Several studies have described cranio–cerebral correlations in accordance with the 10–20 electrode placement system. These studies have made a significant contribution to human brain imaging ...techniques, such as near-infrared spectroscopy and trans-magnetic stimulation. With the recent development of high resolution EEG, an extension of the 10–20 system has been proposed. This new configuration, namely the 10–10 system, allows the placement of a high number (64–256) of EEG electrodes. Here, we describe the cranio–cerebral correlations with the 10–10 system. Thanks to the development of a new EEG-MRI sensor and an automated algorithm which enables the projection of electrode positions onto the cortical surface, we studied the cortical projections in 16 healthy subjects using the Talairach stereotactic system and estimated the variability of cortical projections in a statistical way. We found that the cortical projections of the 10–10 system could be estimated with
a grand standard deviation of 4.6 mm in
x, 7.1 mm in
y and 7.8 mm in
z. We demonstrated that the variability of projections is greatest in the central region and parietal lobe and least in the frontal and temporal lobes. Knowledge of cranio–cerebral correlations with the 10–10 system should enable to increase the precision of surface brain imaging and should help electrophysiological analyses, such as localization of superficial focal cortical generators.
Highlights ► Transient prosopagnosia from human brain intracerebral stimulation is reported. ► The recognition impairment is specific to faces. ► The area stimulated is functionally defined as the ...right ‘occipital face area’. ► A face-sensitive N170 potential is recorded directly in this area.
Fatigue in multiple sclerosis is a frequent and disabling symptom that can interfere in daily functioning. The aim of this study is to demonstrate the relationship between fatigue and disability, ...disease course, depression and quality of life.
We administered French valid versions of the Fatigue Impact Scale (EMIF-SEP), the short form of the Beck depression inventory (13 items) and the SF-36 to 237 out of 312 patients with clinically definite multiple sclerosis with EDSS
≤
6.5.
The EMIF-SEP is composed of four dimensions (cognitive, physical, social role and psychological) and allows a multidimensional evaluation.
Using a multivariate analysis, EMIF-SEP total scores with physical and social role subscales were highly correlated with EDSS (
p
<
0.0001). Cognitive and psychological dimensions of the EMIF-SEP were not linked to EDSS. EMIF-SEP was not correlated with disease course after adjusting for EDSS. EMIF-SEP scores were significantly associated with depression scores (
r
=
0.74,
p
<
0.0001). The multivariate analysis also showed a significant impact of fatigue on each scale of quality of life of the SF-36.
These data confirm that fatigue is correlated with disability, but cognitive and psychological dimensions of fatigue remain independent. Fatigue is also associated with depression and quality of life.
Le traitement de référence du syndrome d’apnées du sommeil (SAS) reste la ventilation nocturne par pression positive continue (PPC). Ce traitement peut s’avérer contraignant chez certains patients. ...L’accompagnement du traitement est primordial pour sa bonne mise en œuvre et son succès.
L’éducation thérapeutique du patient est un processus continu, intégré et centré sur le patient. Elle repose pleinement sur les soignants, dont l’activité d’éducation thérapeutique est un élément de la définition de leur fonction. Elle intègre le patient dans une démarche active d’appropriation de sa pathologie.
Le SAS est une pathologie se prêtant à son application. La coopération entre les médecins et les paramédicaux est devenue une priorité : l’éducation thérapeutique dans le cadre du traitement du SAS peut en être une belle illustration.
L’enjeu est de faire comprendre au patient qu’il peut attendre des bénéfices sur sa santé d’un usage plus constant de sa machine. Mais cela va plus loin : passé le processus d’acquisition de savoirs et de compétences, il doit passer au processus d’appropriation de sa pathologie.
L’éducation thérapeutique dans le cadre de la prise en charge du patient apnéique devrait progressivement se développer et ainsi gagner ses lettres de noblesse comme dans d’autres disciplines où cela est déjà le cas, comme l’insuffisance cardiaque, l’asthme ou le diabète.
L’accueil se définit comme le fait de « recevoir bien ou mal une personne ». Cette phrase met en exergue qu’il est possible de faire un bon ou un mauvais accueil. Le bon accueil n’est donc pas une ...évidence et il implique une manière d’être et de faire particulière. Le soignant doit donc adopter une attitude spécifique.
Accueillir le patient dans un centre de sommeil c’est se mettre à disposition physiquement, le recevoir à son arrivée avec une attitude rassurante, empathique et bienveillante. C’est accueillir sans condition et avec neutralité, sans jugement de valeur.
Donner une image positive avec une écoute attentive, montrer que l’on est disponible pour le soigné, informer le patient avec un langage adapté à son niveau de compréhension des différentes étapes des explorations nocturne et diurne au cours de l’hospitalisation.
L’accueil doit être personnalisé et individualisé. Dans nos centres de sommeil CEREVES cela reste un moment privilégié dans le soin, l’attitude du soignant est prépondérante. Il doit faire preuve d’une qualité de présence relationnelle, essentielle à l’accueil de qualité car cela détermine le ressenti premier du patient par rapport à son hospitalisation et détermine son bon déroulement.
L’entrée en relation avec le patient correspond à un moment décisif du processus de soin, posant les bases de confiance et de l’alliance thérapeutique. L’accueil ne se limite pas à l’arrivée du patient, mais se prolonge tout au long du séjour par un accompagnement bienveillant, courtois, efficace et professionnel qui facilitera la relation soignant/soigné.
This paper deals with the co-registration of an MRI scan with EEG sensors. We set out to evaluate the effectiveness of a 3D handheld laser scanner, a device that is not widely used for ...co-registration, applying a semi-automatic procedure that also labels EEG sensors. The scanner acquired the sensors’ positions and the face shape, and the scalp mesh was obtained from the MRI scan. A pre-alignment step, using the position of three fiducial landmarks, provided an initial value for co-registration, and the sensors were automatically labeled. Co-registration was then performed using an iterative closest point algorithm applied to the face shape. The procedure was conducted on five subjects with two scans of EEG sensors and one MRI scan each. The mean time for the digitization of the 64 sensors and three landmarks was 53 s. The average scanning time for the face shape was 2 min 6 s for an average number of 5,263 points. The mean residual error of the sensors co-registration was 2.11 mm. These results suggest that the laser scanner associated with an efficient co-registration and sensor labeling algorithm is sufficiently accurate, fast and user-friendly for longitudinal and retrospective brain sources imaging studies.
Abstract Objective This paper describes and assesses a new semi-automatic method for temporal lobe seizures lateralization using raw scalp EEG signals. Methods We used the first two Hjorth parameters ...to estimate quadratic mean and dominant frequency of signals. Their mean values were computed on each side of the brain and segmented taking into account the seizure onset time identified by the electroencephalographist, to keep only the initial part of the seizure, before a possible spreading to the contralateral side. The means of segmented variables were used to characterize the seizure by a point in a (frequency, amplitude) plane. Six criteria were proposed for the partitioning of this plane for lateralization. Results The procedure was applied to 45 patients (85 seizures). The two best criteria yielded, for the first one, a correct lateralization for 96% of seizures and, for the other, a lateralization rate of 87% without incorrect lateralization. Conclusions The method produced satisfactory results, easy to interpret. The setting of procedure parameters was simple and the approach was robust to artifacts. It could constitute a help for neurophysiologists during visual inspection. Significance The difference of quadratic mean and dominant frequency on each side of the brain allows lateralizing the seizure onset.
Abstract Parkinson's disease (PD) is known to affect postural control, especially in situations needing a change in balance strategy or when a concurrent task is simultaneously performed. However, ...few studies assessing postural control in patients with PD included homogeneous population in late stage of the disease. Thus, this study aimed to analyse postural control and strategies in a homogeneous population of patients with idiopathic advanced (late-stage) PD, and to determine the contribution of peripheral inputs in simple and more complex postural tasks, such as sensory conflicting and dynamic tasks. Twenty-four subjects with advanced PD (duration: median (M)=11.0 years, interquartile range (IQR)=4.3 years; Unified Parkinson's Disease Rating Scale (UPDRS): M “on-dopa”=13.5, IQR=7.8; UPDRS: M “off-dopa”=48.5, IQR=16.8; Hoehn and Yahr stage IV in all patients) and 48 age-matched healthy controls underwent static (SPT) and dynamic posturographic (DPT) tests and a sensory organization test (SOT). In SPT, patients with PD showed reduced postural control precision with increased oscillations in both anterior–posterior and medial–lateral planes. In SOT, patients with PD displayed reduced postural performances especially in situations in which visual and vestibular cues became predominant to organize balance control, as was the ability to manage balance in situations for which visual or proprioceptive inputs are disrupted. In DPT, postural restabilization strategies were often inefficient to maintain equilibrium resulting in falls. Postural strategies were often precarious, postural regulation involving more hip joint than ankle joint in patients with advanced PD than in controls. Difficulties in managing complex postural situations, such as sensory conflicting and dynamic situations might reflect an inadequate sensory organization suggesting impairment in central information processing.
Abstract This prospective study investigated and compared psychiatric features of 25 consecutive patients with psychogenic nonepileptic seizures (PNES) on the basis of presence of reported trauma. ...The “trauma” group comprised 19 patients (76%) and the “no-trauma” group comprised 6 patients (34%). We compared history of PNES, psychiatric comorbidity, alexithymia, and symptoms of dissociation. The study clearly characterized two distinct profiles of patients with PNES on the basis of trauma history. Patients with trauma had at least one psychiatric comorbidity or antecedent (vs 0% in the no-trauma group NT, P < 0.001) and a higher median score of dissociation ( P < 0.001). Patients without trauma had more frequent “frustration situations” as a factor triggering PNES and subsequent sick leaves as perpetuating factors ( P = 0.001). Trauma antecedents correlated with a high rate of psychiatric comorbidity and a strong dissociative mechanism. Patients without trauma had no psychiatric comorbidity and a weaker dissociative mechanism.
Spatial localization of scalp EEG electrodes is a major step for dipole source localization and must be accurate, reproducible and practical. Several methods have been proposed in the last 15 years. ...The most widely used method is currently electromagnetic digitization. Nevertheless, this method is difficult to use in a clinical environment and has not been validated with a high number of electrodes. In this paper, we introduce a new automatic method for localizing and labeling EEG sensors using MRI. First, we design a new scalp EEG sensor. Secondly, we validate this new technique on a head phantom and then in a clinical environment with volunteers and patients. For this, we compare the reproducibility, accuracy and performance of our method with electromagnetic digitization. We demonstrate that our method provides better reproducibility with a significant difference (
p
<
0.01). Concerning precision, both methods are equally accurate with no statistical differences. To conclude, our method offers the possibility of using MRI volume for both source localization and spatial localization of EEG sensors. Automation makes this method very reproducible and easy to handle in a routine clinical environment.
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