave are most commonly used clinically. Factors like check size, contrast and age affect P100 latency and amplitude.
- Abnormalities suggest defects along the visual pathway from eye to cortex. Multi-channel recordings localize defects pre- or post-chiasm.
This document discusses various biomarkers used to study human cognition, including eye tracking, electroencephalography (EEG), and galvanic skin response (GSR). Eye tracking can capture a student's gaze patterns in a classroom to understand where they focus their attention. EEG measures electrical activity in the brain to study cognitive processes. It detects neural oscillations like alpha, beta, theta, and gamma waves. GSR measures sweat gland activity through skin conductance to indicate emotional arousal on a subconscious level. These biomarkers provide objective measures for researching cognition, perception, memory, attention, and emotional states.
Performing electrophysiological measurements in humans inside Magnetic Resona...Trinity College Dublin
Performing electrophysiological measurements in humans inside Magnetic Resonance Imaging scanners; applications in Epilepsy research and other areas by Louis Lemieux
QoMEX2014 - Analysing the Quality of Experience of Multisensory Media from Me...Jacob Donley
This presentation was given at QoMEX 2014, the 6th International Workshop on Quality of Multimedia Experience.
Abstract:
This paper investigates the Quality of Experience (QoE) of multisensory media by analysing biosignals collected by electroencephalography (EEG) and eye gaze sensors and comparing with subjective ratings. Also investigated is the impact on QoE of various levels of synchronicity between the sensory effect and target video scene. Results confirm findings from previous research that show sensory effects added to videos increases the QoE rating. While there was no statistical difference observed for the QoE ratings for different levels of sensory effect synchronicity, an analysis of raw EEG data showed 25% more activity in the temporal lobe during asynchronous effects and 20-25% more activity in the occipital lobe during synchronous effects. The eye gaze data showed more deviation for a video with synchronous effects and the EEG showed correlating occipital lobe activity for this instance. These differences in physiological responses indicate sensory effect synchronicity may affect QoE despite subjective ratings appearing similar.
Investigation of Sensory Gating Processes in First-Episode Schizophrenia Pati...Erdil Arsoy
1. The document presents research investigating sensory gating processes in first-episode schizophrenia patients, their healthy siblings, and healthy controls using event-related potentials (ERPs).
2. Results found reduced P50, N100, and P200 peak-to-peak amplitudes and S1-S2 differences in first-episode schizophrenia patients compared to healthy siblings and controls, suggesting impaired sensory gating in patients.
3. Baseline-to-peak N100 amplitudes and S1-S2 differences were also reduced in patients compared to the other groups, providing further evidence of sensory gating deficits in first-episode schizophrenia.
Current trends in audiological practices and implications for developing coun...Alexander Decker
- Current audiological practices in developing countries still rely heavily on behavioral audiometric testing which requires active patient participation, while developed countries now emphasize electrophysiological testing that does not require active participation.
- Electrophysiological tests like auditory brainstem response testing and otoacoustic emission testing provide objective measures of hearing. Developed countries also use advanced techniques like cochlear implants.
- To better diagnose and treat hearing loss early, some developed countries implement universal newborn hearing screening before 1 month of age to identify problems, with evaluation by 3 months and early intervention starting by 6 months if needed. Early diagnosis and treatment are important for language development.
High-intensity LEDs are embedded in the flash stimulation pad
The small disc shape and silicone properties of the pad make it both flexible and lightweight
Illuminance can be set up to 20,000 lux, and different light emission times and cycles can be chosen.
A common system for placing electrodes is the “10-20 International System” which is based on measurements of head size (Jasper, 1958).
The mid-occipital electrode location (OZ) is on the midline.
The distance above the inion calculated as 10 % of the distance between the inion and nasion, which is 3-4 cm in most adults
Lateral occipital electrodes are a similar distance off the midline.
To have reliable VEPs, Intraoperatively, the following factors are important
Maintaining normal intraoperative physiological/hemodynamic parameters
Use of TIVA instead of inhalational anesthesia
Better stimulus delivery methods
Recording intraoperative ERG to ensure good retinal stimulation and
Employing optimal recording parameters
This document provides information about EEG recordings and analysis. It discusses topics like the Nyquist theorem, types of EEG recordings, artifacts in EEG like EMG and eye blinks, reviewing EEG characteristics, spectral maps of EEG under different conditions, microstates in EEG, normal and abnormal distributions in EEG data, and life span normative EEG databases.
Introduction, history and neurophysiologic basis of vepkalpanabhandari19
1. VEPs measure the electrical activity in the visual cortex generated by light stimulation of the retina. They provide an objective measure of the functional integrity of the visual pathways.
2. VEPs were initially observed in the 1930s but were refined through the development of signal averaging techniques from the 1950s onward.
3. Standard VEP stimulation includes flash, pattern onset/offset, and pattern reversal, with the latter being the preferred clinical technique. Check size, luminance, and reversal rate are standardized.
The document summarizes the new sleep scoring guidelines from the American Academy of Sleep Medicine (AASM). Key changes include the addition of frontal EEG leads, closer EOG electrode placement, more chin EMG electrodes, and new definitions for sleep stages, arousals, respiratory events, and movements. The AASM guidelines were developed through an evidence-based process and aim to standardize sleep scoring based on advances in neurobiology and technology.
basic of polysomnography presentation.pptxshaitansingh8
Polysomnography is a multi-parameter test used to diagnose sleep disorders. It involves the simultaneous recording of biophysiological changes that occur during sleep including brain waves, eye movements, muscle activity, heart rate, respiration, and oxygen levels. Key components measured include EEG, EOG, EMG, respiratory effort, airflow, oximetry. Together these provide information about sleep stages and identify disorders like sleep apnea, narcolepsy, restless leg syndrome. Polysomnography is performed in a sleep lab with technicians monitoring the patient overnight.
Diagnostic test in neurological disorder and it's nursing managementRakhiYadav53
A diagnostic test is performed to aid in the diagnosis of neurological disorders. There are non-invasive tests like neurological examination, CT scan, PET scan, and evoked potential studies. Invasive tests include cerebral angiography, cerebrospinal fluid analysis, and brain biopsy. Obtaining brain biopsy specimens is often the last diagnostic resort for patients with rapidly deteriorating neurological conditions to determine the cause. A review of brain biopsies performed between 1993-2002 found they provided a diagnosis in many cases and helped identify features that could enable earlier diagnosis in the future.
1. Evoked potentials are electrical potentials recorded from the brain following presentation of a stimulus. There are several types including visual, auditory, and somatosensory evoked potentials.
2. Visual evoked potentials assess the visual pathway by recording electrical activity in the brain in response to visual stimuli. Patterns or flashes of light are used to stimulate the retina.
3. Auditory evoked potentials evaluate the auditory pathway by recording brain activity following auditory clicks or tones. This can help detect lesions in the auditory nerve or brainstem.
Exploring statistical approaches to Auditory Brainstem Response testingMohammad B S Khan
This document summarizes a dissertation exploring statistical approaches to auditory brainstem response (ABR) testing. It begins by introducing ABRs and their current subjective interpretation method. It then discusses the need for objective statistical measures and compares experts' interpretations of ABR waveforms to measure variability. Two objective parameters, Fsp and Autratio, are evaluated using experts' interpretations as the gold standard. Simulated data is also analyzed to propose critical values for the parameters. The dissertation finds high variability between experts and that objective parameters show potential but still have limitations. It concludes by recommending the proposed critical values be explored further to address limitations and improve ABR interpretation objectivity.
Advances in neuro anesthesia monitoringWesam Mousa
The document discusses various techniques for monitoring the brain during anesthesia to prevent neurological insults. It describes electroencephalography (EEG) techniques like raw EEG, bispectral index, and entropy which can detect cerebral ischemia. It also discusses evoked potentials like somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) using electrical stimulation to assess spinal cord and brain function. Additional monitoring methods covered are intracranial pressure (ICP), cerebral blood flow (CBF), brain oxygenation, and electromyography (EMG) for nerve function. The document emphasizes multimodal monitoring as the gold standard to reduce intraoperative neurological injury.
Diagnostic test in neurological disorderRakhiYadav53
A diagnostic test is performed to aid in the diagnosis of neurological disorders. This document discusses various diagnostic tests for neurological disorders including neurological examination, CT scan, PET scan, evoked potential studies, transcranial Doppler, cerebral spinal fluid analysis, biopsy, and cerebral angiography. It also covers the nursing management aspects for these diagnostic tests such as pre-procedure, during procedure, and post-procedure care. Brain biopsy is often used as a last resort diagnostic for rapidly deteriorating neurological conditions or dementia, and this analysis found it to have a high diagnostic sensitivity to identify the underlying cause.
Mai EchoG and OAEs ENT [Recovered].pptxEmanZayed17
This document discusses electrocochleography (ECochG), otoacoustic emissions (OAEs), and their clinical applications. ECochG involves recording stimulus-evoked electrical potentials from the cochlea and auditory nerve, including the cochlear microphonic, summating potential, and action potential. OAEs are sounds generated by the normal cochlea in response to acoustic stimuli that can be measured. Clinical uses of ECochG and OAEs include diagnosing Meniere's disease, auditory neuropathy, and monitoring for ototoxicity or cochlear damage.
Functional Ultrasound Neuroimaging in Awake & Behaving Non-Human PrimatesInsideScientific
To learn more and watch the webinar, go to:
https://insidescientific.com/webinar/functional-ultrasound-neuroimaging-in-awake-behaving-non-human-primates/
While there are many neuroimaging modalities to study the brain, each comes with its own set of benefits and limitations. MRI and EEG can record from the whole brain, but it comes at the price of limited spatiotemporal resolution and low sensitivity. Recently, functional ultrasound (fUS) imaging has made a name for itself, with its ability to image the full depth of the brain and provide a quantitative view of brain activation and connectivity.
In this webinar, Dr. Pierre Pouget discusses the use of fUS imaging to assess local changes in cerebral blood flow in awake, behaving non-human primates. He provides an overview of fUS technology and highlight recent and ongoing research showing how unexpected functions can be tracked in the fronto-medial cortex.
Dr. Serge Picaud discusses the application fUS imaging to study the neural circuits underlying vision in rats and nonhuman primates. He presents recent research using fUS in rats to study activation of the visual system, and in NHPs to map brain activity and to study ocular dominance columns in the visual cortex.
Key topics will include:
Pierre Pouget
- Using fUS to assess brain activity in non-human primates in a single trial, without averaging
- Possibilities when coupling fUS with electrophysiology and pharmacology
- How fUS imaging can be used to track short and long-term variations in brain activation
Serge Picaud
- Studying activation of neuronal circuits with either prosthetics or optogenetic activation
- Procedure to generate retinotopic maps in behaving non-human primates
- Demonstrating the lateral and spatial resolution of fUS by imaging ocular dominance columns
This document discusses an experiment on silent speech recognition using electromyography (EMG) and electrode arrays. The experiment tested four setups using either 16 or 35 EMG channels attached to the face. Results showed that recognition performance was better when using more training sentences, with optimal context widths for feature extraction differing based on the number of channels and training sentences. Principal component analysis preprocessing led to more consistent relative word error rate improvements between 10-18% across setups.
The document summarizes visual evoked potentials (VEPs), including:
- VEPs measure electrophysiological signals from the visual cortex in response to visual stimuli.
- International standards exist for stimulus parameters, recording procedures, and normal values.
- Pattern-reversal VEPs eliciting the P100 wave are most commonly used clinically. Factors like check size, contrast and age affect P100 latency and amplitude.
- Abnormalities suggest defects along the visual pathway from eye to cortex. Multi-channel recordings localize defects pre- or post-chiasm.
This document discusses various biomarkers used to study human cognition, including eye tracking, electroencephalography (EEG), and galvanic skin response (GSR). Eye tracking can capture a student's gaze patterns in a classroom to understand where they focus their attention. EEG measures electrical activity in the brain to study cognitive processes. It detects neural oscillations like alpha, beta, theta, and gamma waves. GSR measures sweat gland activity through skin conductance to indicate emotional arousal on a subconscious level. These biomarkers provide objective measures for researching cognition, perception, memory, attention, and emotional states.
Performing electrophysiological measurements in humans inside Magnetic Resona...Trinity College Dublin
Performing electrophysiological measurements in humans inside Magnetic Resonance Imaging scanners; applications in Epilepsy research and other areas by Louis Lemieux
Similar to IDEAL Lead Placement IN EEG-10-20 SYSTEM.pdf (20)
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Hiranandani Hospital in Powai, Mumbai, is a premier healthcare institution that has been serving the community with exceptional medical care since its establishment. As a part of the renowned Hiranandani Group, the hospital is committed to delivering world-class healthcare services across a wide range of specialties, including kidney transplantation. With its state-of-the-art facilities, advanced medical technology, and a team of highly skilled healthcare professionals, Hiranandani Hospital has earned a reputation as a trusted name in the healthcare industry. The hospital's patient-centric approach, coupled with its focus on innovation and excellence, ensures that patients receive the highest standard of care in a compassionate and supportive environment.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
1. Thank you for viewing this presentation.
We would like to remind you that this
material is the property of the author.
It is provided to you by the ERS for your
personal use only, as submitted by the
author.
2016 by the author
2. 10-20 system EEG Placement
Andrew Morley
Andrew Morley (BSc Hons, RPSGT)
(BSc Hons, RPSGT) ,
, Lizzie Hill
Lizzie Hill (EST RPSGT)
& Prof. Dr Athanasios G. Kaditis
Chief Respiratory (Sleep) Physiologist,
Royal Hospital for Children, Glasgow
Specialist Respiratory Clinical Physiologist,
Royal Hospital for Sick Children, Edinburgh
3. Conflict of interest disclosure
I have no, real or perceived, direct or indirect conflicts of interest that relate to this
presentation.
I have the following, real or perceived direct or indirect conflicts of interest that relate to
this presentation:
Affiliation / financial interest Nature of conflict / commercial company name
Tobacco-industry and tobacco corporate affiliate
related conflict of interest
Grants/research support (to myself, my institution or
department):
Honoraria or consultation fees:
Participation in a company sponsored bureau:
Stock shareholder:
Spouse/partner:
Other support or other potential conflict of interest:
This event is accredited for CME credits by EBAP and speakers are required to disclose their potential conflict of
interest going back 3 years prior to this presentation. The intent of this disclosure is not to prevent a speaker with a
conflict of interest (any significant financial relationship a speaker has with manufacturers or providers of any
commercial products or services relevant to the talk) from making a presentation, but rather to provide listeners with
information on which they can make their own judgment. It remains for audience members to determine whether the
speaker’s interests or relationships may influence the presentation.
Drug or device advertisement is strictly forbidden.
x
4. 10-20 EEG Placement
AIMS
• Demonstrate the International 10‐20 EEG system
• Understand steps required to set‐up a10‐20 EEG montage for a
Polysomnography sleep study.
• Give each delegate a practical experience setting up a Sleep EEG montage
using the 10‐20 EEG system.
5. Workshop Plan
• This session is going to be a mainly practical session.
• Brief presentation : 10‐20 basics
• Split into pairs and have a go.
• Slides from the session are available as part of the workshop
materials – via website
10-20 EEG Placement
8. What is the 10-20 system?
• An internationally recognised method that allows EEG electrode placement to be standardised.
• Ensures inter‐electrode spacing is equal
•Electrode placements proportional to skull size & shape
• Covers all brain regions
F = Frontal T = Temporal
P = Parietal O = Occipital
• Numbering system
Odd = left side, Even = right side, Z = midline
10-20 EEG Placement
10. American Academy of Sleep Medicine
• Utilises 10‐20 for polysomnography studies
10-20 EEG Placement
11. Sleep Montage
Sleep PSG montage
(8 Channels + References & ground)
Recommended Back‐up
• F3‐M2 • F4‐M1
• C3‐M2 • C4‐M2
• O1‐M2 • O2‐M1
(There are other acceptable derivations.)
“A minimum of 3 EEG derivations are required
in order to sample activity from the frontal
central and occipital regions”
The AASM Manual for the Scoring of Sleep and Associated Events. Version 2.0
10-20 EEG Placement
12. Why a minimum of 3 EEG derivations?
F4‐M1 – best for slow waves
0.5‐2.0hz
C4‐M1 – best for spindles
11‐16hz (most common 12‐14hz)
O2‐M1 – best for alpha rhythm
(8‐13hz)
10-20 EEG Placement
15. Skin Preparation
How ?
• Isopropyl alcohol wipes to clean (removes grease)
• Abrasive paste & cotton tip to reduce skin impedance (removes dead skin cells)
10-20 EEG Placement
16. Why is it important
Need to have good electrical contact
Impedance < 5kOhms
Consequences of poor placement
• ECG artifact
• Movement artifact
• High impedance
• Electrode popping
• Movement artifact
• Sweat sway
10-20 EEG Placement
High impedance
17. Why bother?
“Garbage In, Garbage Out”
Computers will unquestioningly process the most
nonsensical of input data (garbage in) and produce
nonsensical output (garbage out).
Sleep study signal pathway
Patient Sensor Headbox Amplifier Computer
10-20 EEG Placement
20. Measurement of Cz
• Measure the distance from pre‐auricular point to pre‐
auricular point
• Mark the midpoint (50%) with a vertical line
• This cross represents Cz which has been correctly aligned
in the horizontal & vertical planes
10-20 EEG Placement
M M
21. Measurements - T3, C3, Cz, C4, T4
• Reapply the tape transversally between the pre‐auricular points
• The midpoint (50%) should cross with previous point marking for Cz, confirming its location.
• Mark 10%, 20%, 20%, 20%, 20%, 10% = T3,C3, Cz, C4, T4
10-20 EEG Placement
M M
22. Measurements - Fpz, Fz, Cz, Pz, Oz
• Reapply the tape along the midline from nasion to inion
• Mark 10%, 20%, 20%, 20%, 20%, 10% = Fpz, Fz, Cz, Pz, Oz
10-20 EEG Placement
M M
Oz
Fpz
23. Measurements - Fp1, F7, T3, T5, O1, Oz
• Measure the distance between Fpz & Oz by applying the tape around the head via T3.
• Mark at 10%, 20%, 20%, 20%, 20%, 10% = Fp1, F7, T3, T5, O1, Oz
(Repeat the process using T4 to mark O2)
10-20 EEG Placement
24. Measurement - F3
• Measure Fp1 to C3 and mark midpoint
• Measure Fz to F7 and mark midpoint
• Mark 50% = F3
(Repeat the process using Fp2 to C4 & Fz to F8 to mark F4)
10-20 EEG Placement
25. Measurements M1 & M2
• M1 & M2 are the reference electrodes (formally known as A1 & A2)
• M1 & M2 are placed on the mastoid (M) process.
• These are the bony prominences behind the ears.
10-20 EEG Placement
M2
27. Electro-oculogram
• Recording of the movement of the corneo‐retinal potential difference,
not the movement of eye muscle.
• Electrodes are placed at outer canthus of eyes offset 1cm above/below the horizontal
• Right out and up / Left out and down
10-20 EEG Placement
28. Electromyogram (Chin EMG)
• 3 electrodes
• 1 on mentalis
• 2 on submentalis – 2 cm apart (1cm in Paediatrics)
10-20 EEG Placement
1 Mentalis
2 Submentalis
29. 10-20 EEG Placement
You have now completed the EOG & EMG elements of a sleep montage setup !!
M1
M2
30. Calibration (Checking the signals)
• Eyes closed for 30 seconds
Ask the patient to close his/her eyes & lie quietly.
• Eyes open for 30 seconds
Ask the patient to open his/her eyes & look straight ahead.
• Look right & left
Ask the patient without their head to look to the right then to the left several times.
• Look up & down
Ask the patient without moving their head to look up then down several times.
• Blink eyes
Ask the patient to blink their eyes 5 times.
• Clench jaw
Ask the patient clench their jaw.
• Flex foot
Ask the patient to point & flex their foot. Repeat for other foot. Repeat for each leg and document on study.
• Breathe in & out
Ask the patient to breathe normally, and then take a breath in and out. Check polarity and mark IN & OUT on study.
• Snore sound
Ask the patient to imitate a snore sound.
10-20 EEG Placement
32. The AASM annual for the Scoring of Sleep and Associated Events: Rules, Terminology and technical Specifications. Version 2.1
American Academy of Sleep Medicine (2014)
Sleep Medicine Textbook (European Sleep Research Society (ESRS)
Claudio Bassetti, Zoran Dogas, Philippe Peigneux, Regensburg, (2014)
Essentials of Polysomnography.
William H. Spriggs; Jones & Bartlett Publishers (2008)
Essentials of Sleep Technology
Richard S. Rosenberg; American Academy of Sleep Medicine (2010)
Atlas of Clinical Polysomnography Second Edition (Two-volume Set)
Nic Butkov Media matrix , (2011)
The ten twenty system of the International Federation. Electroencephalography and Clinical
Jasper, H.H. , Neurophysiology, 1958, 10:371-375.
Polysomnographic technique: An overview. In: Sleep disorders medicine, 2nd ed. Boston
Chokroverty S. Butterworth Heinemann (1999)
Fundamentals of EEG technology, Volume 1: Basic concepts and methods.
Tyner F, Knott J, Mayer W Jr. New York: Raven Press; (1983).
Sleep medicine.
Lee-Chiong T, Sateia M, Carskadon M, (Hanley & Belfus, 2002)
Further Reading
33. Further Training
• Practical Polysomnography – Edinburgh, UK
– Various dates
• Edinburgh Sleep Medicine Course – Edinburgh, UK
– March 2016
• European Sleep School – Orihuela Costa, Spain
– Various dates
• International Sleep Medicine Course – Cardiff, UK
– June 2016
