Modulation of epileptiform EEG discharges in juvenile myoclonic epilepsy: An investigation of reflex epileptic traits
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/34821 http://dx.doi.org/10.1111/j.1528-1167.2012.03454.x |
Resumo: | Purpose: Previous studies have suggested that cognitive tasks modulate (provoke or inhibit) the epileptiform electroencephalography (EEG) discharges (EDs) in patients with juvenile myoclonic epilepsy (JME). Their inhibitory effect was found to be especially frequent (6490%). These studies arbitrarily defined modulation as a >100% increase or >50% decrease of the EDs compared with baseline, which may not sufficiently distinguish from spontaneous fluctuations. the aim of our study was to assess the modulation of EDs and the precipitation of myoclonic seizures by cognitive tasks and by conventional provocation methods, taking into account also the spontaneous fluctuation of EDs. Method: Sixty patients with JME underwent video-EEG recordings including 50-min baseline, sleep, hyperventilation, intermittent photic stimulation (IPS), and cognitive tasks. To account for spontaneous fluctuations of the EDs we divided the baseline period into 5-min epochs and calculated the 95% confidence interval for the baseline EDs in each patient. Modulation was assumed when the number of EDs during any 5-min test period was outside the 95% confidence interval. Key Findings: Using the arbitrary method, our results were similar to previous publications: Cognitive tasks seemed to inhibit the EDs in 94% of the patients, and to provoke them in 22%. However, when the spontaneous fluctuations were accounted for, inhibition was found in only 29% of the patients and provocation in 18%. A nonspecific effect of any cognitive task seemed to account for the observed significant inhibition in two-thirds of the cases, but was observed in only one of the patients with significant provocation. Photoparoxysmal response was observed in 23% of the patients. When accounting for the spontaneous occurrence of EDs, IPS had provocative effect in 10% of the patients. Hyperventilation and sleep had provocative effect on EDs to an extent similar to the cognitive tasks (hyperventilation: 22%; sleep: 18%). the conventional provocation methods tended to be more efficient in patients who were not seizure free. Myoclonia were recorded most often during the cognitive tasks (10 patients). Significance: Spontaneous fluctuations of EDs account for most of the previously described inhibitory effect of the cognitive tasks. the provocative effect of the cognitive tasks is task-specific, whereas the inhibitory effect seems to be related to cognitive activation in general. |
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Beniczky, SandorBittar Guaranha, Mirian Salvadori [UNIFESP]Conradsen, IsaSingh, Mamta BhushanRutar, VeronikaLorber, BogdanBraga, PatriciaBogacz Fressola, AliciaInoue, YushiTargas Yacubian, Elza Marcia [UNIFESP]Wolf, PeterDanish Epilepsy CtrUniv AarhusUniversidade Federal de São Paulo (UNIFESP)Tech Univ DenmarkAll India Inst Med SciUniv Med Ctr LjubljanaInst NeurolNatl Epilepsy Ctr2016-01-24T14:27:09Z2016-01-24T14:27:09Z2012-05-01Epilepsia. Malden: Wiley-Blackwell, v. 53, n. 5, p. 832-839, 2012.0013-9580http://repositorio.unifesp.br/handle/11600/34821http://dx.doi.org/10.1111/j.1528-1167.2012.03454.x10.1111/j.1528-1167.2012.03454.xWOS:000303195200013Purpose: Previous studies have suggested that cognitive tasks modulate (provoke or inhibit) the epileptiform electroencephalography (EEG) discharges (EDs) in patients with juvenile myoclonic epilepsy (JME). Their inhibitory effect was found to be especially frequent (6490%). These studies arbitrarily defined modulation as a >100% increase or >50% decrease of the EDs compared with baseline, which may not sufficiently distinguish from spontaneous fluctuations. the aim of our study was to assess the modulation of EDs and the precipitation of myoclonic seizures by cognitive tasks and by conventional provocation methods, taking into account also the spontaneous fluctuation of EDs. Method: Sixty patients with JME underwent video-EEG recordings including 50-min baseline, sleep, hyperventilation, intermittent photic stimulation (IPS), and cognitive tasks. To account for spontaneous fluctuations of the EDs we divided the baseline period into 5-min epochs and calculated the 95% confidence interval for the baseline EDs in each patient. Modulation was assumed when the number of EDs during any 5-min test period was outside the 95% confidence interval. Key Findings: Using the arbitrary method, our results were similar to previous publications: Cognitive tasks seemed to inhibit the EDs in 94% of the patients, and to provoke them in 22%. However, when the spontaneous fluctuations were accounted for, inhibition was found in only 29% of the patients and provocation in 18%. A nonspecific effect of any cognitive task seemed to account for the observed significant inhibition in two-thirds of the cases, but was observed in only one of the patients with significant provocation. Photoparoxysmal response was observed in 23% of the patients. When accounting for the spontaneous occurrence of EDs, IPS had provocative effect in 10% of the patients. Hyperventilation and sleep had provocative effect on EDs to an extent similar to the cognitive tasks (hyperventilation: 22%; sleep: 18%). the conventional provocation methods tended to be more efficient in patients who were not seizure free. Myoclonia were recorded most often during the cognitive tasks (10 patients). Significance: Spontaneous fluctuations of EDs account for most of the previously described inhibitory effect of the cognitive tasks. the provocative effect of the cognitive tasks is task-specific, whereas the inhibitory effect seems to be related to cognitive activation in general.Prof. Dr. Peter & Jytte Wolf Foundation for Epilepsy, Bielefeld (Germany)Danish Epilepsy Ctr, Dept Clin Neurophysiol, DK-4293 Dianalund, DenmarkUniv Aarhus, Aarhus, DenmarkUniversidade Federal de São Paulo, Dept Neurol & Neurosurg, Escola Paulista Med, São Paulo, BrazilTech Univ Denmark, DK-2800 Lyngby, DenmarkAll India Inst Med Sci, Dept Neurol, New Delhi, IndiaUniv Med Ctr Ljubljana, Dept Neurol, Ljubljana, SloveniaInst Neurol, Epilepsy Sect, Montevideo, UruguayNatl Epilepsy Ctr, Shizuoka, JapanUniversidade Federal de São Paulo, Dept Neurol & Neurosurg, Escola Paulista Med, São Paulo, BrazilProf. Dr. Peter & Jytte Wolf Foundation for Epilepsy, Bielefeld (Germany): PJWS 09/002FWeb of Science832-839engWiley-BlackwellEpilepsiahttp://olabout.wiley.com/WileyCDA/Section/id-406071.htmlinfo:eu-repo/semantics/openAccessCognitive tasksEEGJuvenile myoclonic epilepsyExternal modulationReflex epilepsyPhotoparoxysmal responseModulation of epileptiform EEG discharges in juvenile myoclonic epilepsy: An investigation of reflex epileptic traitsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlereponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP11600/348212022-11-04 15:40:35.42metadata only accessoai:repositorio.unifesp.br:11600/34821Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652022-11-04T18:40:35Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Modulation of epileptiform EEG discharges in juvenile myoclonic epilepsy: An investigation of reflex epileptic traits |
title |
Modulation of epileptiform EEG discharges in juvenile myoclonic epilepsy: An investigation of reflex epileptic traits |
spellingShingle |
Modulation of epileptiform EEG discharges in juvenile myoclonic epilepsy: An investigation of reflex epileptic traits Beniczky, Sandor Cognitive tasks EEG Juvenile myoclonic epilepsy External modulation Reflex epilepsy Photoparoxysmal response |
title_short |
Modulation of epileptiform EEG discharges in juvenile myoclonic epilepsy: An investigation of reflex epileptic traits |
title_full |
Modulation of epileptiform EEG discharges in juvenile myoclonic epilepsy: An investigation of reflex epileptic traits |
title_fullStr |
Modulation of epileptiform EEG discharges in juvenile myoclonic epilepsy: An investigation of reflex epileptic traits |
title_full_unstemmed |
Modulation of epileptiform EEG discharges in juvenile myoclonic epilepsy: An investigation of reflex epileptic traits |
title_sort |
Modulation of epileptiform EEG discharges in juvenile myoclonic epilepsy: An investigation of reflex epileptic traits |
author |
Beniczky, Sandor |
author_facet |
Beniczky, Sandor Bittar Guaranha, Mirian Salvadori [UNIFESP] Conradsen, Isa Singh, Mamta Bhushan Rutar, Veronika Lorber, Bogdan Braga, Patricia Bogacz Fressola, Alicia Inoue, Yushi Targas Yacubian, Elza Marcia [UNIFESP] Wolf, Peter |
author_role |
author |
author2 |
Bittar Guaranha, Mirian Salvadori [UNIFESP] Conradsen, Isa Singh, Mamta Bhushan Rutar, Veronika Lorber, Bogdan Braga, Patricia Bogacz Fressola, Alicia Inoue, Yushi Targas Yacubian, Elza Marcia [UNIFESP] Wolf, Peter |
author2_role |
author author author author author author author author author author |
dc.contributor.institution.none.fl_str_mv |
Danish Epilepsy Ctr Univ Aarhus Universidade Federal de São Paulo (UNIFESP) Tech Univ Denmark All India Inst Med Sci Univ Med Ctr Ljubljana Inst Neurol Natl Epilepsy Ctr |
dc.contributor.author.fl_str_mv |
Beniczky, Sandor Bittar Guaranha, Mirian Salvadori [UNIFESP] Conradsen, Isa Singh, Mamta Bhushan Rutar, Veronika Lorber, Bogdan Braga, Patricia Bogacz Fressola, Alicia Inoue, Yushi Targas Yacubian, Elza Marcia [UNIFESP] Wolf, Peter |
dc.subject.eng.fl_str_mv |
Cognitive tasks EEG Juvenile myoclonic epilepsy External modulation Reflex epilepsy Photoparoxysmal response |
topic |
Cognitive tasks EEG Juvenile myoclonic epilepsy External modulation Reflex epilepsy Photoparoxysmal response |
description |
Purpose: Previous studies have suggested that cognitive tasks modulate (provoke or inhibit) the epileptiform electroencephalography (EEG) discharges (EDs) in patients with juvenile myoclonic epilepsy (JME). Their inhibitory effect was found to be especially frequent (6490%). These studies arbitrarily defined modulation as a >100% increase or >50% decrease of the EDs compared with baseline, which may not sufficiently distinguish from spontaneous fluctuations. the aim of our study was to assess the modulation of EDs and the precipitation of myoclonic seizures by cognitive tasks and by conventional provocation methods, taking into account also the spontaneous fluctuation of EDs. Method: Sixty patients with JME underwent video-EEG recordings including 50-min baseline, sleep, hyperventilation, intermittent photic stimulation (IPS), and cognitive tasks. To account for spontaneous fluctuations of the EDs we divided the baseline period into 5-min epochs and calculated the 95% confidence interval for the baseline EDs in each patient. Modulation was assumed when the number of EDs during any 5-min test period was outside the 95% confidence interval. Key Findings: Using the arbitrary method, our results were similar to previous publications: Cognitive tasks seemed to inhibit the EDs in 94% of the patients, and to provoke them in 22%. However, when the spontaneous fluctuations were accounted for, inhibition was found in only 29% of the patients and provocation in 18%. A nonspecific effect of any cognitive task seemed to account for the observed significant inhibition in two-thirds of the cases, but was observed in only one of the patients with significant provocation. Photoparoxysmal response was observed in 23% of the patients. When accounting for the spontaneous occurrence of EDs, IPS had provocative effect in 10% of the patients. Hyperventilation and sleep had provocative effect on EDs to an extent similar to the cognitive tasks (hyperventilation: 22%; sleep: 18%). the conventional provocation methods tended to be more efficient in patients who were not seizure free. Myoclonia were recorded most often during the cognitive tasks (10 patients). Significance: Spontaneous fluctuations of EDs account for most of the previously described inhibitory effect of the cognitive tasks. the provocative effect of the cognitive tasks is task-specific, whereas the inhibitory effect seems to be related to cognitive activation in general. |
publishDate |
2012 |
dc.date.issued.fl_str_mv |
2012-05-01 |
dc.date.accessioned.fl_str_mv |
2016-01-24T14:27:09Z |
dc.date.available.fl_str_mv |
2016-01-24T14:27:09Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Epilepsia. Malden: Wiley-Blackwell, v. 53, n. 5, p. 832-839, 2012. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/34821 http://dx.doi.org/10.1111/j.1528-1167.2012.03454.x |
dc.identifier.issn.none.fl_str_mv |
0013-9580 |
dc.identifier.doi.none.fl_str_mv |
10.1111/j.1528-1167.2012.03454.x |
dc.identifier.wos.none.fl_str_mv |
WOS:000303195200013 |
identifier_str_mv |
Epilepsia. Malden: Wiley-Blackwell, v. 53, n. 5, p. 832-839, 2012. 0013-9580 10.1111/j.1528-1167.2012.03454.x WOS:000303195200013 |
url |
http://repositorio.unifesp.br/handle/11600/34821 http://dx.doi.org/10.1111/j.1528-1167.2012.03454.x |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.none.fl_str_mv |
Epilepsia |
dc.rights.driver.fl_str_mv |
http://olabout.wiley.com/WileyCDA/Section/id-406071.html info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
http://olabout.wiley.com/WileyCDA/Section/id-406071.html |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
832-839 |
dc.publisher.none.fl_str_mv |
Wiley-Blackwell |
publisher.none.fl_str_mv |
Wiley-Blackwell |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
|
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1802764187824291840 |