The method of assessing the functional state of the brain
The invention relates to medicine, namely to clinical physiology, neurology, neurotraumatology, neuroanesthesiology. Register the EEG in the time interval between two heart beats and record it in the form of a trend, then subjected to Fourier analysis and domination of power fluctuations, the relevant range of activity regulators hemodynamics, determine the integrity of the regulatory mechanisms of the brain. The method allows to estimate the functional state of the brain, the safety and activity of regulatory systems in various neurological and somatic diseases, as well as in terms of neuroanaesthesia and neuro protection of the brain in the intensive care unit. 12 Il. The invention relates to medicine, namely to the functional study of the nervous system, and can be used in clinical physiology, neurology, neurotraumatology, neuroanesthesiology.Currently there are about 200 different automatic frequency-amplitude analysis of background EEG signal that is used to assess the functional state of the brain (see Review of O. B. Sazonova "Monitoring of spontaneous bioelectrical activity of the brain in nattakom known methods, in General, their use is assessed only the presence or absence (in register with the various departments of the scalp EEG signals) of the main EEG rhythms (alpha, beta, theta, Delta), the amplitude of these rhythms and their relationship to dominance in the spectrum of the EEG signal. While not quantitatively determined oscillation (modulation) of the amplitude of EEG rhythms in time, reflecting changes in the functional activity of the brain. In addition, the traditional assessment of the background EEG does not provide information about the safety regulatory mechanisms of the brain in terms of neuroanesthesia, neurovegetative "protection", as well as in patients in comatose States, because these conditions are recorded only abnormal background EEG rhythms.Closest to the claimed method according to essential features, the achieved result and selected as a prototype, is the monitoring of brain function in P. F. Pryor (see P. F. Pryor. Monitor control functions of the brain. M.: Medicine, 1982, 328 S., ill.).The disadvantage of this method is that the degree of variability in the amplitude of the EEG is only qualitative characteristic strip width write (change of values of signal amplitude EEG wonam levels recorded brain activity): the wider the strip, the greater the variability. Quantitative analysis of variability with the assessment of the hemodynamic component of the EEG signal, this method does not provide.The objective of the invention is to develop the most effective method for quantitative assessment of functional activity of the brain by the nature of the changes in the hemodynamic component of the EEG signal.This object is achieved in that the registration of the average amplitude of the EEG signal from a blow to the heart beat according to the invention is recorded in the form of trend with subsequent Fourier analysis allows us to evaluate the functional activity of the brain associated with the main afferent influences (baroreflex, metabolomics and others).The proposed method of analysis functional activity of the brain changes over time of the amplitude of the EEG signal (variability amplitude) corresponds to the criterion "Novelty", because it is unknown at the current level of science and technology.The proposed method can be implemented in any medical facility (clinic, hospital and other) in the presence of miniature EEG software ("the monitoring Module functional activity of the brain); the manufacturer firm "Microlending on the scalp over the right and left parietal regions, registered EEG. (The third electrode is placed on the skin anterior to the first two for the purpose of protection from powerful electrical interference).The registered values are recorded in the form of a trend to assess the variability of the amplitude of the EEG by the method of Fourier analysis with determination of the total power fluctuations and power of the frequency bands corresponding activity of different regulators hemodynamics. Based on the analysis of absolute and relative power values of the oscillation amplitude of the EEG, the conclusion about the presence and dominance of certain regulatory mechanisms of the brain, preservation of the brain's response to afferentation (baroreflex, metabolomics and others). Analysis of the variability of the amplitude of the EEG reflects the functional state of the brain, regardless of what the basic rhythms recorded in this period (alpha, beta, theta, Delta).Example 1. Egorov, S. A., age 18, (main group health.) The background EEG is recorded alpha rhythm (Fig.1). The change of the amplitude registered in the form of the trend (Fig.2). The average amplitude of 15 mV. Assessment of variability carried out using the method of Fourier (Fig.3). The power fluctuations of the amplitude of the rhythm - 20 mV2. Power fluctuations in absolute and relative units of Priya amplitude of the alpha rhythm of a young healthy person connected with the breathing and pararegulatory brain activity although it has a place and humoral-metabolic regulation of the rhythm (Fig.3 and 4).Example 2. Patient Monogram centuries, 22 years. Diagnosis: traumatic brain injury. Brain injury severe. Coma (4 points on the scale of Glasgow). IVL. 6 days of illness. Is neuro-vegetative protection of the brain (again within days intravenous Relanium and GHB).The background EEG is recorded pathological Delta and theta waves (Fig. 5). The change of the amplitude registered in the form of the trend (Fig.6). The average amplitude (10 mV) and power fluctuations rhythms (14 mV2) reduced (Fig.8). In Fig.8 presents the power fluctuations in absolute and relative units. Respiratory and baroreflex modulation saved and dominate (Fig.7 and 8). Despite the coma patient and pathological rhythms in the background EEG, we can talk about the good prognosis of the disease. (After 16 days the patient was transferred from the intensive care unit neurology in satisfactory condition.) Example 3. Sick of Gagiu C. A., 23 years. Diagnosis: traumatic brain injury. Brain injury severe. Coma (4 points on the scale of Glasgow). 6 days of illness. Is neuro-vegetative protection of the brain (again within days intravenous injection of relani is registered in the form of the trend (Fig.10). The average amplitude (8 mV) and power fluctuations rhythms (11 mV2) is reduced. In Fig.12 presents the power fluctuations in absolute and relative units. Respiratory and baroreflex modulation drastically reduced not only in absolute value, but also for representation in the total spectrum of fluctuations. Dominated by waves humoral-metabolic regulation (Fig.11 and 12). According to the analysis it can be assumed poor prognosis of the disease. Coma the patient has been transformed into a chronic vegetative state.
ClaimsMethod of assessment of hemodynamic component of the functional activity of the brain, including the registration of the electroencephalogram (EEG) and measurement of its amplitude, characterized in that the recorded amplitude of the EEG in the time interval between two heart beats, record it as a trend, is subjected to Fourier analysis and domination of power fluctuations, the relevant range of activity regulators hemodynamics, determine the integrity of the regulatory mechanisms of the brain.
FIELD: medicine, neurology, psychopathology, neurosurgery, neurophysiology, experimental neurobiology.
SUBSTANCE: one should simultaneously register electroencephalogram (EEG) to detect the level of constant potential (LCP). At LCP negativization and increased EEG power one should detect depolarizational activation of neurons and enhanced metabolism. At LCP negativization and decreased EEG power - depolarized inhibition of neurons and metabolism suppression. At LCP positivation and increased EEG power - either repolarized or hyperpolarized activation of neurons and enhanced metabolism. At LCP positivation and decreased EEG power - hyperpolarized suppression of neurons and decreased metabolism of nervous tissue. The method enables to correctly detect therapeutic tactics due to simultaneous LCP and EEG registration that enables to differentiate transition from one functional and metabolic state into another.
EFFECT: higher accuracy of diagnostics.
5 dwg, 1 ex, 1 tbl
FIELD: medicine, neurology.
SUBSTANCE: one should establish neurological status, bioelectric cerebral activity, availability of perinatal and ORL pathology in patients, establish their gradations and numerical values followed by calculation of prognostic coefficients F1 and F2 by the following formulas: F1=-31,42+1,49·a1-2,44·a2+0,2·а3+1,63·a4+0,62·а5+3,75·a6+1,8·а7-3,23·a8-0,8·а9-1,32·а10+3,26·а11+8,92·a12-2,0·a13+3,88·а14+1,79·a15+0,83·a16-2,78·a17; F2=-27,58+1,43·a1+3,31·а2+0,08·а3+3,05·а4-0,27·а5+2,69·а6+3,11·а7-6,47·a8-6,55·a9+1,99·а10+5,25·а11+7,07·a12-0,47·a13+0,13·a14+4,04·a15-1,0·a16-1,14·а17, correspondingly, where a1 - patient's age, a2 - studying either at the hospital or polyclinic, a3 - duration of stationary treatment (in days), a4 - unconscious period, a5 - terms of hospitalization since the moment of light close craniocerebral trauma, a6 - smoking, a7 - alcohol misuse, a8 - arterial hypertension, a9 - amnesia, a10 - close craniocerebral trauma in anamnesis, a11 - psychoemotional tension, a12 - meteolability, a13 - cervical osteochondrosis, a14 - ORL pathology, a15 - availability of perinatal trauma in anamnesis with pronounced hypertension-hydrocephalic syndrome, a16 - availability of paroxysmal activity, a17 - availability and manifestation value of dysfunction of diencephalic structures. At F1 ≥ F2 on should predict the development of remote aftereffects in young people due to evaluating premorbid background of a patients at the moment of trauma.
EFFECT: higher reliability of prediction.
2 ex, 1 tbl
FIELD: medicine; medical engineering.
SUBSTANCE: method involves doing multi-channel recording of electroencephalogram and carrying out functional tests. Recording and storing rheoencephalograms is carried out additionally with multi-channel recording of electroencephalogram synchronously and in real time mode in carotid and vertebral arteries. Electroencephalograms and rheoencephalograms are visualized in single window with single time axis. Functional brain state is evaluated from synchronous changes of electroencephalograms, rheoencephalograms and electrocardiograms in response to functional test. The device has electrode unit 1 for recording bioelectric brain activity signals, electrode unit 2 for recording electric cardiac activity signals, current and potential electrode unit 3 for recording rheosignals, leads commutator 4, current rheosignal oscillator 5, synchronous rheosignal detector 6, multi-channel bioelectric brain activity signals amplifier 7, electrophysiological signal amplifier 8, demultiplexer 9, multi-channel rheosignal amplifier 10, multi-channel analog-to-digital converter 11, micro-computer 12 having galvanically isolated input/output port and personal computer 13 of standard configuration.
EFFECT: enhanced effectiveness of differential diagnosis-making.
11 cl, 6 dwg
FIELD: medicine; medical engineering.
SUBSTANCE: method involves recording multichannel electroencephalogram, electrocardiogram record and carrying out functional test and computer analysis of electrophysiological signals synchronously with multichannel record of electroencephalogram and electrocardiogram in real time mode. Superslow brain activity is recorded, carotid and spinal artery pools rheoelectroencephalogram is recorded and photopletysmogram of fingers and/or toes is built and subelectrode resistance of electrodes for recording bioelectrical cerebral activity is measured. Physiological values of bioelectrical cerebral activity are calculated and visualized in integrated cardiac cycle time scale as absolute and relative values of alpha-activity, pathological slow wave activity in delta and theta wave bandwidth. Cerebral metabolism activity dynamics level values are calculated and visualized at constant potential level. Heart beat rate is determined from electrocardiogram, pulsating blood-filling of cerebral blood vessels are determined from rheological indices data. Peripheral blood vessel resistance level, peripheral blood vessel tonus are determined as peripheral photoplethysmogram pulsation amplitude, large blood vessel tonus is determined from pulse wave propagation time data beginning from Q-tooth signal of electrocardiogram to the beginning of systolic wave of peripheral photoplethysmogram. Postcapillary venular blood vessels tonus is determined from constant photoplethysmogram component. Functional brain state is determined from dynamic changes of physiological values before during and after the functional test. Device for evaluating functional brain state has in series connected multichannel analog-to-digital converter, microcomputer having galvanically isolated input/output ports and PC of standard configuration and electrode unit for reading bioelectric cerebral activity signals connected to multichannel bioelectric cerebral activity signals amplifier. Current and potential electrode unit for recording rheosignals, multichannel rheosignals amplifier, current rheosignals generator and synchronous rheosignals detector are available. The device additionally has two-frequency high precision current generator, master input of which is connected to microcomputer. The first output group is connected to working electrodes and the second one is connected to reference electrodes of electrode unit for reading bioelectrical cerebral activity signals. Lead switch is available with its first input group being connected to potential electrodes of current and potential electrodes unit for recording rheosignals. The second group of inputs is connected to outputs of current rheosignals oscillator. The first group of outputs is connected to current electrodes of current and potential electrodes unit for recording rheosignals. The second group of outputs is connected to inputs of synchronous detector of rheosignals. Demultiplexer input is connected to output of synchronous detector of rheosignals and its outputs are connected to multichannel rheosignals amplifier inputs. Outputs of multichannel bioelectrical cerebral activity signals amplifier, multichannel rheosignals amplifier and electrophysiological signal amplifier are connected to corresponding inputs of multichannel analog-to-digital converter. Microcomputer outputs are connected to control input of lead switch, control input of multichannel demultiplexer, control input of multichannel analog-to-digital converter and synchronization inputs of current rheosignals oscillator and synchronous detector of rheosignals. To measure subelectrode resistance, a signal from narrow bandwidth current generator of frequency f1 exceeding the upper frequency fup of signals under recording is supplied. A signal from narrow bandwidth current generator of frequency f2≠ f1>fup is supplied to reference electrode. Voltages are selected and measured at output of each amplifier with frequencies of f1, f2 - Uf1 and Uf2 using narrow bandwidth filtering. Subelectrode resistance of each working electrode is determined from formula Zj=Ujf1 :(Jf1xKj), where Zj is the subelectrode resistance of j-th electrode, Ujf1 is the voltage at output from j-th amplifier with frequency of f1, Kj is the amplification coefficient of the j-th amplifier. Subelectrode resistance of reference electrode is determined from formula ZA=Ujf2 :(Jf2xKj), where ZA is the subelectrode resistance of reference electrode, Ujf2 is the voltage at output from j-th amplifier with frequency of f2, Jf2 is the voltage of narrow bandwidth current oscillator with frequency of f2.
EFFECT: wide range of functional applications.
15 cl, 10 dwg
FIELD: medicine, psychiatry.
SUBSTANCE: one should conduct EEG-testing to detect total value of the indices of spectral power or percentage spectral power of delta- and teta-rhythms due to spectrometric technique in frontal, parietal, central and temporal areas both before and during emotional-negative loading when visual emotionally negative stimuli are presented followed by their imaginary reproduction. In case of higher indices to visual stimuli being above 15% against the background one should diagnose epilepsy. The method enables to increase the number of diagnostic means, increase accuracy and objectivity in predicting epilepsy with polymorphic paroxysms at dissociation of clinical and EEG-values.
EFFECT: higher efficiency of diagnostics.
1 ex, 1 tbl
FIELD: medicine, neurophysiology.
SUBSTANCE: one should carry out EEG survey to detect spectrometrically the index of full range if alpha-rhythm both before and after therapy. Moreover, power index of full range of alpha-rhythm and the index of 9-10 Hz-strip's spectral power should be detected in occipital cerebral areas. One should calculate the value of the ratio of the index of 9-10 Hz-strip's spectral power to the index of full range of alpha-rhythm and at the increase of this value by 20% against the background it is possible to evaluate positive result of therapy. The method increases the number of diagnostic means applied in evaluating therapeutic efficiency in the field of neurophysiology.
EFFECT: higher efficiency of evaluation.
FIELD: medicine, neurology.
SUBSTANCE: method involves carrying out the standard vascular and nootropic therapy. Diazepam is administrated under EEG control with the infusion rate that is calculated by the following formula: y = 0.0015x - 0.025 wherein y is the rate of diazepam administration, mg/h; x is an average EEG amplitude, mcV. Method provides enhancing the effectiveness of treatment of patients. Invention can be used for treatment of patients in critical severe period of ischemic insult.
EFFECT: enhanced effectiveness of treatment.
2 tbl, 1 dwg, 1 ex
SUBSTANCE: method involves selecting signals showing patient consciousness level and following evoked auditory potentials as responses to repeating acoustic stimuli, applying autoregression model with exogenous input signal and calculating AAI index showing anesthesia depth next to it.
EFFECT: quick tracing of unconscious to conscious state and vice versa; high accuracy of measurements.
9 cl, 3 dwg
FIELD: medicine; experimental and medicinal physiology.
SUBSTANCE: device can be used for controlling changes in functional condition of central nervous system. Device has receiving electrodes, unit for reading electroencephalograms out, analog-to-digital converter and inductor. Low noise amplifier, narrow band filter linear array which can be program-tuned, sample and store unit, online memory, microcontroller provided with controlled permanent storage, liquid-crystal indicator provided with external control unit are introduced into device additionally. Receiving electrodes are fastened to top part of patient's head. Outputs of electrodes are connected with narrow band filters linear array through electroencephalograph. Output of linear array is connected with input of input unit which has output connected with input of analog-to-digital converter. First bus of analog-to-digital converter is connected with online storage. Recording/reading bus of microcontroller is connected with control input of input unit and its starting bus is connected with address input of online storage. Third control bus is connected with narrow band filters linear array. Second control bus is connected with liquid-crystal indicator. Output bus is connected with inductor. External control (keyboard) of first control bus is connected with microcontroller. Output of online storage is connected with data input of microcontroller through 12-digit second data bus. Efficiency of influence is improved due to getting specific directed influence being based onto general technological transparency of processing of human brain's signals and strictly specific influence based on the condition of better stimulation.
EFFECT: increased efficiency.
3 cl, 1 dwg, 1 tbl
FIELD: medicine, neurology, professional pathology.
SUBSTANCE: one should carry out either biochemical blood testing and electroencephalography or SMIL test, or ultrasound dopplerography of the main cranial arteries, rheoencephalography (REG) to detect the volume of cerebral circulation and hypercapnic loading and their digital values. Then it is necessary to calculate diagnostic coefficients F by the following formulas: Fb/e=6.3-0.16·a1+0.12·a2-1·a3+0.2·a4, or FSMIL=9.6+0.16·a5-0.11·a6-0.14·a7+0.07·a8, or Fhem=48.6-0.04·a9+0.15·a10+13.7·a11-0.02·a12+24.7·a13, where Fb/e -diagnostic coefficient for biochemical blood testings and EEG; FSMIL - diagnostic coefficient for SMIL test; Fhem - diagnostic coefficient for hemodynamic testing; 6.3; 9.6 and 48.6 - constants; a1 - the level of vitamin C in blood; a2 - δ-index by EEG; a3 - atherogenicity index; a4 - the level of α-proteides in blood; a5 - scale 3 value by SMIL; a6 - scale K value by SMIL; a7 - scale 5 value by SMIL; a8 - scale 7 value by SMIL; a9 - the level of volumetric cerebral circulation; a10 - the value of linear circulatory rate along total carotid artery, a11 - the value of resistive index along total carotid artery; a12 - the value for the tonicity of cerebral vessels at carrying out hypercapnic sampling by REG; a13 - the value for the intensity of cerebral circulation in frontal-mastoid deviation by REG. At F value being above the constant one should diagnose toxic encephalopathy, at F value being below the constant - discirculatory encephalopathy due to applying informative values.
EFFECT: higher accuracy of diagnostics.
6 ex, 1 tbl