Method of diagnosing korsakoff's syndrome in patients with tumours of basal-diencephalic localisation by data of electroencephalographic examination
SUBSTANCE: invention relates to field of medicine, namely to oncologic neurosurgery, neurology, psychiatry and functional diagnostics. Electroencephalographic examination is carried out. Level of coherent connection between pole-frontal and anterior temporal regions of cerebral cortex on the right is calculated in beta-range. If said parameter is higher than 0.52, Korsakoff's syndrome is diagnosed.
EFFECT: method makes it possible to increase reliability of Korsakoff's syndrome diagnostics.
1 tbl, 2 ex
The invention relates to medicine, namely to neurosurgery, neurology, psychiatry and functional diagnostics.
When brain tumors along with focal neurological symptoms often develop modal nonspecific mental disorder until the development of the expanded amnestic (Korsakov) syndrome (KS) with fixation, Antero - and retrograde amnesie, a violation of disorientate in place, time, personal situation, confabulatory the confusion, decreased critics and physical activity, and emotional disorders.
Especially often the COP develops with tumors of the basal cerebral localization [Great psychological dictionary/Ed. and General Ed. Bgeneral, V.P. Zinchenko. - SPb.: Prime-EUROSAC, 2003. - 672 C.]. Objectification COP is important to predict the risk of surgical intervention, planning adequate treatment, preoperative preparation and practice of medical-social examination in these patients.
A known method for the diagnosis of KS on the basis of neuroradiological methods, in particular according to functional MRI. Typical activation dorsolateral prefrontal areas of the cortex of the right hemisphere fusiform gyrus [Caulo M, Van Hecke J, Toma L, Ferretti A, Tartaro A, Colosimo C, Romani GL, Uncini A. Functionl MRI study of diencephalic amnesia in Wernicke-Korsakoff syndrome. Brain. 2005 Jul;128(Pt 7): 1584-94]. The limited application of this method is due to its high cost and lack of availability of clinics respective scanners.
A known method for the diagnosis of KS on the basis of positron emission tomography - hypometabolism in the hippocampus, mamillary bodies and hypermetabolism in the white matter [Lechevalier, Aupee AM, de la Sayette V, Eustache F, Baron JC.Function imaging of the hippocampus in Korsakoff's syndrome. Bull Acad Natl Med. 2000; 184(7): 1491-7; Reed LJ, Lasserson D, Marsden P, Stanhope N, Stevens T, Bello F, et al. FDG-PET findings in the Wernicke-Korsakoff syndrome. Cortex 2003; 39: 1027-45]. The disadvantage of this method of diagnosis is the practical inaccessibility of its use in most hospitals.
There is a method for the diagnosis of KS according to MRI studies: the presence of atrophy of the medial group of nuclei of the thalamus, the hippocampus [Sullivan EV, Marsh L. Hippocampal volume deficits in alcoholic Korsakoff's syndrome. Neurology. 2003 Dec 23;61(12): 1716-9], cingulate gyrus [Brion S, Plas J, Mikol J, Peters A, Brion F. Post-traumatic Korsakoff's syndrome: clinical and anatomical report. Encephale. 2001 Nov-Dec; 27(6):513-25], white matter posterior areas of the cortex [Fama R, Marsh L, Sullivan EV. Dissociation of remote and anterograde memory and his or her neural correlates in alcoholic Korsakoff's syndrome. J Int Neuropsychol Soc. 2004 Mau;10(3):427-41]. The disadvantage of this method is the impossibility of its application when developing acute KS, which is mainly observed in neurooncological sick.
The described method for the diagnosis of KS on the basis of data m is ufologicheskogo research method: the degeneration and loss of neurons in the anterior nuclei of the thalamus [Harding, A., Halliday G., Caine D., J. Kril Degeneration of anterior thalamic nuclei differentiates alcoholics with amnesia.Oxford Journals Medicine Brain. 1999. Volume 123, Issue lPp.141-154], cingolani cortex [Brion S, Plas J, Mikol J, Peters A, Brion F. Posttraumatic Korsakoff's syndrome: clinical and anatomical report. Encephale. 2001 Nov-Dec;27(6):513-25]. The disadvantage of this method is invasive nature of diagnostic procedures, information, only in patients with acute forms of the COP.
The described method for the diagnosis of KS on the basis of neuropsychological tests - by the presence of anterograde and retrograde amnesia regarding verbal and non-verbal information [Cabanyes J.Neuropsychology of Korsakoff's syndrome.// Neurologia. 2004 May; 19(4): 183-92; Brokate Century, Hildebrandt H, Eling P, Fichtner H, Runge K, Timm C. Frontal lobe dysfunctions in Korsakoff's syndrome and chronic alcoholism: continuity or discontinuity? // Neuropsychology. 2003 Jul; 17(3):420-8]. However, this method has limited application in neuro-Oncology, because patients often are in an altered state of consciousness, psychomotor agitation or, on the contrary, stunned.
The majority of the listed methods of diagnosis refers to the identification of chronic forms of KS are different, most often benign, Genesis. The complexity of the diagnosis of KS in patients with tumors of the basal cerebral localization is, first, severity of condition of patients, limiting the use of neuropsychological diagnostic methods, and secondly, in a small distance to the present methods narora the sociology in stationary conditions - functional magnetic resonance and positron emission tomography.
Informative and cheap way to diagnose the COP is the EEG with the mathematical analysis of the data [ravens VG, secuties GA, Grendel O.M. software Package for statistical comparison of EEG recordings // Materials of International conference "Clinical neuroscience: neurophysiology, neurology, neurosurgery, Ukraine, Gurzuf, June 2003, C-24].
The described method for the diagnosis of CC on anomalous values of EEG indicators at different nosological forms of brain lesions. For CS traumatic Genesis informative hippocampal alpha rhythm, stable slow activity, epileptiform potentials in the right hemisphere, reduced by 20-80% hemispheric and reinforced vnutripolusharnaya average levels of coherent ties, often for lengthy or diagonal relations, particularly on the left, with emphasis in theta range, and reinforced on 6-55% longest diagonal inter - and vnutripolusharnaya of coherently beta activity 13-20 Hz (often Fpl-02). Moreover, reduced levels of average coherence symmetric temporal and occipital areas, as well as vnutripolusharnaya fronto-Central-temporal relations [Sharova EV, Obraztsova ER, hares O.S, Kulikov M.A., Urakov ST. Features of the EEG in post-traumatic Korsakov with ndrome // J. Neurology and psychiatry. CSV, 2001, t, N5, p.32-38]. The disadvantage of this method of diagnosis is the lack of clear diagnostic EEG syndrome calculating its sensitivity and specificity.
Shows the information content to the increased power of theta rhythm in patients with KS toxic Genesis [Kalechstein AD, De la Garza R 2nd, Newton TF, Green MF, Cook IA, Leuchter AF. Quantitative EEG abnormalities are associated with his or her memory in recently abstinent methamphetamine-dependent individuals./ J Neuropsychiatry Clin Neurosci. 2009 Summer;21(3):254-8]. However, for patients with tumors of the basal cerebral localization has increased the power of theta rhythm, regardless of the presence or absence of the COP, so this diagnostic criterion cannot be extrapolated to neurooncological sick.
Proposed method for the diagnosis of KS by evaluating anomalistic caused cortical bioelectrical activity. When the COP vascular described reduced peak amplitude and increased latency period of RSOO cognitive evoked potential [Stakhovsky L.V. Transient global amnesia (clinic, diagnosis, prognosis). Dessert. Prof. the honey. of Sciences, Moscow, 2006, 239 S.]. The disadvantage of this method of detection of the COP is the lack of specificity of a diagnostic test.
The described method for the diagnosis of mental disorders on the basis of complex neurophysiological data and neuroradiological the research: EEG, magnetic electroencephalography, evoked potentials, functional magnetic resonance imaging [US Patent 20090062676, A. 05.03.2009]. The disadvantage of this method of diagnosis is its complexity, high cost.
There is a US patent [20050159671 A1. 21.07.2005] in the method for the diagnosis of memory problems on the basis of the power of theta rhythm in time to perform neuropsychological tests. The disadvantage of using this method in neurosurgery is to limit the possibility of performing neuropsychological tests in patients with brain tumors due to the severity of the condition.
Thus, the above methods show the possibility of the diagnosis of KS in patients with brain tumors on the basis of the analysis of frequency-power of anomalistic spectrum of the EEG. To date, however, patients with KS in brain tumors not described method of detecting the diagnostic EEG test to assess its sensitivity and specificity.
The closest prototype of the adopted method for the diagnosis of KS in the presence of abnormal EEG indicators in spectral and coherence analysis of EEG [Obraztsova ER Neurophysiological analysis of post-traumatic Korsakov syndrome. Diss. Kida. Biol. of Sciences, Moscow, 2007, 120 S.]. This method shows the informativeness of moderate diffuse disorders PA the thorns EEG signs of dysfunction mesencephalic-diencephalic and subcortical structures with a significant reduction compared to the normal average levels of coherence symmetric temporal and occipital cortical areas, and fronto-Central-temporal regions within the right and left hemispheres. Limit the use of this method of diagnosis for neurooncological patients is the lack of specificity of the diagnostic EEG pattern and the impossibility of its extrapolation for the diagnosis of KS in neurooncological sick.
This disadvantage is eliminated by means of odnomomento comparative analysis of all possible relevant EEG indicators in patients with verified KS and anatomo-topographical and histological variants of tumors of the basal cerebral localization and identification of the most informative diagnostic EEG test that objectify the COP.
The problem solved by the invention is the improvement to the method for the diagnosis of KS in patients with tumors of the basal cerebral localization.
The technical result is ensuring the unambiguous evaluation of the COP on the basis of diagnostic EEG test. The technical result is achieved by analysis of all relevant EEG indicators in the background recording EEG in patients with KS by different types of tumors of the basal cerebral localization, calculations among the most informative and selection of the optimum, which will be diagnostic EEG test.
Method for the diagnosis of CC on diagnostic EEG-TEC is the background EEG without additional functional loads can significantly reduce the time of the survey category of patients, to use relatively inexpensive EEG equipment, to rely on only one indicator, thereby to reduce employment neurophysiologist, financial costs and improve the efficiency of diagnosis COP.
Diagnostic EEG-test (table) for the diagnosis Korsakov syndrome in patients with tumors of the basal cerebral localization is statistically significant high coherent link between the right polysto-frontal and anterior temporal regions of the cortex in the beta range, compared with a median value of the indicator for patients with tumors of the basal cerebral localization - 0,52.
|Diagnostic EEG test for the diagnosis of KS in patients with tumors of the basal cerebral localization|
the range of the syndrome
|Diagnostic EEG test||Selected values of the characteristics of EEG-test and 95% confidence intervals (in parentheses)|
|risk (Ri)||ness (Se)||ness (Sp)|
In the name of the EEG test, the sign "+" indicates a significantly high value of the indicator relative to the standards, b - beta-subrange, (F8-Fp2p) right anterior temporal pole-frontal coherent communication.
The risk ratio >1 in the diagnostic EEG test indicates its statistical significance for the diagnosis of KS.
Thus, the identified diagnostic EEG test for patients with KS tumors basal cerebral localization, which allows not only to optimize therapeutic tactics, the effectiveness of neurosurgical intervention, but also to use it during the psychiatric examination.
Interpretation of diagnostic EEG test.
High compared to the norm of the coherent relationship between the right polysto-frontal and anterior temporal regions of the cortex in the beta sub-band reflects irritatio in kortiko-thalamic and kortiko-limbic-reticular circles [Sharova EV Adaptive-compensatory adjustment of bioelectric activity of human brain damage stroykompanii: author. Diss. Prof. Biol. Sciences, M.: In-t GNI and NF RAS, 1999, 43 S.]. The increase in the spatial synchronization in a narrow band of frequencies (beta-subrange) indicates irritation mesencephalic reticular formation, sydneytalent influences and caudate nucleus to the cortex [Zhirmunskaya E.A., Losev B.C. Electroencephalography in clinical practice. Methodical manual. M., 1997, 118 S.].
The formation of abnormal communication between the orbitofrontal cortex and hippocampus at KS due to increased thalamo-cortical synchronization effects on cortical activity caused by irritating tumor thalamo-hypothalamic structures ['govskii CENTURIES Physiology of the Central nervous system. M.: Izd-vo MGU, 1997, 391 S.; Daniel N. Psychophysiology. M: Aspekt press, 2000, 371 S.]. The lateralization of EEG test is associated with a closer functional relationship diencephalic departments with cortical areas of the right hemisphere [Boldyrev GN. The electrical activity of the human brain with the defeat of diencephalic and limbic structures. M.: Nauka, 2000,181 C.].
Diagnostic EEG test is consistent with previously obtained in the experiment data imbalance between basal cholinergic system of the forebrain and adrenergic systems in the rear of the hypothalamus [Danilov You. M: Aspekt press, 2000, 371 S.; swiderski N.E., Korolkova T.A. P is ostrastrona organization electrical processes of the brain: problems and solutions. Journe. the Supreme. nerve. death, t (5): 792-811]. Damage to the nuclei of the anterior thalamus in this category of patients disrupts the normal activity of the hippocampus and leads to coarse memory disorders [Savage LM, Chang Oh, Gold RE. Diencephalic damage decreases hippocampal acetylcholine release during spontaneous alternation testing. Learn Mem 2003; 10:242-6; Jenkins TA, Dias R, Amin E, Brown MW, Aggleton JP. Fos imaging reveals that lesions in the anterior thalamic nuclei produce widespread limbic hypoactivity in rats. J Neurosci 2002; 22: 5230-8]. Functional MPT confirms that the Genesis of KS is associated with damage to diencephalic structures and errors in the coding of incoming information in the hippocampus [Caulo M, Van Hecke J, Toma L, Ferretti A, Tartaro A, Colosimo C, Romani GL, Uncini A. Functional MRI study of diencephalic amnesia in Wernicke-Korsakoff syndrome. Brain. 2005 Jul;128(Pt 7): 1584-94].
Thus, the diagnostic EEG test confirms earlier experimental and neuroimaging data on the occurrence patologicheskih connections between frontal and temporal areas of the cortex of the right hemisphere in the beta range during the occurrence of KS. Offer electroencephalographic method for the diagnosis of KS cheaper, technically easily feasible and practically available in any medical institution.
The method is as follows.
Nosological options tumours set according to x-ray examinations (CT, MRI), protocols, surgical interventions and morphological data. Mental disorders cenvat scale MMSE [M.Folstein et al., 1975; J. De Pualo et al., 1980; D. Wade, 1992; Ancelovici VG, Bragin N.N., Voronin I.A., Dobrokhotova T.A., Sidneva YG Mental disorder, and water - electrolyte disorders in patients with tumors of the diencephalic region. // Social and clinical psychiatry, 2004. - N 2.-Pp.93-96; Great psychological dictionary/Ed. and General Ed. Bgeneral, V.P. Zinchenko. - SPb.: Prime-EUROSAC, 2003. - 672] with the definition of orientation in time, place, checked memory (memorizing 3 words), concentration (subtract in reverse order), speech, Gnostic, mnestic functions, emotional speech sphere. Evaluation result: more than 28 points - norm, 24-27 points - light, 19-23 points - moderate and below 19 - gross cognitive disorders.
Recording EEG performed on the 18-channel analog EEG firm "Nihon KOHDEN (Japan) international scheme 10-20% according to the recommendations of the International Federation of clinical neurophysiology [http://eeg-online.ru/standards/rec_mtr_acns.htm]. Register 1-minute segment of EEG, bitartarate EEG segments is subjected to spectral processing. After the fast Fourier transform to calculate the EEG indicators of frequency power spectra for standard leads and coherence for all pairs of these leads across the physiological range (0.5 to 25 Hz and four standard ranges. Calculate the abnormally low ("-") and high ("+") in relation to normal EEG indicators in groups according to the results of testing statistical hypotheses nonparametric test Mann-Whitney [Glanz S. Biomedical statistics. TRANS. from English. - M., Practice, 1999, 459 S.]. The significance level is equal to 0.05. The algorithm spectral analysis will verify using the software package MatLab 7.
The database was 370 patients with tumors of the basal cerebral localization. It includes anatomical-topographical and histological variants of tumors, the presence of the COP and Modesto-coherent abnormal EEG spectrum.
Psychiatric, neuroimaging and EEG data lead to a nominal scale and bring to the table "case characteristics". Based on the method of "associative search" from the Arsenal of data mining [Duke Century, Samoilenko A. Data Mining: a tutorial (+CD). - St. Petersburg: Publishing house "Piter", 2001, 368 S.] and modified by your program [Voronin I.A., ravens VG Builder syndromes on the basis of Association rules. The certificate of state registration of computer programs. No. 2008615256 of October 31, 2008; Voronin I.A., ravens VG Statistical tester EEG. The certificate of state registration of computer programs No. 2998615815 from 15 December 2008; Voronin I.A., ravens VG Statistical tester EEG. The certificate of state registration of computer programs No. 2998615815 from 15 December 2008]. Next programmatically detect EEG-candidate diagnostic syndrome according to the criteria of maximum truly put the nutrient and true-negative solutions, i.e. their occurrence in the group with the COP and estrechamente in control. Then calculate the most informative diagnostic EEG test by calculating the sensitivity, specificity, risk and 95% confidence intervals of its sample values.
In the study it was found that when the level of coherent communication between the pole-frontal and anterior temporal areas of the cortex on the right in the beta range above 0,52 (median rate for patients with tumors of the basal cerebral localization) is diagnosed KS. Thus, the method provides the possibility of objective evaluation of KS in patients with deep brain tumors based on the presence of high right anterior temporal pole-frontal coherent communication in the beta sub-band can improve diagnostic accuracy and to optimize the treatment.
B-e K-on FORCE, 42 years old, diagnosis: fibrillar astrocytoma columns of the fornix. From the anamnesis it is known that about 1 year ago there was a progressive decline in memory on current events, 2 months - headache with nausea, vomiting, seizures, severe weakness in the legs, blurred vision, disturbed orientation in time, personal situation.
During the examination at the Institute: the emotional and personal defect with reduced critics to their condition, f is katianna amnesia, violation of orientation in time, personal situation. Tendon reflexes increased, with dissociation them along the axis of the body. VIS OD=OS-1,0. Oculomotor disorders no. Disks of optic nerves pink, right edema predominantly in the nasal half of the left disc edema, prominenet in the vitreous body. MRI study - extensive education in the field of holes Monroe, the lateral ventricles are enlarged, moderate periventricular edema.
For EEG study revealed increased to 0.56 (rate of 0.48), the right pole-frontal-anterior-temporal coherent communication in the beta sub-band, indicating the presence of the COP.
This conclusion is confirmed by the available data previously received conventional neurophysiological method for the diagnosis of reversible COP traumatic Genesis about the informativeness increase vnutripolusharnaya coherent links temporo-fronto-Central areas of the cortex in the beta range [Obraztsova ER, Sharova EV, hares O.S, ravens VG, Coratina I.G. Features bioelectrical activity of the brain for post-traumatic Korsakov syndrome // J. of Neurology and psychiatry. CSV, 2003, t, N8, p.59-65].
B-Neu-in E.N., 34 years old, diagnosis: oligoastrocytoma anterior transparent partitions. About 8 months ago came the headaches, the last 6 months they have increased, became provoditsya nausea, vomiting at the height of the background which appeared in episodes of loss of consciousness with convulsions with a frequency of several times a month. MRI study was identified tumor transparent partitions. On a background of conservative therapy, the patient's condition improved slightly.
Upon admission to the Institute: the decline in voluntary activity, reduction of memory on current events, criticism of the state, violation of orientation, episodes confabulatory confusion. VIS OD=OS=0, 7. The reaction of pupils to light, convergence is reduced. The movement of the eyeballs in full. The fundus of the eye: the disk of the right optic nerve pale, edema, arteries narrowed veins tortuous, full-blooded, stagnant optic nerve pallor. Drive left pale optic nerve, artery narrowed veins moderately full. Tendon reflexes are increased, higher in the lower extremities. Unclear implementation coordinatory samples, the instability in the Romberg position. MRI study tumor of the anterior transparent partitions.
For EEG study revealed increased to 0.65 (rate of 0.48), the right pole-frontal-anterior-temporal coherent communication in the beta range, which indicates the presence of a COP. This conclusion is confirmed by the known diagnostic EEG method, evidencing dysfunction mainly the substantial right hemisphere on average coherence in the beta sub-band with a rough mental disorders in patients with tumors of the basal cerebral localization [Boldyrev GN. The electrical activity of the human brain with the defeat of diencephalic and limbic structures. M.: Nauka, 2000, 181 S.].
The way to diagnose Korsakov syndrome in patients with tumors of the basal cerebral localization, including EEG studies, and the subsequent evaluation of these spectra coherence between areas of the cortex, characterized in that it further assess the level of coherent communication between the pole-frontal and anterior temporal areas of the cortex on the right in the beta range, and when the values of its more 0,52 diagnose Korsakov syndrome.
SUBSTANCE: invention refers to medicine, namely to drug-free methods for activation of the cerebral verbal functions. Cerebral signals are recorded. Their duration is measured. A related verbal stimulus is established for the derived wave duration and has an effect on the patient. That is followed by measuring the duration of the next current wave through a time interval not less than the maximum duration of the used verbal stimuli, and the patient is exposed to the verbal stimulus corresponding to the current wave. According to the other version of implementing the method, the duration of the current wave is measured, and the corresponding verbal and contextually harmonised visual stimuli are set for the above duration. The patient is exposed thereto. That is followed by measuring the duration of the regular current wave through a time interval not less than the maximum duration of the used verbal stimuli, and the patient is exposed to the verbal and contextually harmonised visual stimuli corresponding to the current wave.
EFFECT: invention enables acceleration the process of verbal development in children.
1 dwg, 3 ex
SUBSTANCE: invention relates to medicine, namely to neurology, psychiatry and pediatrics. Factors of perinatal pathology risk are determined: extragenital diseases of mother during pregnancy and labour, complications of pregnancy and labour, low gestational age, estimation by Apgar scale and compromised obstetric history. Also determined is presence of neurological malfunctions during 1-st year of life: syndromes of motor malfunctions, increased neuroreflex excitability, vegetative-visceral disorders, depression, retardation of physhomotor and speech development; and in older age - cerebrosthenic syndrome and syndrome of child dysphasia in structure of symptom complex of MBD, epileptiform activity by EEG. Results of questionnaire for MBD detection are evaluated in points. Prognostic coefficients F1 and F2 are calculated in discriminating equations. If F1 is higher than F2, favorable courseof MBD is predicted, if F1 is less than F2, unfavorable course of MBD is predicted.
EFFECT: method makes it possible to increase reliability of MBD course prediction.
2 tbl, 2 ex
SUBSTANCE: invention relates to medicine. Electroencephalogram (EEG) is registered in background mode, spectrograms are calculated by means of wavelet conversion with Morlet mother function. Frequency ranges of leading EEG rhythms are determined by finding values of coordinate minimums by frequency of envelope projections of wavelet spectrograms on "amplitude-frequency" coordinate plane. In frequency ranges times Ti of spectrogram peak appearance are determined by values of positions of maximums on envelope projection of wavelet spectrograms. Frequencies Fi and amplitudes Ai of peaks of spectrograms, which correspond to values of times of their appearance in each frequency range, are determined. For each discretisation window with ΔT, ΔF parameters, obtained by fragmentation of duration T and frequency range F of EEG registration, values ΣAi of sums of amplitudes of spectrogram peaks are calculated. If frequency increases, range of frequencies of peaks expands, interhemispheric asymmetry of electric activity is detected, early stage of Parkinson disease is diagnosed.
EFFECT: method makes it possible to increase reliability of determination of early stage of PD.
4 cl, 9 dwg, 1 ex
SUBSTANCE: invention relates to field of medicine, namely to functional diagnostics. Electroencephalogram (EEG) is registered, indices of averaged powers of spectra in background EEG registration in frequency range 8-13 Hz MI before 1up to 16 minute long HF impact and M2 after EHF impact consisting of 6-10 procedures are determined. Dynamics of ratios of said indices of powers M2/M1 presence of compensatory reserves of brain is determined. In case if ratios M2/M1, equal more than 1.2 are present, conclusion about positive dynamics of general functional state of brain an possibility of carrying out standard EHF therapy is made.
EFFECT: method extends arsenal of means for control over state of patient with encephalopathy in EHF therapy.
6 tbl, 3 ex
SUBSTANCE: invention relates to medicine, in particular to field of medical and psychophysiological diagnostics. Assessment of character of motor asymmetries - determination of degree of right-handedness - left-handedness by dominance of hand and leg, as well as sensor asymmetries - determination of leading eye and ear, is performed. Also calculated is coefficient of amplitude and frequency of mu-rhythm in central parts of left and right hemisphere, as ratio of difference of maximal and minimal values to their sum. Difference between maximal and minimal values is calculated within 3-second long interval. Dominating hemisphere of motor cortex by mu-rhythm is registered at the moment of alternate clenching right and left hand fist with application of sensomotor test by scheme: "Close eyes - make right fist - open eyes - undo the fist", "Close eyes - make left fist - open eyes - then undo the fist', during standard registration of electroencephalogram.
EFFECT: method extends arsenal of means for assessment of functional interhemispheric asymmetry.
9 dwg, 4 tbl, 2 ex
SUBSTANCE: invention relates to field of medicine, namely to neuroinfections. Assessment of anamnesis data, virological indices, fever reaction and spotty-papular rash appearance is carried out. EEG is additionally registered in the first three days from the moment of admission, leukocyte index of intoxication, presence of mixed hypervirus infection are determined. If hypoxy-ischemic affection of central nervous system, spotty-papular rash on the body from the first day of disease with its "additional appearance" during 5-7 days, fever to 39-40°C during first 3-5 days are present in child's anamnesis, reduction of index of main physiological rhythm less than 30%, increased paroxysmal activity in form of diffuse sharp waves and flashes of slow activity with amplitude more than 100 mcV during 3 days or at least on one of these days are detected on EEG, value of leukocyte index is 0.2-3 conv.units, mixed hyperviruses together with varicella zoster virus, virus of type 6 herpes and/or type I herpes simplex virus are detected, risk of neurological complications is predicted.
EFFECT: method makes it possible to increase reliability of predicting risk of neurological complications in case of chicken pox in children.
SUBSTANCE: group of inventions refers to medicine and medical equipment, particularly to methods and apparatuses for scalp electric potential measurement. The apparatus comprises a number of sensors obtaining the initial measurement of a scalp electric potential through a hair-covering and an air contact area; a number of preamplifiers connected to one of the appropriate mentioned sensors. The contact area produces a high and variable coupling impedance of the source and the scalp. Each preamplifier contains a broadband high-impedance input and an active bias circuit generating input impedance more than 10 petaOhm over the range from 0.01 Hz to 400 Hz; a high-gain low-noise operating amplifier with the input impedance of 10 teraOhm; and a shielded feedback and bias circuit. The preamplifier is configured to have the input impedance substantially higher than the impedance produced by the source-sensor contact area. One version of the implementation of the method for scalp electric potential measurement, the preamplifier obtains the initial measurement of the scalp electric potential and forms a pre-intensified measurement of the scalp electric potential. The measurement is taken through the hair-covering and air. In the other version of the implementation of the method, an input signal of the initial scalp electric potential is obtained from the number of sensors to generate an appropriate number of channels. It is followed by the signal pre-amplification by the preamplifier with the high input impedance to form the pre-intensified measurement of the scalp electric potential. Then, a measurement mode is configured in a group containing a channel mode relative to a reference channel, a channel mode relative to a middle channel and a differential interchannel mode. Then, the pre-intensified measurement of the scalp electric potential is biased with maintaining the mentioned high input impedance; a channel gain is adjusted to differential obtaining of the channel signal. An additional stage providing the processed channel signal is suppressing radiofrequency interferences of the channel signal with maintaining adjustment of the gain and the phase; a common-mode of the channel signal is suppressed, and the band-pass channel filtration is provided. The processed channel signal is digitised to present a digital signal of the measurement of the scalp electric potential, characterising the mentioned input signal measured according to the mentioned chosen measurement mode.
EFFECT: use of the group of inventions allows more effective measurements of the scalp electric potential due to the preamplifiers, and allows reducing the need of exfoliating of the necrotic epithelial cells or application of abrasive or conducting gels.
27 cl, 11 dwg
SUBSTANCE: invention concerns medicine and medical technology. A patient is exposed to electrical stimulation generated by the 'simpaticor-01' apparatus. A one-element electrode is placed in a projection of cervical ganglia, while a multiple-element electrode - on a patient's neck. The exposure to the field is paused. A convulsive readiness threshold is assessed. Neurometabolic preparation dosage is specified in accordance with age, while anticolvulsants are dosed as per manufacturer's recommendations. Amplitude, frequency and length of the current pulse field, length of exposure and pauses are specified individually for each patient so that in the process of treatment and later on, the convulsive readiness threshold tends to decrease in the form of reducing a number of paroxysmal sharp and slow waves, as well as elimination of epileptoid activity.
EFFECT: method provides higher clinical effectiveness ensured by combining drug-induced therapy with electrical stimulation of the vegetative nervous system.
7 dwg, 1 tbl, 1 ex
SUBSTANCE: invention relates to field of medicine, namely to oncologic neurosurgery, neurology and functional diagnostics. Electroencephalographic (EEG) examination is carried out. Power of delta-range waves in parietal regions is estimated on EEG. In case of simultaneous increase of power in left parietal region above 80 mcV2 and in right region above 85 mcV2, malignant form of growth of neuroepithelial tumour of III ventricle is diagnosed.
EFFECT: method extends arsenal of means for diagnosing type of growth of neuroepithelial tumours of III brain ventricle.
1 tbl, 2 ex
SUBSTANCE: invention relates to field of medicine, namely to oncologic neurosurgery, neurology and functional diagnostics. Estimation of clinical status and neurovisualisation data and EEG examination are carried out in preoperative period. Depending on anatomical-topographical and histological version of tumour, as well as detected clinical-EEG complex of symptoms risk of development of complications in early postoperative period in patients after ablation of tumours of basal-diencephalic localisation is predicted.
EFFECT: method extends arsenal of means for predicting development of complications in early postoperative period in patients with different anatomical-topographical versions of tumours of basal-diencephalic localisation.
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