Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
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J Clin Neurophysiol · Jun 2012
Randomized Controlled TrialAdvanced pharmaco-EEG reveals morphine induced changes in the brain's pain network.
By using a novel brain source modeling approach, where the evoked potential (EP) signal was decomposed with multichannel matching pursuit (MMP) before source localization, we investigated brain generators of EPs after a pain stimulus in the esophagus before and after administration of placebo/morphine. We showed that this new approach of pharmaco-electroencephalogram (EEG) analysis can shed light on subtle changes, which cannot be foreseen from conventional analysis (amplitude/latency/topography). ⋯ Decomposing the EPs into the original brain generators showed that morphine mainly changes the low frequency electrical activity in the frontal brain area. This method can be used to increase the basic understanding of the opioid effect on the brain's processing of pain and eventually identify biomarkers of analgesia in experimental pain models.
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Standardized research terminology critical to the establishment of a multicenter intensive care unit (ICU) electroencephalogram (EEG) database was originally proposed in 2005 and has been modified many times since. However, interrater agreement (IRA) of the revised terminology has not been investigated. ⋯ Main terms 1 and 2 have high IRA and are reasonable for use in multicenter research. There is a suggestion that assessment of amplitude has good reliability, while assessment of frequency may have less reliability. The fast and rhythmic "plus" modifiers have moderate IRA, while sharp/spike modifier has only slight IRA implying that further refinement and assessment of terminology modifiers may be necessary.
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There is evidence for comorbidity of migraine and epilepsy. We used transcranial magnetic stimulation (TMS) to assess cortical excitability in migraine compared with control subjects and patients with epilepsy. ⋯ Cortical excitability increases in migraine suggesting the involvement of intracortical inhibitory circuits. This may be a common feature underlying some of the similarities observed in migraine and epilepsy.
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J Clin Neurophysiol · Apr 2012
EditorialNIOM for spinal deformity surgery: there's more than one way to skin a cat.
This was a 23-year retrospective study of 3436 consecutive pediatric orthopedic spinal surgery patients between 1995 and 2008. ⋯ The combined use of somatosensory evoked potentials, transcranial electric motor evoked potentials, descending neurogenic evoked potentials, and electromyography monitoring allowed accurate detection of permanent neurologic status in 99.6% of 3436 patients and reduced the total number of permanent neurologic injuries to 6.
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J Clin Neurophysiol · Apr 2012
ReviewUtility of electromyography for nerve root monitoring during spinal surgery.
In addition to potential spinal cord injury, spinal surgery carries a risk of damage to spinal nerve roots, which could result in sensory or motor deficit. Both spontaneous and triggered electromyography (sEMG and tEMG, respectively) have been employed to reduce the risk of these deficits. This article reviews the theory and best practice of electromyographic monitoring for spinal surgery, the evidence supporting its use for various types of spine surgery, and finally, suggestions for future directions to improve knowledge and advance electromyographic monitoring of spinal nerves.