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Andrew F Leuchte - One of the best experts on this subject based on the ideXlab platform.
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evaluating cognitive complaints in breast cancer survivors with the fact cog and Quantitative Electroencephalography
Breast Cancer Research and Treatment, 2017Co-Authors: Kathlee Van Dyk, Aimee M Hunte, Linda M Ercoli, Laura A Peterse, Andrew F Leuchte, Patricia A GanzAbstract:Targeted methods for evaluating cognitive dysfunction in breast cancer survivors are needed to effectively address this important survivorship issue. To address this need, we examined the validity of a self-report instrument (The functional assessment of cancer therapy: cognitive function; FACT-Cog) regarding correspondence with neuropsychological performance versus depression and evaluated neurophysiological biomarkers of cognition and depressed mood in a sample of breast cancer survivors several years from diagnosis. This is a cross-sectional study sample from the prospective observational Mind Body Study. Recruited participants were breast cancer survivors at least 3 years from cancer diagnosis who were part of a longitudinal cohort, and were without current psychiatric disorder or history of a neurological or cognitive disorder at baseline (after completion of primary cancer treatment). Exploratory analysis of the FACT-Cog and Quantitative Electroencephalography (qEEG) were conducted, with respect to their association with neuropsychological domain scores and depressive symptoms as measured by the Beck Depression Inventory, 2nd edition (BDI-II). Self-reported cognitive abilities and the impact of cognitive dysfunction on quality of life were associated with memory function in addition to depressive symptoms in our sample of breast cancer survivors. qEEG measures exhibit differential patterns of association with neuropsychological performance and mood. Our findings indicate that perceived cognitive abilities and the impact of cognitive difficulties on quality of life are valid indicators of objective cognitive function, independent of depressive symptoms. Neurophysiological correlates of cognitive function and depressive symptoms represent promising biomarkers of these behavioral difficulties in survivorship.
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Quantitative Electroencephalography biomarkers of cognitive complaints after adjuvant therapy in breast cancer survivors a pilot study
Psycho-oncology, 2014Co-Authors: Aimee M Hunte, Linda M Ercoli, Andrew F Leuchte, Patricia A Ganz, Lorna Kwa, Arbara Kah Mills, Ia A CookAbstract:Psycho-Oncology Psycho-Oncology 23: 713–715 (2014) Published online 6 February 2014 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/pon.3487 Clinical Correspondence Quantitative Electroencephalography biomarkers of cognitive complaints after adjuvant therapy in breast cancer survivors: a pilot study Aimee M. Hunter 1,2 , Lorna Kwan 3 , Linda M. Ercoli 1 , Barbara Kahn Mills 3 , Ian A. Cook 1,2 , Patricia A. Ganz 3,4,5 and Andrew F. Leuchter 1,2 Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA Laboratory of Brain, Behavior, and Pharmacology, UCLA, Los Angeles, CA, USA Division of Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA, USA Department of Health Policy and Management, Fielding School of Public Health, UCLA, Los Angeles, CA, USA Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA *Correspondence to: Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Rm 57-455, Los Angeles, CA 90024-1759, USA. E-mail: amhunter@ucla.edu Received: 19 December 2013 Accepted: 30 December 2013 Dear Editor, for BCS with cognitive complaints [6] and the UCLA mind body study (MBS)—a prospective study of early stage, posttreatment breast cancer patients [1]. All patients had been treated for stage 0, I, II, or IIIA breast cancer and were on no active cancer therapy other than possible endocrine therapy. For CRS, patients had to have increased cognitive complaints to enter the rehabilitation intervention trial, and for MBS, there were no selection criteria other than the exclusion of health conditions that would interfere with the assessment of study outcomes. Across protocols, exclusions were evi- dence of current or past central nervous system or medical disorder/disease that might be expected to impact cognitive functioning (e.g., multiple sclerosis, thyroid dysfunction); history of head trauma with loss of consciousness greater than 30 min; epilepsy, dementia, or severe learning disability; current mood, anxiety, or psychotic disorder, or current substance abuse or dependence; and history of whole-brain irradiation or brain surgery. These same criteria were applied during recruitment to the secondary, qEEG study. Participants were treated in accordance with the Declaration of Helsinki. Experimental procedures were approved by the UCLA Institutional Review Board, and all participants provided written informed consent. Cognitive complaints are pervasive among breast cancer survivors (BCS), yet their biology is not well understood. Complaints are only partly reflected in neuropsychological test performance [1]. Moreover, their etiology is likely mul- tifactorial; such complaints have been linked not only to ad- juvant therapies (‘chemobrain’ phenomenon) but also to the development of cancer itself [2]. In fact, biologic processes including DNA damage, oxidative stress, inflammation, and shortened telomeres have been shown to underlie both can- cer progression and the impact of cancer treatments; further, these same processes are related to aging and cognitive de- cline [3]. Models of aging therefore have been proposed as a framework for studying cognitive dysfunction in BCS [4]. Resting-state Quantitative Electroencephalography (qEEG) offers an indicator of brain function that has been related to aging and cognitive function [5]. Changes in the resting- state EEG have been linked to cognitive decline in normal aging and to cognitive deficits in mild cognitive impairment (MCI) and Alzheimer’s disease. An overarching pattern is one of the shifts in EEG power from higher (beta and alpha) to lower (theta and delta) frequencies with decreased cognitive status. Physiologic tests such as qEEG constitute a reproducible objective measure that could complement performance measures. In this vein, we explored resting- state qEEG measures as correlates of cognitive complaints in a cross-section of well-characterized BCS. Methods Participants and recruitment Participants were recruited from the University of California, Los Angeles (UCLA) cognitive rehabilitation study (CRS) Copyright © 2014 John Wiley & Sons, Ltd. Clinical assessments Participants completed the Patient’s Assessment of Own Functioning Inventory (PAOFI) at the time of the EEG assessment. This 33-item self-report questionnaire has been used previously in studies of cognitive complaints in BCS [7]. The PAOFI assesses the frequency with which an individual experiences difficulties in four functional domains: memory (MEM), higher-level cognition (HLC), language and communication (LC), and motor sensory
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resting state Quantitative Electroencephalography reveals increased neurophysiologic connectivity in depression
PLOS ONE, 2012Co-Authors: Andrew F Leuchte, Aimee M Hunte, Ia A Cook, Chaochao Cai, Steve HorvathAbstract:Symptoms of Major Depressive Disorder (MDD) are hypothesized to arise from dysfunction in brain networks linking the limbic system and cortical regions. Alterations in brain functional cortical connectivity in resting-state networks have been detected with functional imaging techniques, but neurophysiologic connectivity measures have not been systematically examined. We used weighted network analysis to examine resting state functional connectivity as measured by Quantitative electroencephalographic (qEEG) coherence in 121 unmedicated subjects with MDD and 37 healthy controls. Subjects with MDD had significantly higher overall coherence as compared to controls in the delta (0.5–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), and beta (12–20 Hz) frequency bands. The frontopolar region contained the greatest number of “hub nodes” (surface recording locations) with high connectivity. MDD subjects expressed higher theta and alpha coherence primarily in longer distance connections between frontopolar and temporal or parietooccipital regions, and higher beta coherence primarily in connections within and between electrodes overlying the dorsolateral prefrontal cortical (DLPFC) or temporal regions. Nearest centroid analysis indicated that MDD subjects were best characterized by six alpha band connections primarily involving the prefrontal region. The present findings indicate a loss of selectivity in resting functional connectivity in MDD. The overall greater coherence observed in depressed subjects establishes a new context for the interpretation of previous studies showing differences in frontal alpha power and synchrony between subjects with MDD and normal controls. These results can inform the development of qEEG state and trait biomarkers for MDD.
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antidepressant response trajectories and Quantitative Electroencephalography qeeg biomarkers in major depressive disorder
Journal of Psychiatric Research, 2010Co-Authors: Aimee M Hunte, Ia A Cook, Eng Muthe, Andrew F LeuchteAbstract:Individuals with Major Depressive Disorder (MDD) vary regarding the rate, magnitude and stability of symptom changes during antidepressant treatment. Growth mixture modeling (GMM) can be used to identify patterns of change in symptom severity over time. Quantitative electroencephalographic (QEEG) cordance within the first week of treatment has been associated with endpoint clinical outcomes but has not been examined in relation to patterns of symptom change. Ninety-four adults with MDD were randomized to eight weeks of double-blinded treatment with fluoxetine 20 mg or venlafaxine 150 mg (n = 49) or placebo (n = 45). An exploratory random effect GMM was applied to Hamilton Depression Rating Scale (Ham-D17) scores over 11 timepoints. Linear mixed models examined 48-h, and 1-week changes in QEEG midline-and-right-frontal (MRF) cordance for subjects in the GMM trajectory classes. Among medication subjects an estimated 62% of subjects were classified as responders, 21% as non-responders, and 17% as symptomatically volatile—i.e., showing a course of alternating improvement and worsening. MRF cordance showed a significant class-by-time interaction (F(2,41) = 6.82, p = .003); as hypothesized, the responders showed a significantly greater 1-week decrease in cordance as compared to non-responders (mean difference = −.76, Std. Error = .34, df = 73, p = .03) but not volatile subjects. Subjects with a volatile course of symptom change may merit special clinical consideration and, from a research perspective, may confound the interpretation of typical binary endpoint outcomes. Statistical methods such as GMM are needed to identify clinically relevant symptom response trajectories.
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cordance a new method for assessment of cerebral perfusion and metabolism using Quantitative Electroencephalography
NeuroImage, 1994Co-Authors: Andrew F Leuchte, Ia A Cook, Robe Lufki, Jennife J Dunki, Thomas F Newto, Jeffrey L Cummings, Kevi J Mackey, Donald O WalteAbstract:Increased slow-wave and decreased fast-wave activity on the electroencephalogram is common in brain dysfunction and may be caused by partial cortical deafferentation. No measure that is specific or sensitive for this deafferentation, however, has yet been reported. We studied a series of subjects with white-matter lesions undercutting the cortex and developed a method for analyzing electrical activity called "cordance" that has face validity as a measure of cortical deafferentation. Cordance is measured along a continuum of values: positive values denote "concordance," an indicator associated with normally functioning brain tissue; negative values denote "discordance," an indicator associated with undercutting lesions, low perfusion, and low metabolism. We present a series of subjects studied with magnetic resonance imaging, positron emission tomography, and single-photon emission computed tomography that demonstrate strong associations between cordance and other measures of brain structure and function.
Aimee M Hunte - One of the best experts on this subject based on the ideXlab platform.
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evaluating cognitive complaints in breast cancer survivors with the fact cog and Quantitative Electroencephalography
Breast Cancer Research and Treatment, 2017Co-Authors: Kathlee Van Dyk, Aimee M Hunte, Linda M Ercoli, Laura A Peterse, Andrew F Leuchte, Patricia A GanzAbstract:Targeted methods for evaluating cognitive dysfunction in breast cancer survivors are needed to effectively address this important survivorship issue. To address this need, we examined the validity of a self-report instrument (The functional assessment of cancer therapy: cognitive function; FACT-Cog) regarding correspondence with neuropsychological performance versus depression and evaluated neurophysiological biomarkers of cognition and depressed mood in a sample of breast cancer survivors several years from diagnosis. This is a cross-sectional study sample from the prospective observational Mind Body Study. Recruited participants were breast cancer survivors at least 3 years from cancer diagnosis who were part of a longitudinal cohort, and were without current psychiatric disorder or history of a neurological or cognitive disorder at baseline (after completion of primary cancer treatment). Exploratory analysis of the FACT-Cog and Quantitative Electroencephalography (qEEG) were conducted, with respect to their association with neuropsychological domain scores and depressive symptoms as measured by the Beck Depression Inventory, 2nd edition (BDI-II). Self-reported cognitive abilities and the impact of cognitive dysfunction on quality of life were associated with memory function in addition to depressive symptoms in our sample of breast cancer survivors. qEEG measures exhibit differential patterns of association with neuropsychological performance and mood. Our findings indicate that perceived cognitive abilities and the impact of cognitive difficulties on quality of life are valid indicators of objective cognitive function, independent of depressive symptoms. Neurophysiological correlates of cognitive function and depressive symptoms represent promising biomarkers of these behavioral difficulties in survivorship.
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Quantitative Electroencephalography biomarkers of cognitive complaints after adjuvant therapy in breast cancer survivors a pilot study
Psycho-oncology, 2014Co-Authors: Aimee M Hunte, Linda M Ercoli, Andrew F Leuchte, Patricia A Ganz, Lorna Kwa, Arbara Kah Mills, Ia A CookAbstract:Psycho-Oncology Psycho-Oncology 23: 713–715 (2014) Published online 6 February 2014 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/pon.3487 Clinical Correspondence Quantitative Electroencephalography biomarkers of cognitive complaints after adjuvant therapy in breast cancer survivors: a pilot study Aimee M. Hunter 1,2 , Lorna Kwan 3 , Linda M. Ercoli 1 , Barbara Kahn Mills 3 , Ian A. Cook 1,2 , Patricia A. Ganz 3,4,5 and Andrew F. Leuchter 1,2 Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA Laboratory of Brain, Behavior, and Pharmacology, UCLA, Los Angeles, CA, USA Division of Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA, USA Department of Health Policy and Management, Fielding School of Public Health, UCLA, Los Angeles, CA, USA Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA *Correspondence to: Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, 760 Westwood Plaza, Rm 57-455, Los Angeles, CA 90024-1759, USA. E-mail: amhunter@ucla.edu Received: 19 December 2013 Accepted: 30 December 2013 Dear Editor, for BCS with cognitive complaints [6] and the UCLA mind body study (MBS)—a prospective study of early stage, posttreatment breast cancer patients [1]. All patients had been treated for stage 0, I, II, or IIIA breast cancer and were on no active cancer therapy other than possible endocrine therapy. For CRS, patients had to have increased cognitive complaints to enter the rehabilitation intervention trial, and for MBS, there were no selection criteria other than the exclusion of health conditions that would interfere with the assessment of study outcomes. Across protocols, exclusions were evi- dence of current or past central nervous system or medical disorder/disease that might be expected to impact cognitive functioning (e.g., multiple sclerosis, thyroid dysfunction); history of head trauma with loss of consciousness greater than 30 min; epilepsy, dementia, or severe learning disability; current mood, anxiety, or psychotic disorder, or current substance abuse or dependence; and history of whole-brain irradiation or brain surgery. These same criteria were applied during recruitment to the secondary, qEEG study. Participants were treated in accordance with the Declaration of Helsinki. Experimental procedures were approved by the UCLA Institutional Review Board, and all participants provided written informed consent. Cognitive complaints are pervasive among breast cancer survivors (BCS), yet their biology is not well understood. Complaints are only partly reflected in neuropsychological test performance [1]. Moreover, their etiology is likely mul- tifactorial; such complaints have been linked not only to ad- juvant therapies (‘chemobrain’ phenomenon) but also to the development of cancer itself [2]. In fact, biologic processes including DNA damage, oxidative stress, inflammation, and shortened telomeres have been shown to underlie both can- cer progression and the impact of cancer treatments; further, these same processes are related to aging and cognitive de- cline [3]. Models of aging therefore have been proposed as a framework for studying cognitive dysfunction in BCS [4]. Resting-state Quantitative Electroencephalography (qEEG) offers an indicator of brain function that has been related to aging and cognitive function [5]. Changes in the resting- state EEG have been linked to cognitive decline in normal aging and to cognitive deficits in mild cognitive impairment (MCI) and Alzheimer’s disease. An overarching pattern is one of the shifts in EEG power from higher (beta and alpha) to lower (theta and delta) frequencies with decreased cognitive status. Physiologic tests such as qEEG constitute a reproducible objective measure that could complement performance measures. In this vein, we explored resting- state qEEG measures as correlates of cognitive complaints in a cross-section of well-characterized BCS. Methods Participants and recruitment Participants were recruited from the University of California, Los Angeles (UCLA) cognitive rehabilitation study (CRS) Copyright © 2014 John Wiley & Sons, Ltd. Clinical assessments Participants completed the Patient’s Assessment of Own Functioning Inventory (PAOFI) at the time of the EEG assessment. This 33-item self-report questionnaire has been used previously in studies of cognitive complaints in BCS [7]. The PAOFI assesses the frequency with which an individual experiences difficulties in four functional domains: memory (MEM), higher-level cognition (HLC), language and communication (LC), and motor sensory
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resting state Quantitative Electroencephalography reveals increased neurophysiologic connectivity in depression
PLOS ONE, 2012Co-Authors: Andrew F Leuchte, Aimee M Hunte, Ia A Cook, Chaochao Cai, Steve HorvathAbstract:Symptoms of Major Depressive Disorder (MDD) are hypothesized to arise from dysfunction in brain networks linking the limbic system and cortical regions. Alterations in brain functional cortical connectivity in resting-state networks have been detected with functional imaging techniques, but neurophysiologic connectivity measures have not been systematically examined. We used weighted network analysis to examine resting state functional connectivity as measured by Quantitative electroencephalographic (qEEG) coherence in 121 unmedicated subjects with MDD and 37 healthy controls. Subjects with MDD had significantly higher overall coherence as compared to controls in the delta (0.5–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), and beta (12–20 Hz) frequency bands. The frontopolar region contained the greatest number of “hub nodes” (surface recording locations) with high connectivity. MDD subjects expressed higher theta and alpha coherence primarily in longer distance connections between frontopolar and temporal or parietooccipital regions, and higher beta coherence primarily in connections within and between electrodes overlying the dorsolateral prefrontal cortical (DLPFC) or temporal regions. Nearest centroid analysis indicated that MDD subjects were best characterized by six alpha band connections primarily involving the prefrontal region. The present findings indicate a loss of selectivity in resting functional connectivity in MDD. The overall greater coherence observed in depressed subjects establishes a new context for the interpretation of previous studies showing differences in frontal alpha power and synchrony between subjects with MDD and normal controls. These results can inform the development of qEEG state and trait biomarkers for MDD.
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antidepressant response trajectories and Quantitative Electroencephalography qeeg biomarkers in major depressive disorder
Journal of Psychiatric Research, 2010Co-Authors: Aimee M Hunte, Ia A Cook, Eng Muthe, Andrew F LeuchteAbstract:Individuals with Major Depressive Disorder (MDD) vary regarding the rate, magnitude and stability of symptom changes during antidepressant treatment. Growth mixture modeling (GMM) can be used to identify patterns of change in symptom severity over time. Quantitative electroencephalographic (QEEG) cordance within the first week of treatment has been associated with endpoint clinical outcomes but has not been examined in relation to patterns of symptom change. Ninety-four adults with MDD were randomized to eight weeks of double-blinded treatment with fluoxetine 20 mg or venlafaxine 150 mg (n = 49) or placebo (n = 45). An exploratory random effect GMM was applied to Hamilton Depression Rating Scale (Ham-D17) scores over 11 timepoints. Linear mixed models examined 48-h, and 1-week changes in QEEG midline-and-right-frontal (MRF) cordance for subjects in the GMM trajectory classes. Among medication subjects an estimated 62% of subjects were classified as responders, 21% as non-responders, and 17% as symptomatically volatile—i.e., showing a course of alternating improvement and worsening. MRF cordance showed a significant class-by-time interaction (F(2,41) = 6.82, p = .003); as hypothesized, the responders showed a significantly greater 1-week decrease in cordance as compared to non-responders (mean difference = −.76, Std. Error = .34, df = 73, p = .03) but not volatile subjects. Subjects with a volatile course of symptom change may merit special clinical consideration and, from a research perspective, may confound the interpretation of typical binary endpoint outcomes. Statistical methods such as GMM are needed to identify clinically relevant symptom response trajectories.
James T Mcdeavi - One of the best experts on this subject based on the ideXlab platform.
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a history and review of Quantitative Electroencephalography in traumatic brain injury
Journal of Head Trauma Rehabilitation, 2001Co-Authors: Ia E Wallace, Amy K Wagne, Eugene P Wagne, James T McdeaviAbstract:The electroencephalogram (EEG) is a physiologic measure of cerebral function that has been used by some to assess coma and prognosticate survival and global outcome after traumatic brain injury (TBI). Surface recordings of the brain's electrical activity reveal distinct patterns that indicate injury severity, depth of unconsciousness, and patient survival. The data produced with traditional qualitative studies, however, does not allow resolution and quantification of the wave frequency spectrum present in the brain. As a result, conventional EEG typically has only been used for gross and qualitative analyses and is not practical for use in long-term patient monitoring or as a sophisticated prognostic tool. One area of investigation that is working to address the limitations of conventional EEG has been the development and implementation of Fourier Transform (FT) EEG which resolves and quantifies frequency bands present in the brain. When FT analysis is applied to EEG, it provides concurrent and continuous monitoring, resolution, and quantification of all frequencies emitted. This review discusses the history and significance of conventional EEG and provides a review of how FT-EEG, commonly referred to as Quantitative EEG (QEEG), is being used in the clinical setting. The specific applications and significance of QEEG methods regarding treatment of patients with TBI are discussed in detail. The advantages, disadvantages, and future directions of QEEG in TBI are also discussed.
Robe A Van Huls - One of the best experts on this subject based on the ideXlab platform.
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Quantitative Electroencephalography in a swine model of cerebral arterial gas embolism
Clinical Neurophysiology, 2012Co-Authors: Robert P Weenink, Markus F Stevens, Xavie C E Vrijdag, Michel J A M Van Putte, Markus W Hollma, Thomas M Van Gulik, Robe A Van HulsAbstract:Abstract Objective Cerebral arterial gas embolism (CAGE) is a serious hazard in cardiovascular surgery and other invasive procedures. We used a swine model of CAGE to determine if Quantitative Electroencephalography (qEEG) is a useful tool in diagnosis and prognostication of CAGE. Methods 0.05 ml/kg of air was injected into the ascending pharyngeal artery in 16 pigs. Intracranial pressure, lactate in brain microdialysate and brain oxygen tension were measured during 4 h after embolization. The qEEG parameters mean amplitude (MAMP), alpha-delta ratio (ADR), spectral edge frequency (SEF 90 ), spatial brain symmetry index (sBSI) and temporal brain symmetry index (tBSI) were calculated. Results MAMP and tBSI but not ADR, SEF 90 and sBSI correlate with intracranial pressure, brain lactate and brain oxygen tension after 4 h. Early levels of MAMP and tBSI can predict intracranial pressure, brain lactate and brain oxygen tension after 4 h. Conclusions MAMP and tBSI are sensitive for cerebral injury and can predict outcome in a swine model of CAGE. Significance This study provides evidence for the utility of qEEG for diagnosis and prognosis in CAGE. Further studies are necessary to investigate the use of this method in patients.
Robert P Weenink - One of the best experts on this subject based on the ideXlab platform.
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detection of cerebral arterial gas embolism using regional cerebral oxygen saturation Quantitative Electroencephalography and brain oxygen tension in the swine
Journal of Neuroscience Methods, 2014Co-Authors: Robert P Weenink, Markus F Stevens, Julian Kager, Robert A Van Hulst, Thomas M. Gulik, Markus W HollmannAbstract:Abstract Background Cerebral air emboli occur as a complication of invasive medical procedures. The sensitivity of cerebral monitoring methods for the detection of air emboli is not known. This study investigates the utility of Electroencephalography and non-invasively measured cerebral oxygen saturation in the detection of intracerebrovascular air. New method In 12 pigs oxygen saturation was continuously measured using transcranial near-infrared spectroscopy and oxygen tension was continuously measured using intraparenchymal probes. Additionally, Quantitative Electroencephalography and microdialysis were performed. Doses of 0.2, 0.4, 0.8, and 1.6 ml of air were injected into the cerebral arterial vasculature through a catheter. Results Oxygen saturation and Electroencephalography both reacted almost instantaneously on the air emboli, but were less sensitive than the intraparenchymal oxygen tension. There was reasonable correlation (ρ ranging from 0.417 to 0.898) between oxygen saturation, oxygen tension, Electroencephalography and microdialysis values. Comparison with existing methods Our study is the first to demonstrate the effects of cerebral air emboli using multimodal monitoring, specifically on oxygen saturation as measured using near-infrared spectroscopy. Conclusions Our results show that non-invasively measured oxygen saturation and Quantitative Electroencephalography can detect the local effects of air emboli on cerebral oxygenation, but with reduced sensitivity as compared to intraparenchymal oxygen tension. Prospective human studies using multimodal monitoring incorporating Electroencephalography and oxygen saturation should be performed.
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Quantitative Electroencephalography in a swine model of cerebral arterial gas embolism
Clinical Neurophysiology, 2012Co-Authors: Robert P Weenink, Markus F Stevens, Xavie C E Vrijdag, Michel J A M Van Putte, Markus W Hollma, Thomas M Van Gulik, Robe A Van HulsAbstract:Abstract Objective Cerebral arterial gas embolism (CAGE) is a serious hazard in cardiovascular surgery and other invasive procedures. We used a swine model of CAGE to determine if Quantitative Electroencephalography (qEEG) is a useful tool in diagnosis and prognostication of CAGE. Methods 0.05 ml/kg of air was injected into the ascending pharyngeal artery in 16 pigs. Intracranial pressure, lactate in brain microdialysate and brain oxygen tension were measured during 4 h after embolization. The qEEG parameters mean amplitude (MAMP), alpha-delta ratio (ADR), spectral edge frequency (SEF 90 ), spatial brain symmetry index (sBSI) and temporal brain symmetry index (tBSI) were calculated. Results MAMP and tBSI but not ADR, SEF 90 and sBSI correlate with intracranial pressure, brain lactate and brain oxygen tension after 4 h. Early levels of MAMP and tBSI can predict intracranial pressure, brain lactate and brain oxygen tension after 4 h. Conclusions MAMP and tBSI are sensitive for cerebral injury and can predict outcome in a swine model of CAGE. Significance This study provides evidence for the utility of qEEG for diagnosis and prognosis in CAGE. Further studies are necessary to investigate the use of this method in patients.
