Method and device for studying functional state of brain

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

 

The invention relates to medicine and can be used for studies of the functional state of the brain in order to detect violations of cerebral circulation.

There is a method of determining the bioelectrical activity of the brain, including the imposition on the patient's head measuring electrodes over the brain and zero electrode at a certain distance from the brain, the amplification of signals from the measuring electrodes in two stages: in the first phase of the action potential from each of the measuring electrode is fed to one input of a respective differential amplifier, the second input of which is applied biopotential zero electrode, the second stage output signal of each differential amplifier is compared with the averaged output signal of the differential amplifiers adjacent measurement electrodes (see application great Britain No. 1501803, IPC 3 And 61 In 5/04, NCI G 1 N A 3 R, publ. 1979). This method does not provide detection of violations of cerebral circulation.

Patent of the Russian Federation No. 2187958, IPC 7 And 61 In 5/04, publ. 2002, secure way to explore the state of the cerebral vessels, including local cold exposure and rheoencephalography not, characterized in that the local cold exposure is carried out in the projection of the pool vessels of the internal carotid artery heat exchanger with temperature is Roy t° =10±2°C for 10 min, and rheoencephalography conducted before, immediately and after 10 and 20 min after cold exposure. This method has limited izmenenie and unfit to identify the causes of cerebral circulation.

There is a method of determining the disturbance in the blood supply of the head (see Russian Federation patent No. 2159075, IPC 7 And 61 In 5/05, publ. 2000), according to which register of the differential rogramme with the neck, chest, hands. Measure their amplitude and time characteristics. Calculate the volume of inflow of blood to the head as the difference between the volume of blood flow to parts of the chest neck and chest - hands. Register circumflex rogramme on the site of the chest neck and measure its amplitude venous systolic and primary waves. I hope their relationship. Register ultrasonic dopplergram blood flow through the right atrioventricular orifice of the heart. Measure her average blood velocity during early filling of the right ventricle of the heart and the systole of the right ventricle. I hope their relationship. Circulatory disorders of the head is determined according to the calculated values. The disadvantage of this method is that it allows one to identify pathological disorders only when their clinical manifestations and ineffective in prenosological diagnostics.

From the patent of the Russian Federation for the promotion No. 2103912, IPC6And 61 In 5/0476, publ. 1998 there is a method of brain research, according to which relieve the EEG before and after presentation of the stimulus, calculate the power spectrum of the EEG or the coefficient of the synchronous electrical processes in each point location of the electrode relative to its neighbors. Determine the change in the value of the obtained values after the stimulus and present the results of calculations in the form of topographic maps. Additionally, the locations of the electrodes measure the temperature, calculate its difference and contribute to the map. This method allows simultaneous measurement and study of electrical processes to measure and explore thermal margin of the head. The disadvantage of this method of investigation of the functional state of the brain is the low efficiency when determining the causes of disorders of cerebral circulation.

The problem solved by the invention is the increased efficiency in the determination of causes of disorders of cerebral circulation and the identification of the initial manifestations of cerebrovascular disorders.

The solution of the stated problem is achieved in that in the method of the study of the functional state of the brain, including multitrack recording electroencephalogram (EEG), additionally carry out a functional test on hyperventilation and/or orthostatic who Rob, when carrying out functional tests simultaneously with multi-channel recording and registration of EEG synchronously and in real time carry out the recording and registration of rheoencephalography (REG) in the basins of the carotid and vertebral arteries and the electrocardiogram (ECG), and visualization of EEG, rheoencephalography and exercise electrocardiogram in a single window with a single time axis, while the functional state of the brain is judged by synchronous changes in EEG, REG and ECG in response to functional test. If after the beginning of the test to hyperventilation observed a decrease in the amplitude of the REG more than 25%, and then there are paroxysmal manifestations on EEG in the form of a sharp increase in slow-wave waves, it is potentially possible reason proximally manifestations on EEG formulated as vascular disorders of the brain. If the localization reduction of the amplitude of the REG and the emergence of proximally manifestations of EEG spatial match, it is additionally a conclusion about the presence of the pathological activity associated with the inadequacy of regional cerebral blood flow. If, prior to the carrying out functional tests on hyperventilation was observed disorganization EEG, decreased pulse blood and toning on the REG, and in the process of conducting tests on hypervent is the isolation was observed normalization of indicators of cerebral blood flow, reflected in the increase in pulse blood, and normalization of the EEG, which is expressed in increased levels of alpha-aktivnosti preserving zonal differences in fronto-occipital areas, formulate a hypothesis about the presence of cerebrovascular disorders associated with disturbance of blood gas composition in the initial background state. If in the process of conducting tests hyperventilation observed on the ECG extrasystoles and they precede an epileptic on simultaneously recorded EEG signals, we conclude zerbrochenem nature of cardiac arrhythmias. If in the process of conducting tests hyperventilation there is no causal link between seizures on EEG and appearances PVCs on the ECG, it is concluded cardiogenic nature of cardiac arrhythmias. If in the process of conducting long-term passive orthostatic sample from the patient is recorded cynocephalidae state, when pronounced bradycardia or asystole ECG before sincopalnah state and the decline of cerebral blood flow by REG diagnose cardioinhibitory the cause of the syncopal state, when the previous cynocephalidae state of decline in cerebral blood flow on the REG and no significant reduction in heart rate by ECG to diagnostico the t vasodepressive the cause of the syncopal status, and pre-syncopal status epileptic EEG and no significant reduction in heart rate by ECG diagnosed with spasmodic type of fainting.

The inventive method for evaluation of the functional state of the brain according to the applicant meets the criteria of the invention of "novelty" and "inventive step", because there is no source of information, which would describe the opportunity when carrying out functional tests simultaneous removal in real-time multichannel electroencephalography, RHEOENCEPHALOGRAPHY in the basins of the carotid and vertebral arteries and ECG and imaging electroencephalogram, rheoencephalography and electrocardiogram in a single window with a single time axis.

Device for the study of the functional state of the brain is a separate object of the invention.

A device for evaluation of pathological changes in the system of activity of the human brain, comprising a set of sensors placed on a person's head and/or plug-in to deep electrodes, multi-channel amplifier of the sensor signals with the number of channels corresponding to the number of sensors, the block synchronous signal conversion from continuous form to the discrete unit of statistical processing of the obtained data and the block surround playback (see patent school is No. 4736751, IPC 5 And 61 In 5/04, publ. 1988). Such a device does not provide synchronous eat in real-time EEG and REG.

From the patent of the Russian Federation No. 2177716, IPC 7 And 61 In 5/0476, publ. 2002 a device for evaluation of pathological changes in the systemic activity of the brain, which includes a set of sensors placed on a person's head and/or plug-in to deep electrodes, and/or have at some distance from the head, multi-channel amplifier sensor signals, such as EEG, with the number of channels corresponding to the number of sensors, the power signal conversion, such as conversion from continuous form to the discrete unit of measurement statistical relationships between processes, the unit of measurement of the dimension of the display process corresponding to the aggregate statistical properties of the relationship between the measured processes, the evaluation unit coordinates and/or values of the radius vectors display processes, block the visualization of the spatial distribution of the radius-vectors of the displayed processes, such as a plotter or graphics display, a storage device, the unit of measurement differences between the parameters of the spatial distributions of the radius-vectors of the displayed processes, block the visualization of differences in the integrative activity of the brain of the patient unit of presentation of tests and synchronization unit. The device allows you to accurately identify the extent and nature of sustainable pathological abnormalities of the systemic activity of the human brain, to determine their localization and the nature of the violations, to quantify the degree of pathological abnormalities associated with any of the tests or with any changes of the functional state of the brain. This device also does not provide synchronous eat multichannel electroencephalography, RHEOENCEPHALOGRAPHY in the basins of the carotid and vertebral arteries.

Closest to the claimed device for the study of the functional state of the brain is a device for measuring, recording and analysis of electrophysiological signals, protected by the patent of Russian Federation №2102004, IPC 6 And 61 In 5/04, publ. 1998, contains one United block of electrodes, selective multi-channel amplifier, multiplexer, analog-to-digital Converter, the control device and the primary processing unit galvanic separation, interface unit and a personal computer. Circuit power multichannel amplifier connected to the output busbar protection unit from the emergency current, the first group of inputs of which are connected to the electrodes, and the second output power supply buses. This device for the study of the functional state of the brain is not effective when the analysis is e causes of cerebral circulation due to the lack of the possibility of simultaneous removal in real-time multichannel EEG, REG in the basins of the carotid and vertebral arteries and ECG.

The problem solved by the invention is the provision of opportunities for simultaneous extraction and analysis of real-time multi-channel EEG, REG and ECG, the efficiency differential diagnosis of disorders of cerebral circulation.

The solution of the stated problem is achieved in that the device for the study of the functional state of the brain, containing serially connected multi-channel analog-to-digital Converter, a microcomputer with a galvanically isolated ports I / o and PC standard configuration, the electrode Assembly for pickup signals of bioelectric brain activity connected to multi-channel amplifier bioelectric activity of the brain, the electrodes for picking up electrical activity of the heart, United with the power of electrophysiological signals, the unit current and potential electrodes to provide a record of Rosignano, multi-channel amplifier Rosignano, generator current Rosignano and synchronous detector Rosignano, further comprises a switch leads, the first group input of which is connected with the potential electrodes of the unit current and potential electrodes to provide a record of Rosignano, the second group of inputs - outputs of the generator current Rosignano, the first group of outputs with a current electrode block of the current and potential electrodes to provide a record of Rosignano, the second group of outputs with the inputs of the synchronous detector Rosignano, and the demultiplexer, the input connected to the output of a synchronous detector Rosignano, and outputs to the inputs multi-channel amplifier Rosignano, while the outputs multi-channel amplifier bioelectric brain activity, multi-channel amplifier Rosignano & amp electrophysiological signals connected to respective inputs of the multi-channel analog-to-digital Converter, the outputs of the microcomputer is connected to the control input of the switch leads, the control input of the demultiplexer and control input multi-channel analog-to-digital Converter. The generator current Rosignano contains a source of constant voltage, the poles of which are connected to a switching input of the controlled switch, the output controlled switch through a narrow-band amplifier connected to the input line of the inverter voltage - current output which is the output of the generator. Synchronous detector Rosignano contains serially connected differential amplifier, bandpass filter and inverter, as well as a managed switch, switch is anticipated by so the inputs of which are connected to the input and output of the inverter, the inputs of the synchronous detector are the inputs of the differential amplifier and the control input of the controlled switch, the output - output controlled switch. Amplifying channel multi-channel amplifier bioelectric brain activity contains serially connected differential amplifier, a noninverting input connected to the input connection of the respective working electrode, and inventoriumi through matching cascade input for connecting the reference electrode, the amplifier gain DC current equal to one, and increased in the operating frequency band equal to the nominal, and the lowpass filter.

The applicant is not aware of any publication that would contain information about the impact of the distinctive features of the claimed device for the study of the functional state of the brain at the technical result achieved. In this regard, according to the applicant, it is possible to draw a conclusion on the conformity of the proposed technical solution the criterion of "inventive step".

The invention illustrated by the drawings. Figure 1 shows the structural diagram of the device for the study of the functional state of the brain, figure 2 - block diagram of the generator current neosignal in figure 3 - functional circuits of the synchronous detector Rosignano, figure 4 is a functional diagram of the amplifier channel amplifier signals bioelectric brain activity, figure 5 and 6 shows examples of displaying multi-channel ECG, REG and ECG in a single window with a single time axis.

The list of positions in the drawings figure 1 - 4:

1 - electrode Assembly for pickup signals of bioelectric brain activity;

2 - electrode Assembly for pickup signals of electrical activity of the heart;

3 - unit current and potential electrodes to provide a record of Rosignano;

4 - switch leads;

5 - generator current RESIGNAL;

6 - a synchronous detector RESIGNAL;

7 is a multichannel amplifier bioelectric brain activity;

8 - unit electrophysiological signals;

9 - demultiplexer;

10 is a multichannel amplifier RESIGNAL;

11 - multi-channel analog-to-digital Converter - MACP;

12 is a microcomputer with a galvanically isolated port I / o;

13 - PC standard configurations;

14 - operated switch;

15 is a lowpass filter;

16 - bandpass filter;

17 is a managed switch.

The claimed method of the study of the functional state of the brain is implemented as follows. On the head of the patient to impose the electrodes for the removal of bio signals is elektricheskoi brain activity, current and potential electrodes to provide a record of Rosignano in the basins of the carotid and vertebral arteries, chest clip electrodes for picking up electrical activity of the heart. Electrodes for pickup signals of bioelectric activity of the brain and the electrodes for picking up electrical activity of the heart each connected to a separate input of a multichannel amplifier. The potential electrodes to provide a record of Rosignano connected to the multichannel inputs of the amplifier Rosignano through the switch leads, synchronous detector and a demultiplexer. Outputs multi-channel amplifiers are connected to a multichannel analog-to-digital Converter connected to the galvanically isolated port I / o of microcomputers. This allows for synchronous real-time multi-channel recording of the electroencephalogram (EEG), the recording rheoelectroencephalography (REG) in the basins of the carotid and vertebral arteries and record the electrocardiogram (ECG) and to make their computer analysis. On the display screen of the PC in one box, with a common time axis displays the captured synchronously in real-time EEG, REG and ECG. After you enable and test the operation of the apparatus carry out a functional test for hyperventilation in standard mode. Patient a is oboko rhythmically breathing for 3 minutes. The depth of the breath and depth of exhalation should be the maximum, and the breathing frequency within 16 to 20 per minute. The respiration parameters can be monitored using the sensor of the respiratory wave. Recording EEG, REG and ECG should be carried out at least 3 minutes before trial and not less than 5 minutes after it ends. The costs in the process of conducting samples having a reduced level eographical signal and the emergence of proximally manifestations on EEG in the form of a sharp increase in relation abnormal slow-wave waves differencebut potential causes proximally features on EEG. If in the beginning there was a decrease in the amplitude of the REG more than 25%, and then there are proximally manifestations on EEG, then with high probability should be considered vascular disorders of the brain. If the localization reduction of the amplitude of the REG and the emergence of proximally manifestations of EEG spatial match, it is additionally a conclusion about the presence of the pathological activity associated with the inadequacy of regional cerebral blood flow. If, prior to the carrying out functional tests on hyperventilation was observed disorganization EEG, decreased pulse blood and toning on the REG, and in the process of conducting samples were observed normalization of indicators of cerebral blood who Otok, reflected in the increase in pulse blood and normalization of the EEG, which is expressed in increased levels of alpha activity with preservation of zonal differences in fronto-occipital areas, suggest the presence of cerebrovascular disorders associated with disturbance of blood gas composition in the initial background state. If you carry out a functional test on hyperventilation and in the process of conducting tests on the ECG signal are observed extrasystoles and they precede an epileptic on simultaneously recorded EEG signals, we conclude zerbrochenem nature of cardiac arrhythmias. If there is no causal and temporal relationship between seizures on EEG and extra beats in the ECG, it is concluded cardiogenic nature of cardiac arrhythmias. To identify the causes cynocephalic States spend extended passive orthostatic test and, if during the test the patient is fixed cynocephalidae state, when pronounced bradycardia or asystole ECG to the onset of syncopal state and the decline of cerebral blood flow by REG diagnose cardioinhibitory the cause of the syncopal status pre cynocephalidae state of reduced cerebral blood flow in the REG and no significant reduction in heart rate is okraseni ECG diagnosed vasodepressive the cause of the syncopal status, and pre-syncopal status epileptic EEG and no significant reduction in heart rate by ECG diagnosed with spasmodic type of fainting.

Simultaneous registration of EEG, REG and ECG with the possibility of a compressed representation in a single time scale trends of physiological parameters allows to extend the diagnostic capabilities in the study of various diseases and disorders. It allows you to control the correctness of the research (in particular, provoking samples for hyperventilation), influenced by the vascular factor in epilepsy, to identify patients with malformed breathing pattern, leading to cerebrovascular disorders, to provide useful information for differential diagnosis of syncopal States, to explore the nature of interactions between body systems at various violations, to provide a more informed choice of therapeutic measures and evaluating their effectiveness.

The above technical result is illustrated by the following examples. At the initial manifestations of insufficiency of blood circulation of the brain often EEG with a high degree of synchronization (mainly in the alpha range). This is due to the activation of integrative structures mesencephali the level, occur in response to deterioration of blood supply to the brain. When dyscirculatory disorders of the vertebrobasilar mainstream phenomenon can be observed in timing and flattening of the EEG, thrombosis and stenosis with relevant clinical manifestations (paresis, intermittent blindness and aphasia) EEG changes appear slow waves. Revealed a close correlation between the volume of blood flow in the basin of the affected vessel and the average frequency of rhythmic activity in this area, which makes it possible to judge according to EEG about the possibilities of compensation and rehabilitation in ischemic disorders of cerebral circulation. On the same basis EEG is used to monitor brain function during surgery carotid endarterectomy. In ischemic disorders of cerebral circulation EEG data can to some extent serve as differential diagnostic purposes. So when carotid stenosis abnormal EEG occur in 50% of patients with thrombosis of the carotid artery is 70%, and thrombosis of silvaloy artery - 95%. It is of some significance electroencephalography in the differential diagnosis of vascular stroke. In hemorrhagic stroke EEG changes much more rough and persistent, accompanied by more pronounced cerebral changes, which corresponds to more severe Kli is practical a painting. Simultaneous registration of EEG and REG makes it possible to detect the influence of the vascular factor in paroxysmal States and epilepsy by comparing the changes of cerebral blood flow prior to the manifestations of epileptiform activity. For example, inadequately strong deterioration of parameters of cerebral blood flow (this is most often expressed in the decrease of pulse blood, increased vascular tone, growth, instability indices tone etc.) conducted functional tests can cause epileptiform activity on EEG. Comparing the rate of change of the parameters of cerebral blood flow on the REG with the corresponding changes in the EEG when conducting functional tests (for example, hyperventilation, light rhythmic stimulation, sound stimuli, with the introduction of convulsant and anticonvulsant drugs or other precipitating factors), and timing of these changes may be decided predominant emphasis in the treatment of vascular disorders or joint medication, improves cerebral hemodynamics, and anticonvulsants. Additional registration of the respiratory curve using a respiration belt helps to control the correctness of the execution of sample g is preventively and breath holding. Such control is highly desirable for correct content interpretation, since the surface fast or, on the contrary, slow breath when performing hyperventilation can lead to the opposite physiological effect (hypercapnia instead of hypocapnia). If the time of occurrence of epileptiform bursts and discharges preceded by significant changes of cerebral blood flow, it may indicate the primary influence violations exactly cerebral blood flow.

As an illustration, let us consider a few examples of research. In the first study (figure 5), the patient was revealed reduction of the threshold of convulsive readiness to hyperventilation. Before the three-minute hyperventilation in the initial state was observed somewhat disorganized alpha-activity of high amplitude, irregular in frequency. Rheoencephalogram in the initial state was relatively normal form with a slightly higher tone. In the third minute of hyperventilation began to show flashes of polymorphic, mainly medlennovolnovoj, epileptiform activity. Before the outbreak in the REG, there is a significant instability of pulse blood and tonus of vessels of different caliber, even in neighboring cardiocycle different amplitude pulsations REG form rowany menees is from hypotonic to hypertonic. Low values of the tone of the arterioles of the cerebral vessels comply with the minimum changes of the EEG. The growth of the pathological elements of the EEG increases in proportion to the growing phenomena of intracranial hypertension. From the prognostic point of view, the low initial values of the tone is testimony to the preservation of the Central mechanisms of vasomotor regulation, and high values of tone correlate with loss of Central mechanisms of vasomotor regulation and the initial manifestations of ischemic brain disease. Figure 5 presents the mapping of EEG, REG and ECG in a single window with a single time axis. Left : the original, the background on the right is the 3rd minute of hyperventilation. Noticeably pronounced deterioration of the EEG signals and the REG on provoking impact, in particular the reduction of pulse cerebral blood vessels and the appearance of paroxysmal bursts of slow-wave activity on EEG.

In the second study, the patient was observed normalization of EEG and REG on hyperventilation. Figure 6 is visible the dynamics of changes in EEG, REG and ECG on provoking impact in the second study, when the patient was recorded normalization of EEG and REG on hyperventilation. The initial state is characterized by low-amplitude desynchronizing EEG (al the a-wave is almost not noticeable), increased tone of cerebral vessels (second systolic wave is higher in amplitude than the first, reduced pulse volume (eographically index level...0,09 0,08 Ohms). When provoking influence in the form of hyperventilation observed the following changes: alpha rhythm is significantly more pronounced with preservation of the normal zonal differences, the tone of cerebral vessels is normalized (the second systolic wave has become lower than the first amplitude), pulse volume of cerebral vessels normalized (eographically index at the level of 0.12 Ohms).

Comparison of the deviations of physiological parameters in two patients allows to draw the following conclusions. On the 1st patient with the detection of increased threshold of convulsive readiness when hyperventilation should be noted that the deterioration of the EEG is accompanied by deterioration of pulse cerebral blood vessels (reducing the amplitude of the signal REG 30%). First, there is a significant deterioration of cerebral blood flow (observed from the 1st minute of hyperventilation), and then the occurrence of paroxysmal manifestations of pathological activity (on the 3rd minute of hyperventilation).

The patient with normalization of the EEG during hyperventilation there is another picture. A sample of hyperventilation leads to normalization of the EEG and avoided improved pulse cerebral blood vessels (increasing the amplitude of the signal REG is almost 30%). Normalization of EEG and REG starts at the same time within 30 seconds after the onset of hyperventilation.

It can be assumed that the second patient in the initial state was the lack of oxygen in the blood, causing baseline EEG and REG were somewhat disturbed. Hyperventilation resulted in increased oxygen content in the blood, which led to normalization of cerebral blood flow and EEG parameters. In addition, the second patient, apparently, more developed adaptive capacity, as if provoking influence worked adaptation mechanisms for enhancing the tone of peripheral vessels, and thus improved ratio for General redistribution of blood flow in favor of the brain through peripheral. The first patient peripheral vascular tone is increased slightly, the corresponding redistribution of blood flow has not occurred, cerebral blood flow decreased significantly, which could lead to deterioration of the EEG.

It should be noted that abrupt changes of EEG and REG are observed in many cases and the execution of mental stress. After mental strain, there is a compensatory increase in the amplitude of the signal REG. Method of aggregate analysis of the synchronously captured EEG and REG can also be successfully used for research in various who's groups of patients with psychiatric and neuropsychiatric disorders with dementia for studies of the mechanisms of memory, etc.

Device for the study of the functional state of the brain, from which the claimed method is implemented, contains (1) block 1 electrodes for pickup signals bioelectrical activity of the brain, block 2 electrodes for picking up electrical activity of the heart, block 3 current and potential electrodes to provide a record of Rosignano, switch the leads 4, the generator 5 current Rosignano, synchronous detector 6 Rosignano, multichannel amplifier 7 signals the bioelectrical activity of the brain, the amplifier 8 electrophysiological signal, the demultiplexer 9, multichannel amplifier Rosignano 10, multichannel analog-to-digital Converter (MACP) 11, a microcomputer 12 with electrically isolated port I / o, and PC 13 standard configuration. Unit 1, including a device for securing electrodes, working (signal), reference and zero electrodes, wires and a connector for connecting to multi-channel amplifier 7 may be made in the form of an elastic cap and is designed for easy and comfortable fastening of the electrodes on the patient's head. Block 2 includes electrocardiographic electrodes and elements of fastening of the electrodes on the patient's body. If necessary, control the length and depth of breathing during which rosedene functional tests on giperventilatia unit 2 may further comprise a sensor respiratory waves (for example, respiratory zone). Block 3 includes a current electrode for supplying a current pulse signals and potential electrodes for pickup voltage drops from the current pulse signals, and can be combined with unit 1, i.e. the current and potential electrodes can be mounted on the same elastic cap, with the fastening elements of the electrode unit 3 are grouped in pairs - current electrode b1and the corresponding potential of the electrode B1. The switch 4 is intended for the temporary separation of Rosignano and includes two demultiplexer, one of which connects to the generator output 5 current electrode unit 3 and to the input of the synchronous detector 6 potential electrode unit 3 with even numbers, the other with odd. The generator 5 (figure 2) contains the constant voltage source E, the poles of which are managed through the switch 14 and a narrow-band amplifier, including C1, R1, N1 and the low pass filter 15 connected to the input line of the inverter voltage - current (U2, Tp1, R2). Generator output 6 frequency sinusoidal current is equal to the switching frequency of the controlled switch 14. Synchronous detector 6 (Fig 3) contains a differential amplifier U3 with bandpass filter 16 output and the controlled switch 17, one input of which is connected to bandpass filter directly and utoro is through the inverter. The control inputs of the switches 14 and 17 are served synchronous signals from the microcomputer 12. Multi-channel amplifier 7 is designed for amplification of the signals bioelectrical activity of the brain, shoot with the working electrode block 1. Each channel gain of this amplifier contains (figure 4) serially connected differential amplifier (A4, R3, R4), power factor DC equal to one, and increased in the working frequency band (u, R5, R6, R7, C2), and a lowpass filter (R8, C3). Non-inverting input of the differential amplifier is connected with the corresponding working electrode block 1, and inverting through matching cascade (u, R9, R10) with an appropriate reference electrode. The output of the synchronous detector 6 is connected to the input of the multiplexer 9, the outputs of which are connected to the inputs of the amplifier system 10. The connection of the outputs of the multiplexer 9 is supplied from the microcomputer 12 synchronously with switching of the electrode unit 3 switch lead 4. The multichannel outputs of the amplifiers 7 and 10 and the amplifier 8 is connected to the corresponding inputs of multi-channel analog-to-digital Converter 11, the purpose of which is to convert the analog signal into a discrete form with spatial division multiplexing. The microcomputer 12 is designed to provide removal in real time of all rings is fishing, pre-processing (digital filtering), control over the functioning of the unit 1 and multichannel amplifier 7 and control the operation of the switch 4, the generator 5, the synchronous detector 6, a multiplexer 9 and multi-channel analog-to-digital Converter 11. The microcomputer 12 of the exchange channel is connected to the PC 13. The purpose of the PC 13 - aggregate recorded synchronously in real-time values of electrophysiological signals (EEG, ECG, REG) and displaying these signals on the display screen. Additionally, the PC 13 can calculate in a single cardio-cyclic time scale, i.e. in relation to each of the automatically recognized cardiocycle, physiological parameters: bioelectrical activity of the brain - the absolute and the relative values of power alphaactivity, abnormal slow-wave activity in the range of Delta and theta waves, the dynamics of metabolic brain activity on a permanent component of the EEG, heart rate on ECG, pulse blood vessels of the brain iographica.com index REG, peripheral resistance of cerebral vessels (PCSL) and display these indicators on the display screen in the volume and to allow differential diagnosis of epilepsy and epileptiform PR the phenomena.

The claimed device operates as follows. The electrodes for the removal of the electroencephalogram and rogramme fixed to the head with elastic helmet (special elastic electrode cap), electrodes for pickup electrocardiogram fixed to the patient using a conductive adhesive or adhesive tape. With long-term monitoring, when the channel exchange of the microcomputer 12 to the PC 13 is arranged over the air, on the patient may be optionally attached accelerometers, the signals on which is mounted motor activity of the patient. The communication of the PC 13 to the microcomputer 12 through the air not only allows the patient to be in a comfortable environment, but also to simultaneously monitor multiple patients. After installation of the electrodes and turn on the power, check the efficiency and reliability of the connection electrodes. Then on the microcomputer 12 in the mode of removal of physiological signals. Electrical signals applied to the inputs, amplified, converted to MACP 3 analog-to-discrete, cleaned from artifacts in the computer 12 and stored in code form. The performance of microcomputers 12 allows real-time synchronous write and save data EEG signals over the desired number of leads (up to 32 digital displayer), rheographic the fir signals (up to 6 channels), physiological signals through the channels of ECG markers of various types, reflecting these or other events, these functional tests outlined by the program or performed by a doctor during EEG-video monitoring, the results of pre-processing to identify anomalies EEG and ECG. Recorded information from the microcomputer 12 is transmitted to the personal computer 13 when it is connected to PC port 13 or over the air. In the PC 13 is processed the necessary fragments of electrophysiological signals and, depending on the purpose of the study, displaying in a single time interval required for visual evaluation by a physician of the ongoing processes. Processing is performed using all the possibilities of mathematical processing. For example, processing of the EEG can be made using all the possibilities of computerized EEG, such as the reference reconstruction, vertical split, automatic search of artifacts and epileptiform activity, two - and three-dimensional toposcope, spectral, auto-cross-correlation analysis and the coherence function with the topographic mapping, analysis of functional asymmetry, as well as automatic generation of the description and classification of EEG allows editing, three-dimensional localization of the sources of pathological electr the political activity of the brain, etc.

Long-term monitoring of EEG and synchronously removed from her other physiological parameters is an important diagnostic method to differentiate between pseudoepinephrine and true epileptic seizures. EEG-video monitoring is used when necessary to confirm the preliminary diagnosis “epilepsy”, especially in complex cases where accurate differential diagnosis is crucial to select the best treatment strategy and prognosis of the disease. The diagnosis “epilepsy” obvious upon detection of epileptic EEG patterns on interictal/paroxysmal EEG. The absence of anomalies in interictal EEG/paroxysmal period does not completely rule out epilepsy. It is known that a significant number of simple partial seizures are accompanied by autonomic and somatosensory symptoms, often characterized by the absence of changes in EEG during surface mapping electrode. The presence of epileptic EEG patterns during the time of the attack is also not absolute proof of epilepsy. In patients with repeated rhythmic motor phenomena in EEG in some cases, there are artifacts resembling epileptic EEG patterns, and is able to mislead the inexperienced electroencephalographic. In itbegan the e errors would require a comparison of simultaneous changes in EEG and REG research. This approach not only provides time-saving research at the expense of a single record in the source (background) and when carrying out functional tests under simultaneous EEG-REG-study. Get complete information when mapping the dynamics of synchronous changes of EEG, REG and ECG during simultaneous research, which, in turn, allows you to:

- to assess the possible impact of vascular factor in paroxysmal symptoms (if any);

- to identify possible cerebrovascular causes changes in the bioelectrical activity of the brain;

- to compare paroxysmal manifestations of EEG and signs of cardiac rhythm and conduction ECG (if available) to identify the type of violation (cardiogenic or cerebrogenic);

- to analyze the interaction of the CNS, ANS and cerebral blood flow on the basis of comparison of the dynamics of EEG signals, REG and ECG, as well as physiological indicators calculated on the basis of these signals.

According to the data obtained using the claimed device, for patients with baseline low volume cerebral blood flow is characterized by a significant increase in the number of diffuse pathological theta inclusions are equivalent to the processes damiel the organization, atherosclerosis and diffuse cerebral ischemia. In patients with excessive plethora of cerebral vessels (eographically index equal to 0.3 Ohms), moderately reduced tone and delayed venous outflow is also showing signs of bilateral synchronous rhythm, reflecting the phenomenon of dysfunction of the median formations of the brain. That is, in fact, and in another case of significant deviations hemodynamic components of the brain reveal a violation of the Central mechanisms of regulation of vasomotor control. The slowing of the venous outflow-specific effects of increased brain blood supply and high tone of the arterioles is an indication of increasing intracranial hypertension with the loss of negative feedback between the center and the main components of cerebral blood flow with which correlate EEG manifestations of irritative and diffuse changes of the functional state of the brain stem. Low values of the tone of the arterioles corresponded to a minimum in comparison with other groups of patients, changes in EEG. The growth of the pathological elements of the EEG increased in proportion to the growing phenomena of intracranial hypertension. From the prognostic point of view, the low initial values of tone are testimony to the preservation of the Central mechanisms of vasomotor regulation, and high C is achene tone correlate with loss of Central mechanisms of vasomotor regulation and the initial manifestations of ischemic brain disease.

The importance of the mapping of EEG and REG from the point of view of identifying the precipitating factors of the elements of epileptiform activity. If the time of occurrence of epileptiform bursts and discharges preceded by significant changes of cerebral blood flow, it may indicate the primary influence violations exactly cerebral blood flow.

However, this is not limited to the scope of application of the simultaneous recording of EEG and eographically signals reflecting the state of cerebral and peripheral blood flow. Given the dependence of the functional state of the brain from the state of the cardiovascular system, accounting changes recorded indices of cardiovascular system may help in the interpretation of emergent phenomena in EEG. This may relate to the identification of precipitating factors of epileptic seizures (analysis of changes in cerebral blood flow before the onset of the attack), and for the differential diagnosis of epileptic and not epileptic seizures (for example, identification of syncopal conditions associated with heart rhythm or vasodepressor reaction), to identify violations of EEG cerebrovascular character (in fact the normalization of EEG and REG when carrying out any of the samples, such as hyperventilation) and confirmed the structure of the presence of regulatory violations, shown on EEG, REG and heart rate variability. In a separate research EEG, REG, kardiointervalografii, indices of Central hemodynamics often use the same functional tests. Simultaneous registration of these data allows not only to reduce the total time of study, but also get a unique opportunity to compare scores obtained on different types of signals for a more reliable interpretation of the data. Comparison of these data allows us to clarify the nature of the primary disease and the regionality of cerebrovascular disorders. In addition to the REG and ECG advisable to use other physiological signals. This can include the peripheral photoplethysmogram (figs to control the reactivity of resistive vessels, tone of main arteries, state postcapillary-venular bed), galvanic skin response (GSR to control emotional tension, especially when conducting psychological tests), pneumogram (GHG to assess the frequency and depth of breathing, control of the correct implementation of various respiratory samples) and other signals.

1. The method of evaluation of the functional state of the brain mainly in the diagnosis of epilepsy and epileptiform manifestations, including many who channel recording electroencephalogram (EEG), electrocardiogram (ECG) and carrying out functional tests, characterized in that it further with a multi-channel recording and registration of EEG synchronously and in real time carry out the recording and registration of rheoencephalography (REG) in the basins of the carotid and vertebral arteries, and visualization of EEG, rheoencephalography and exercise electrocardiogram in a single window with a single time axis, while the functional state of the brain is judged by synchronous changes in EEG, REG and ECG in response to functional test.

2. The method according to claim 1, wherein if after the beginning of the test to hyperventilation observed a decrease in the amplitude of the REG more than 20%, and then there are paroxysmal manifestations on EEG in the form of a sharp increase in slow-wave waves, a potential cause of paroxysmal EEG manifestations formulated as vascular disorders of the brain.

3. The method according to claim 2, characterized in that if the localization reduction of the amplitude of the REG and the appearance of paroxysmal manifestations of EEG spatial match, it is additionally a conclusion about the presence of the pathological activity associated with the inadequacy of regional cerebral blood flow.

4. The method according to claim 1, characterized in that if, prior to the carrying out functional tests on hypermental the tion was observed disorganization EEG, the reduction of pulse blood and toning on the REG, and in the process of conducting tests hyperventilation was observed normalization of indicators of cerebral blood flow, such as enhancement of pulse blood, and normalization of the EEG, which is expressed in increased levels of alpha activity with preservation of zonal differences in fronto-occipital areas, formulate an assumption about the presence of cerebrovascular disorders associated with disturbance of blood gas composition in the initial background state.

5. The method according to claim 1, wherein if in the process of conducting tests hyperventilation observed on the ECG extrasystoles and they precede an epileptic on simultaneously recorded EEG signals, we conclude zerbrochenem nature of cardiac arrhythmias.

6. The method according to claim 1, wherein if in the process of conducting tests hyperventilation there is no causal link between seizures on EEG and appearances PVCs on the ECG, it is concluded cardiogenic nature of cardiac arrhythmias.

7. The method according to claim 1, characterized in that a long-term passive orthostatic test and, if during the test the patient is fixed cynocephalidae state, when pronounced bradycardia or asystole ECG before he syncopal the ground state and the decline of cerebral blood flow by REG diagnose cardioinhibitory the cause of the syncopal status, when the previous cynocephalidae state of decline in cerebral blood flow on the REG and no significant reduction in heart rate by ECG diagnosed vasodepressive the cause of the syncopal status, and pre-syncopal status epileptic EEG and no significant reduction in heart rate by ECG diagnosed with spasmodic type of fainting.

8. Device for the study of the functional state of the brain, containing serially connected multi-channel analog-to-digital Converter, a microcomputer with a galvanically isolated ports I / o and PC standard configuration, the electrode Assembly for pickup signals of bioelectric brain activity connected to multi-channel amplifier bioelectric activity of the brain, the electrodes for picking up electrical activity of the heart, United with the power of electrophysiological signals, the unit current and potential electrodes to provide a record of Rosignano, multi-channel amplifier Rosignano, generator current Rosignano and synchronous detector Rosignano, characterized in that it further comprises a switch leads, the first group of inputs which connected with potential electrodes Blo is as current and potential electrodes to provide a record of Rosignano, the second group of inputs - outputs of the generator current Rosignano, the first group of outputs with a current electrode block of the current and potential electrodes to provide a record of Rosignano, the second group of outputs with the inputs of the synchronous detector Rosignano, and the demultiplexer, the input connected to the output of a synchronous detector Rosignano and outputs - inputs multi-channel amplifier Rosignano, while the outputs multi-channel amplifier bioelectric brain activity, multi-channel amplifier Rosignano & amp electrophysiological signals connected to respective inputs of the multi-channel analog-to-digital Converter, and the outputs of the microcomputer is connected to the control inputs of the generator current Rosignano, synchronous detector Rosignano, switch leads, demultiplexer and multi-channel analog-to-digital Converter.

9. The device according to claim 8, characterized in that the generator current Rosignano contains a source of constant voltage, the poles of which are connected to a switching input of the controlled switch, the output controlled switch through a narrow-band amplifier connected to the input line of the inverter voltage - current output which is the output of the generator.

10. The device of claim 8, the tives such as those that synchronous detector Rosignano contains serially connected differential amplifier, bandpass filter and inverter, as well as a managed switch, toggle input of which is connected to the input and output of the inverter, the input of the synchronous detector are the inputs of the differential amplifier and the control input of the controlled switch, the output - output controlled switch.

11. The device according to claim 8, characterized in that the amplifying channel multi-channel amplifier bioelectric brain activity contains serially connected differential amplifier, a noninverting input connected to the input connection of the respective working electrode, and inverting through matching cascade - input for connecting the reference electrode, the amplifier gain DC current equal to one, and increased in the operating frequency band equal to the nominal, and the lowpass filter.



 

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