Neurophysiologie clinique = Clinical neurophysiology
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Clinical Trial
Effects of muscle contraction on somatosensory event-related EEG power and coherence changes.
Effects of isometric muscle contraction on amplitude and coherence changes of EEG rhythms during repetitive cutaneous electrical stimulation were analyzed in 10 right-handed subjects. Subjects received electrical stimuli at intensity above pain threshold to their right middle finger while either squeezing a rubber tube with the right index finger and thumb, or keeping their ipsilateral hand muscles relaxed. EEG was recorded using 111 closely spaced electrodes. ⋯ Muscle contraction reduced all coherence changes, but enhanced the 8-12 Hz coherence between ipsilateral S1/M1 and posterior parietal cortex. Early post-stimulus decrease of oscillatory coupling between S1/M1 and premotor cortex and between S1/M1 and medial frontal cortex suggests that these cortical regions act rather independently during processing of somatosensory information, and synchronize only later when the band power in contralateral S1/M1 increases. Motor cortex activation associated with ipsilateral hand muscle contraction interferes with cortical processing of somatosensory stimuli in S1/M1 cortices.
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The indications of emergency electroencephalogram (eEEG) were defined by a French consensus conference in May 1996. We retrospectively confronted the recommendations with the actual requests for emergency EEG in our University hospital, in order to determine the contribution of the eEEG in the most frequent clinical situations encountered. ⋯ The most frequent indications were presumption of brain death (13%), convulsive status epilepticus after treatment (12.1%), and suspicion of nonconvulsive epilepticus status (10.6%). More than one third of the requests (38.6%) were not in conformity with the recommendations of the consensus conference. The contribution of the EEG is much improved by the application of the consensual criteria. Thus, the EEG remains essential for the management of convulsive status epilepticus after treatment, to seek a subtle epilepticus status or a nonconvulsive epilepticus status. Conversely, the EEG did not prove useful in emergency after a transient loss or alteration of consciousness or a focal, non-febrile, neurological transient or permanent deficit.
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Selective attention to signals of impending pain allows the avoidance of bodily harm. In order to identify the attentional components involved in the selection of pain signals over competing demands, we used an emotional modification of an exogenous cueing task. ⋯ It is concluded that attention is more strongly engaged to a signal of impending pain compared with a cue signalling its absence. We explore why disengagement from the pain signal is not impaired compared to the safety signal. The findings are discussed in terms of the defensive importance of pain anticipation.
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In this work we review data on cortical generators of laser-evoked potentials (LEPs) in humans, as inferred from dipolar modelling of scalp EEG/MEG results, as well as from intracranial data recorded with subdural grids or intracortical electrodes. The cortical regions most consistently tagged as sources of scalp LERs are the suprasylvian region (parietal operculum, SII) and the anterior cingulate cortex (ACC). Variability in opercular sources across studies appear mainly in the anterior-posterior direction, where sources tend to follow the axis of the Sylvian fissure. ⋯ With much less consistency than the above-mentioned areas, posterior parietal, medial temporal and anterior insular regions have been occasionally tagged as possible contributors to LEPs. Dipoles ascribed to medial temporal lobe may be in some cases re-interpreted as being located at or near the insular cortex. This would make sense as the insular region has been shown to respond to thermal pain stimuli in both functional imaging and intracranial EEG studies.
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The physiological mechanisms that underlie consciousness and unconsciousness are the sleep/wake mechanisms. Deep sleep is a state of physiological reversible unconsciousness. The change from that state to wakefulness is mediated by the reticular activating mechanism. ⋯ The cognitive change between sleep and wakefulness is accompanied by changes in the autonomic system, the cerebral blood flow and cerebral metabolism. Awareness is an essential component of total consciousness (defined as continuous awareness of the external and internal environment, both past and present, together with the emotions arising from it). In addition to awareness, full consciousness requires short-term and explicit memory and intact emotional responses.