Cortical somatosensory evoked high-frequency (600Hz) oscillations predict absence of severe hypoxic encephalopathy after resuscitation

Endisch, Christian; Waterstraat, Gunnar; Ploner, Christoph J.; Curio, Gabriel; Leithner, Christoph

doi:10.1016/j.clinph.2016.04.014

Cited by 23 publications

(18 citation statements)

References 65 publications

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“…Hence, we suggest that PER inhibited and dispersed epileptic cortical hyperexcitability with hypersynchronization in M1, leading to myoclonus attenuation. To provide further support for our hypothesis, future studies are necessary to investigate cortical neuronal firing, reflected by high frequency band activity (Coppola et al, 2005;Endisch et al, 2016), in accordance with changes in cortical components (P25 and N33) and cortical myoclonus treated by PER. EEG/EMG coherence analysis is also of interest given that it provides the most important information to distinguish between cortical and other types of myoclonus (Shibasaki, 1988).…”

Section: How Does a Small Dose Of Per Suppress Cortical Myoclonus Very Well?mentioning

confidence: 79%

Low-dose perampanel improves refractory cortical myoclonus by the dispersed and suppressed paroxysmal depolarization shifts in the sensorimotor cortex

Neshige

Hitomi

et al. 2019

Clinical Neurophysiology

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h i g h l i g h t sLow dose of perampanel (PER) is tolerable and effective to ameliorate refractory cortical myoclonus. PER suppresses and disperses paroxysmal depolarization shifts directly on the postsynaptic neurons. This action was reflected by temporal dispersion in giant SEPs (a potential clinical biomarker). a b s t r a c tObjective: To elucidate the effects of perampanel (PER) on refractory cortical myoclonus for dose, etiology and somatosensory-evoked potential (SEP) findings. Methods: We examined 18 epilepsy patients with seizure and cortical myoclonus. Based on data accumulated before and after PER treatment, correlations among clinical scores in myoclonus and activities of daily life (ADL); early cortical components of SEP; and PER blood concentration, were analyzed. Results: PER (mean dose: 3.2 ± 2.1 mg/day) significantly improved seizures, myoclonus and ADL and significantly decreased the amplitude of and prolonged latency of giant SEP components. The degree of P25 and N33 prolongations (23.8 ± 1.6 to 24.7 ± 1.7 ms and 32.1 ± 4.0 to 33.7 ± 3.4 ms) were significantly correlated with improved ADL score (p = 0.019 and p = 0.025) and blood PER concentration (p = 0.011 and p = 0.025), respectively. Conclusions: Low-dose PER markedly improved myoclonus and ADL in patients with refractory cortical myoclonus. Our results suggest that SEP, particularly P25 latency, can be used as a potential biomarker for assessing the objective effects of PER on intractable cortical myoclonus. Significance: In this study, PER lessened the degree of synchronized discharges in the postsynaptic neurons in the primary motor cortex.

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Section: How Does a Small Dose Of Per Suppress Cortical Myoclonus Very Well?mentioning

confidence: 79%

Low-dose perampanel improves refractory cortical myoclonus by the dispersed and suppressed paroxysmal depolarization shifts in the sensorimotor cortex

Neshige

Hitomi

et al. 2019

Clinical Neurophysiology

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“…showed that an SSEP amplitude (e.g., the highest short-latency amplitude of 4 cortical recordings) \0.62 mV was found in all patients with poor neurological prognosis, suggesting an additional possibility to increase the accuracy of SSEPs to predict outcome in this setting [52]. A key point for SSEP interpretation is the quality recording for reducing the risk of FPR.…”

Section: Somato-sensory Evoked Potentialsmentioning

confidence: 99%

Targeted temperature management and neuroprognostication after cardiac arrest: A survey in Belgium

Taccone¹,

Colpaert²,

Waele³

et al. 2015

Resuscitation

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The prognosis of patients who are admitted to the hospital after cardiac arrest often relies on neurological examination, which could be significantly influenced by the use of sedative drugs or the implementation of targeted temperature management. The need for early and accurate prognostication is crucial as up to 15-20% of patients could be considered as having a poor outcome and may undergo withdrawal of life-sustaining therapies while a complete neurological recovery is still possible. As current practice in Belgium is still based on a very early assessment of neurological function in these patients, the Belgian Society of Intensive Care Medicine created a multidisciplinary Task Force to provide an optimal approach for monitoring and refine prognosis of CA survivors. This Task Force underlined the importance to use a multimodal approach using several additional tools (e.g., electrophysiological tests, neuroimaging, biomarkers) and to refer cases with uncertain prognosis to specialized centers to better evaluate the extent of brain injury in these patients.

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“…[20][21][22][23][30][31][32][33] The baseline was set at 150-200 ms following stimulation if the analysis window was 200 ms and at 5-15 ms or 35-45 ms following stimulation if the analysis window was 50 ms. These baselines were derived from the data obtained by common SEP recording devices (Viking and Neuropack) in accordance with previous studies 20,31,33,34 and as independent as possible from the activities around 25 ms which were the subject of this study. As an operational definition, P25-HFOs were defined as four consecutive peaks (equivalent to two cycles) or more that exceeded AE4 SD from the baseline in the filtered waveform with an offset latency (HFO end latency) of more than 22 ms to exclude the possibility of HFOs with N20.…”

Section: P25-hfos (As Hfos With P25)mentioning

confidence: 99%

A Biomarker for Benign Adult Familial Myoclonus Epilepsy: High‐Frequency Activities in Giant Somatosensory Evoked Potentials

et al. 2021

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A BS TRACT: Background: Benign adult familial myoclonus epilepsy (BAFME) is one of the diseases that cause cortical myoclonus (CM) with giant somatosensory evoked potentials (SEPs). There are no useful diagnostic biomarkers differentiating BAFME from other CM diseases.Objective: To establish reliable biomarkers including high-frequency oscillations (HFOs) with giant SEPs for the diagnosis of BAFME. Methods: This retrospective case study included 49 consecutive CM patients (16 BAFME and 33 other CM patients) who exhibited giant P25 or N35 SEPs. SEPs were processed by a band-pass filter of 400-1000 Hz to analyze HFOs. Clinical and SEP findings were compared between (1) BAFME and other CM groups and (2) patients with presence and absence of P25-HFOs (HFOs superimposed on giant P25). The diagnostic power of each factor for BAFME was calculated. Results: All 16 BAFME patients showed SEP P25-HFOs with significantly higher occurrence (P < 0.0001) compared with that of other CM groups. The presence of P25-HFOs significantly correlated with a BAFME diagnosis (P < 0.0001) and high SEP P25 and N35 amplitudes (P = 0.01 and P < 0.0001, respectively). BAFME was reliably diagnosed using P25-HFOs with high sensitivity (100%), specificity (87.9%), positive predictive value (80%), and negative predictive value (100%), demonstrating its superiority as a diagnostic factor compared to other factors. Conclusions: P25-HFOs with giant SEPs is a potential biomarker for BAFME diagnosis. P25-HFOs may reflect cortical hyperexcitability partly due to paroxysmal depolarizing shifts in epileptic neuronal activities and higher degrees of rhythmic tremulousness than those in ordinary CM.

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Cortical somatosensory evoked high-frequency (600Hz) oscillations predict absence of severe hypoxic encephalopathy after resuscitation

Cited by 23 publications

References 65 publications

Low-dose perampanel improves refractory cortical myoclonus by the dispersed and suppressed paroxysmal depolarization shifts in the sensorimotor cortex

Low-dose perampanel improves refractory cortical myoclonus by the dispersed and suppressed paroxysmal depolarization shifts in the sensorimotor cortex

Targeted temperature management and neuroprognostication after cardiac arrest: A survey in Belgium

A Biomarker for Benign Adult Familial Myoclonus Epilepsy: High‐Frequency Activities in Giant Somatosensory Evoked Potentials

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