tag:blogger.com,1999:blog-2165188460692654062024-03-05T11:38:57.486-08:00Neurophysiology Plus IcelandInformal Group and community on Clinical Neurophysiology in IcelandUnknownnoreply@blogger.comBlogger18125tag:blogger.com,1999:blog-216518846069265406.post-28725547958835334882021-04-21T13:17:00.004-07:002021-04-21T14:04:53.836-07:00A new method of surgically treated nerve lesion recovery is used in Iceland<h1 style="text-align: left;">Peripheral nerve injury recovery is assessed in small mammals with nerve conduction studies </h1><p>Possible research work with an Icelandic company which promotes technologies of regenerative biological tissues, the use of fish skin and fatty acids in the cellular-therapy</p><div style="text-align: left;"><span style="font-size: x-small;">Ovidiu C. Banea<br />21.04.2021, Reykjavik</span></div><p style="text-align: justify;">Motor neurography of the sciatic nerve to right gastrocnemian muscle was used successfuly in a laboratory mouse (<i>Mus musculus</i>) and a laboratory white rat (<i>Rattus norvegicus</i>) on 21st of April 2021. The technique was performed by Ovidiu C. Banea (neurophysiologist) and the Aron Jónasson (biologist) at invitation of Svava Kristinsdóttir, a research scientist from <a href="https://www.kerecis.com/" target="_blank">Kerecis</a> and Dr Ingvar H. Ólafsson, neurosurgeon who collaborate with the company.</p><p style="text-align: justify;">The nerve microsurgery (microscope) and preparations were performed by Dr Kristín Lilja Eyglóardóttir (Neurosurgeon) and Dr Baldur Tumi Baldursson (Dermatologist). </p><p style="text-align: justify;">The "<i><b>in vivo</b></i>" motor neurography (nerve conduction study) in an anesthetized laboratory small mammal, might be a summation as a quantitative recovery measurement in a broader Icelandic research project. </p><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjO87uyjW1ZKVIKTJB7KXEDdKoUhn9r9Wc-th13OlmBhqBfXCR4O6TksiegQldzMA4SNflESJqvwu3WaEKdu6LYszxZYzQ8QQCiJu2NcD800MifyKLnl9YnZPz3ilpFKeabmPuaFUWHtKmD/s960/175955342_847328229187234_1830864593589859045_n.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="797" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjO87uyjW1ZKVIKTJB7KXEDdKoUhn9r9Wc-th13OlmBhqBfXCR4O6TksiegQldzMA4SNflESJqvwu3WaEKdu6LYszxZYzQ8QQCiJu2NcD800MifyKLnl9YnZPz3ilpFKeabmPuaFUWHtKmD/s320/175955342_847328229187234_1830864593589859045_n.jpg" /></a></div><div class="separator" style="clear: both; text-align: center;">Motor neurography, <i>Mus musculus</i> 10-20 minutes after e.</div></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhd6dkdRDp3XynoFO97aiSM0G5lz1Rw7oCqZIr00xfjfTNE4YnMqmoiI8-yE7i49HVSJeBI3Z1daIDMicR11FEf4Djv30GYshYj2tgqlGFryw_8AyHHaNpZ2FGqu012WLnDaItkNcWEpz5t/s960/176361192_847328192520571_6637954603995537479_n.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="605" data-original-width="960" height="253" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhd6dkdRDp3XynoFO97aiSM0G5lz1Rw7oCqZIr00xfjfTNE4YnMqmoiI8-yE7i49HVSJeBI3Z1daIDMicR11FEf4Djv30GYshYj2tgqlGFryw_8AyHHaNpZ2FGqu012WLnDaItkNcWEpz5t/w400-h253/176361192_847328192520571_6637954603995537479_n.jpg" width="400" /></a></div><div class="separator" style="clear: both; text-align: center;">CMAP from gastrocnemian muscle of euthanized <i>Mus musculus</i>,</div><div class="separator" style="clear: both; text-align: center;">Amplitude 35uV, Latency 2.5 ms.</div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgk_uLi2gsm5ouXPff26J_pMabB_wkmWMkuPEHE1dN4P0VXO3eCr8GkpKwn4Drmtk0zge_gYqFfrfTlfvIw9xsbVdXofh0Bc7pMliWHCwuBAxhyJKpMIHKjzXuLPrp-GZDnuuFpghG-opJW/s960/176258229_847328382520552_741170133239468632_n.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="684" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgk_uLi2gsm5ouXPff26J_pMabB_wkmWMkuPEHE1dN4P0VXO3eCr8GkpKwn4Drmtk0zge_gYqFfrfTlfvIw9xsbVdXofh0Bc7pMliWHCwuBAxhyJKpMIHKjzXuLPrp-GZDnuuFpghG-opJW/s320/176258229_847328382520552_741170133239468632_n.jpg" /></a></div><div class="separator" style="clear: both; text-align: center;">Performing technique in euthanized <i>Rattus norvegigus</i></div><div class="separator" style="clear: both; text-align: center;"><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBojyerAaN3Ig1Gu3QNbMIS0fDxtrjlRarI5KI0IaVuWQJ0HH2VzIyml4i3bymb8qxHbIgqFgqK2e6w2o24sSPwIlxhcSNpqkXupGbBmU0A2iDC1SB4A-JeXTshoLhhL3MjhHck9BVZdqL/s960/175950986_847328302520560_7597234943598562116_n.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="668" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBojyerAaN3Ig1Gu3QNbMIS0fDxtrjlRarI5KI0IaVuWQJ0HH2VzIyml4i3bymb8qxHbIgqFgqK2e6w2o24sSPwIlxhcSNpqkXupGbBmU0A2iDC1SB4A-JeXTshoLhhL3MjhHck9BVZdqL/s320/175950986_847328302520560_7597234943598562116_n.jpg" /></a></div><div class="separator" style="clear: both; text-align: center;">Dr Kristín Lilja Eyglóardóttir, </div><div class="separator" style="clear: both; text-align: center;">performing end-to-end neurorrhaphy of sciatic nerve "<i><b>in vivo</b></i>", </div><div class="separator" style="clear: both; text-align: center;"><i>Rattus norvegicus</i>, anesthesia with Isoflurane</div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: justify;">It seems that end-to-side suture and end-to-end suturing appear to result in equivalent axon regeneration at 12 weeks, end-to-end at 6 weeks showing better axon regeneration rate, which may reduce target organ muscle atrophy (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5950681/" target="_blank">Tateshita et al, 2018</a>).</div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-216518846069265406.post-34222218504957992712020-01-23T06:52:00.003-08:002020-01-23T06:52:31.111-08:00Coherence EEG Journal Club meeting<div dir="ltr" style="text-align: left;" trbidi="on">
At Fossvogur, 24.01.2019 Kl 16:00<br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-216518846069265406.post-913124522756707432019-12-13T06:57:00.000-08:002020-03-10T02:20:36.834-07:00Road map for TMS and schizophrenia project in Iceland<div dir="ltr" style="text-align: left;" trbidi="on">
Reykjavík University, Iceland<br />
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<span style="font-size: x-small;">by Ovidiu C. <a href="mailto:ovidiubanea@gmail.com" target="_blank">Banea</a></span><br />
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On June 2018 a project dedicated to schizophrenia patients with auditory verbal hallucinations and their treatment with trans-cranial magnetic stimulation started in Iceland. </div>
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The perfect coordination between researchers from Kleppur Psychiatric Hospital, Biomedical and Neural Engineering Institute at Reykjavík University, School of Business - Department of Psychology, National Institute of Neurological Disorders and Stroke (NINDS) Bethesda, United States and Clinical Neurophysiology Unit from National University Hospital - Landspítali Iceland made possible the recruitment and treatment of 12 patients with consequent analyses with multi-metric approach.</div>
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Measurements of the brain activity was performed before and after the treatment with P50, N100-P300 complex, resting state and auditory motor-task with 256 High Density-EEG recordings, cortical silent period and psychometric scales.</div>
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The team could organize and present their methodology, results and preliminary data in 14 original works during several local and international meetings in France, Japan, Poland, Portugal and Austria (see all works <a href="https://sites.google.com/view/schizophreniaplus/publications-news" target="_blank">here</a>).</div>
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On 13th of December we met at Reykjavik University and we discussed the detailed of the most important aspects of the <a href="https://sites.google.com/view/schizophreniaplus/home-page" target="_blank">AVH-TMS Icelandic Clinical trial</a> - publishing the results in a peer review international journals. Two teams were formed, one at Reykjavik University and one at University National Hospital. The first team will process event related potential results at BNE and the second team will put together all data obtained at Fossvogur Landspítali and at Kleppur Psychiatric Hospital. By the end of January 2020 the process structure and software analyses will start.</div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-216518846069265406.post-71850774540746181472019-11-01T04:44:00.000-07:002019-11-01T05:25:45.004-07:00Assessment of the lower limb weakness and suspected amyotrophic lateral sclerosis<div dir="ltr" style="text-align: left;" trbidi="on">
A patient with suspected motor neuron disease (MND or ALS) was assessed with TMS in our Unit in Iceland <a href="https://drive.google.com/file/d/1CeryMdxlfFZflU-phGHUu8SDMexnO7O_/view" target="_blank">here</a>. There were no signs of EMG criteria. We further investigated with TMS and it seems that there is a lower spinal level delay of the central motor conduction.<br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-216518846069265406.post-87109166940208157362019-04-08T09:34:00.003-07:002019-04-08T09:36:40.211-07:00FIRST HEILA VISTFRÆÐI JOURNAL CLUB MEETING<div dir="ltr" style="text-align: left;" trbidi="on">
Possible evidence of human ability to detect Earth's magnetic field found <a href="https://www.google.com/url?q=https%3A%2F%2Fwww.biorxiv.org%2Fcontent%2Fbiorxiv%2Fearly%2F2018%2F10%2F20%2F448449.full.pdf&sa=D&sntz=1&usg=AFQjCNFpdUCc6Vgkrv1iPgFcfdvtCmVQlw">HERE</a>.<div>
First Journal Club Meeting at Reykjavik, Iceland</div>
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We talk about the 6th human sense, MAGNETO-RECEPTION IN HUMANS<br /><div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-216518846069265406.post-50202616215254659322019-01-24T06:42:00.001-08:002019-01-24T08:11:41.395-08:00D wave IONM in Iceland. Third case: Meningocele<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="https://www.blogger.com/null" name="MED020202000004S"></a><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB" style="background: teal; color: #eaf1dd; font-family: "calibri" , "sans-serif"; font-size: 16.0pt;">IONM
for medular herniation at T5 level</span></b><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB" style="background: silver; color: #4f6228; font-family: "calibri" , "sans-serif"; font-size: 16.0pt;">
Use of D-wave<span style="mso-spacerun: yes;"> </span></span></b></div>
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<a href="https://youtu.be/JGCc3B2qZEo" target="_blank">HERE</a><br />
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Ovidiu C. Banea, Halldór Skúlasson, Ingvar H. Ólafsson, Aron D. Jónasson and Eysteinn Ívarsson<br />
<span style="white-space: pre;"> </span><br />
52 y.o. with meningocele.<br />
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Modalities:<br />
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MEP with direct cortical stimulation (560 V to the left and 890 V to the right) with train of five from C1-C2 and C3-C4 to:<br />
- Right EDC, APB, TA, AH<br />
- Left APB, TA, AH<br />
SSEP were performed from lower tibialis nerve and recorded to FpZ-Cz´ and from median nerves to Fpz-C3´ and Fpz-C4´. Both were controlled at popliteal fossa level (TN) and spinal C7 (TN and MN).<br />
D wave was obtained rotral and caudal to the defect with D-wave electrodes after stimulation at 1Hz continuously (199V)<br />
TOF was used from rioght median nerve to right APB. was 100-99% during the entire surgery.<br />
EEG was analized from C4´-Fpz and Fpz-C3´channels.<br />
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Results:<br />
At the beginning of the surgery MEP was obtained in the upper limbs and left lower limb muscles. Right AH muscle was very difficult to elicit with 890 V, while TA in the right side was not obtained. At the end of the surgery the MEP were similar with those obtained at the beginning.<br />
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<a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a>SSEP showed normal latencies during all the procedure. At the middle of the surgery, SSEP from right TN decreased 10-20% in amplitude. Rapidly we confirmed the decreased TA when asked the anaesthesiologist. After 5 minutes the SSEP recovered baseline values.<br />
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D-Wave was unchanged during all the spine manipulations and the defect corrective procedures.<br />
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Conclusion:<br />
The IONM was successful and all modalities showed normal evolution. We do not expect sensory or motor new neurological deficits.<br />
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Technical data:<br />
-Surgery duration 4,5 hours.<br />
-Material: 11 subdermal needle paired electrodes, 4 monopolar subdermal needle electrodes, 2 D-wave electrodes, 8 Cork-screw electrodes, 1 ground electrode.<br />
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<a href="https://sites.google.com/view/neurophysiologyplus/neurophysiology-plus-ebulletin" target="_blank">Neurophysiology Plus Iceland <span style="color: #545454; font-family: "arial" , sans-serif; font-size: x-small;">© 2019</span></a><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3B4hMfM5b13N8bu1xFGbjXOHd_-mic3yUNOMHhsXDWuOv8kRykn1BH-GdL3p3Opdfbn1JPflABuUW2SFIMx52zotOe3Nw3wMgrgJ4Jqm8WVllntNIUY4h8M_QmH8TscPMkKYSEsgeBNRZ/s1600/D+wave+1.PNG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="572" data-original-width="395" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3B4hMfM5b13N8bu1xFGbjXOHd_-mic3yUNOMHhsXDWuOv8kRykn1BH-GdL3p3Opdfbn1JPflABuUW2SFIMx52zotOe3Nw3wMgrgJ4Jqm8WVllntNIUY4h8M_QmH8TscPMkKYSEsgeBNRZ/s320/D+wave+1.PNG" width="220" /></a></div>
<div class="MsoNormal">
<span lang="EN-GB">Meningocele at T5 level.</span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiczBYVId6f0CHZuCThJFPElYu4thjuCBwEiTBjhJXqkAcdgKJOzWhRtfSE4NI5LTLt-yFCNaTLx7maHa4397p_5egmBcheyZO2apXrOTLV-Hh8fQLWN7VR2wKeYPq02NEnhsoWKYAgPcF/s1600/D+wave+2.PNG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="404" data-original-width="616" height="209" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiczBYVId6f0CHZuCThJFPElYu4thjuCBwEiTBjhJXqkAcdgKJOzWhRtfSE4NI5LTLt-yFCNaTLx7maHa4397p_5egmBcheyZO2apXrOTLV-Hh8fQLWN7VR2wKeYPq02NEnhsoWKYAgPcF/s320/D+wave+2.PNG" width="320" /></a></div>
After surgery.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjMUboUAZwtlyCqyFBL8jutI498mwlDT4VnM22l5VcyLBwn1ps3yYYzz3t71Qbaazh9UWwgAIQL3-aCJuaZaRRnJhzRaBc7ILc8clV6ij3RboV-3NOTbn_kSi_cKx6nNK92tf8RmOT5EKi9/s1600/D+wave+3.PNG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="698" data-original-width="978" height="228" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjMUboUAZwtlyCqyFBL8jutI498mwlDT4VnM22l5VcyLBwn1ps3yYYzz3t71Qbaazh9UWwgAIQL3-aCJuaZaRRnJhzRaBc7ILc8clV6ij3RboV-3NOTbn_kSi_cKx6nNK92tf8RmOT5EKi9/s320/D+wave+3.PNG" width="320" /></a></div>
SSEP upper and lower limbs<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbDwZcnAOxuCwji52wbRowl7Uc_t4rs2AyT2YPW75WaJOFloBUKf9s_7_D7y29WxK_ZrV1D6uMvhXvt7vjnb_8-ayHQa1kq-2rjBzuVIfdGH8Cbc6Ce08bBLvyGc_Y9zc3rIEwFnlzQCHC/s1600/D+wave+4.PNG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="392" data-original-width="1031" height="121" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbDwZcnAOxuCwji52wbRowl7Uc_t4rs2AyT2YPW75WaJOFloBUKf9s_7_D7y29WxK_ZrV1D6uMvhXvt7vjnb_8-ayHQa1kq-2rjBzuVIfdGH8Cbc6Ce08bBLvyGc_Y9zc3rIEwFnlzQCHC/s320/D+wave+4.PNG" width="320" /></a></div>
MEP in lower limbs<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNSzkVvK0_jGyKXrjCmEVe9CwfMhVX73WbKidPL4FmL5-xtZYs8Zxyist8ay8NI_hPpdDIER5XrcAIiMrxTsl7OFZhcMhYYrxC7mphemZVIIpu2uN3tnr389oLfyEkB2MEBALFMTB4BJdc/s1600/D+wave+5.PNG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="579" data-original-width="518" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNSzkVvK0_jGyKXrjCmEVe9CwfMhVX73WbKidPL4FmL5-xtZYs8Zxyist8ay8NI_hPpdDIER5XrcAIiMrxTsl7OFZhcMhYYrxC7mphemZVIIpu2uN3tnr389oLfyEkB2MEBALFMTB4BJdc/s320/D+wave+5.PNG" width="286" /></a></div>
D wave: left rostral and right caudal<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgf8jE8OG2EzbGcKZyvlt4ajlvOHuVR9IsUPzMbY5lRVH3Tm0VP_VsCdRF5iUbq4w5crDrIg87yA3Hb1U7DkzdFf-ivu7Hf-TB4Ik68CbiXeoZWV2Ju9DxAanaycNGiAWAfRlnE5frbG-eF/s1600/D+wave+6.PNG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="348" data-original-width="613" height="181" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgf8jE8OG2EzbGcKZyvlt4ajlvOHuVR9IsUPzMbY5lRVH3Tm0VP_VsCdRF5iUbq4w5crDrIg87yA3Hb1U7DkzdFf-ivu7Hf-TB4Ik68CbiXeoZWV2Ju9DxAanaycNGiAWAfRlnE5frbG-eF/s320/D+wave+6.PNG" width="320" /></a></div>
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<span lang="EN-GB">D wave: upper trace rostral, lower trace caudal. Latency 5-6 ms and amplitude 8uV.</span></div>
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<a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><span lang="EN-GB">The reference electrode was placed between two electrodes. (phase reversed peak).</span></div>
<div class="MsoNormal">
<a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="https://www.blogger.com/blogger.g?blogID=216518846069265406" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><span lang="EN-GB">It would be useful to reference both electrodes to a proximal sub-dermal well inserted electrode.</span></div>
</div>
Unknownnoreply@blogger.com0Reikiavik, Islandia64.146582 -21.94263539999997264.035742 -22.265358899999971 64.257421999999991 -21.619911899999973tag:blogger.com,1999:blog-216518846069265406.post-15257794114262702142018-08-13T03:54:00.002-07:002018-08-13T03:55:08.226-07:00VAFO project Iceland, QEEG, P50, P300 recordings<div dir="ltr" style="text-align: left;" trbidi="on">
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On 11th of August 2018 VAFO project started officially with the first healthy subject data acquirement in the Icelandic Center for Neurophysiology, Department of Biomedical Engineering, Reykjavik University.</div>
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Valerio Gargiulo, Fabio Barollo, Eysteinn Ívarsson and Martin Freiler</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnkgs3vOTYa2acjprMaiW6E6flZHxxvUYu-AoDTJpF3WbYtQnxRMFC_VUsWWFzJL-OxFI5ck8J9Zi2MQUUsH-BpCPxpSkLpL6btSmECIRfmZH88kByiAFZ6ape0bJoSySeylTXUHy9ZdEm/s1600/20180810_121626.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="1200" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnkgs3vOTYa2acjprMaiW6E6flZHxxvUYu-AoDTJpF3WbYtQnxRMFC_VUsWWFzJL-OxFI5ck8J9Zi2MQUUsH-BpCPxpSkLpL6btSmECIRfmZH88kByiAFZ6ape0bJoSySeylTXUHy9ZdEm/s320/20180810_121626.jpg" width="240" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZeC-Ct0O2Wj3RA9weH_mh_0Ag9SlN5nkZK_lBN_ixwJ76kMYeUjPWLBRLJ3QyM67wRlB4ol9wVgXywrLEp110GiG6mORa9BatN7q9yPxc8uWUjUYHKDsvCecHq63OJn_8nulHNsbJgzLS/s1600/20180810_124113.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1200" data-original-width="1600" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZeC-Ct0O2Wj3RA9weH_mh_0Ag9SlN5nkZK_lBN_ixwJ76kMYeUjPWLBRLJ3QyM67wRlB4ol9wVgXywrLEp110GiG6mORa9BatN7q9yPxc8uWUjUYHKDsvCecHq63OJn_8nulHNsbJgzLS/s320/20180810_124113.jpg" width="320" /></a></div>
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Dr Sigurjón Stefánsson gave us important insights on methodology of P50 and P300. </div>
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Continuous averaging is still a desired EEG system option to avoid artifacts during recordings.</div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-216518846069265406.post-44073792506978947872018-08-09T16:06:00.000-07:002018-08-09T16:12:48.672-07:00VAFO project Iceland: P50, P300, QEEG objective measurements for schizophrenia patients<div dir="ltr" style="text-align: left;" trbidi="on">
by <a href="https://sites.google.com/view/neurophysiologyplus/home" target="_blank"><b>Neurophysiology Plus Iceland</b></a><br />
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Reykjavik, 9th of August 2018<br />
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A team of young researchers leaded by biomedical engineer Dr Paolo Gargiulo, from Reykjavík University, Department of Biomedical Engineering performed successfully the first data acquiring for a healthy subject recording P300, P50 and dense array 256-channel EEG.<br />
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P300 was first used in Iceland by Sigurjón B. Stefánsson and Anna L. Möller since the nineties.<br />
Scientific data was published in <a href="https://ac.els-cdn.com/S1350453396000355/1-s2.0-S1350453396000355-main.pdf?_tid=6147b0fb-9630-4c51-9e40-383787f24c5e&acdnat=1533850185_8253f46bff0b4921f64a0d193f9d87a1" target="_blank">1995</a> and <a href="https://bpspubs.onlinelibrary.wiley.com/doi/epdf/10.1046/j.0306-5251.2001.01486.x" target="_blank">2001</a> and <a href="https://www.tandfonline.com/doi/pdf/10.1080/08039480600790119" target="_blank">2005</a>.<br />
In July 2017 P300 returned to Iceland in Clinical Neurophysiology Unit of Landspitali (<a href="http://neurophysiologyplus.blogspot.com/2017/07/p300-returns-to-iceland.html" target="_blank">here</a>).<br />
P50 was acquired first time in patient with tinnitus on 20th of February 2018 in a paired-stimulus<br />
or conditioning-testing paradigm, (S1, conditioning click; S2, testing click; 500 ms inter-click interval; 10,000 ms inter-pair interval). This was a trial of 30 paired stimulus with sensory gating with stimulus in the left and observed from Cz-A2 (right cortex) and with absent wave and response from the left Cz-A1 channel when stimulus was applied for the right ear.<br />
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Today the team formed by:<br />
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Viktor Díar Jónasson, Clinical Psychology master student at the Department of Psychology, Reykjavik University<br />
Fabio Barrolo, PhD student at Reykjavik University Iceland / Aston University, Birmingham, UK, Biomedical Engineering<br />
Valerio Gargiulo, Research assistant at the Icelandic Center for Neurophysiology, legal advisor and EEG technologist at Department of Biomedical Engineering, Reykjavík University<br />
Eysteinn Ívarsson, Psychologist and technologist at Clinical Neurophysiology Unit, National University Hospital of Iceland<br />
Ovidiu Banea, PhD student at Reykjavík University, Department of Biomedical Engineering and Clinical Neurophysiologist MD at National University Hospital of Iceland<br />
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performed both P300 and P50 acquisition with dense array 256 channel EEG system at the Icelandic Center for Neurophysiology, Department of Biomedical Engineering, Reykjavík University<br />
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<iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dxVA1_c6xSdQVSJ_uVevk1WZrd-6etMKL8sNotiZ2su2fJM0VZrVR2TK0LW8iGSy1oy-5uWkP3Ej7yXzkr7fw' class='b-hbp-video b-uploaded' frameborder='0'></iframe></div>
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Video on <a href="https://youtu.be/RMYIQK3I7Nw" target="_blank">YouTube</a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihw9G_Lzz0xZ19I7DPLPK6JYcyTczN_wweAY_rPKQc2OyDXmceoAX5Hyk8zUqMpatIY8ra9kfxrjqXZKbSLEJ0F-qBUstZ6_ZjcS8QMuWP-svsJYETBAeP9g6dGhrrM8dv-yp-YepDgLcs/s1600/256+EEG+dense+array.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="1200" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihw9G_Lzz0xZ19I7DPLPK6JYcyTczN_wweAY_rPKQc2OyDXmceoAX5Hyk8zUqMpatIY8ra9kfxrjqXZKbSLEJ0F-qBUstZ6_ZjcS8QMuWP-svsJYETBAeP9g6dGhrrM8dv-yp-YepDgLcs/s320/256+EEG+dense+array.jpg" width="240" /></a></div>
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artifact removal process, 256 channels EEG raw data</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuhUoiC7Q8MpDfMnUTLl6uIyGyJI1w6C3_Ur7IF7QRUCJ_QTWxJ262Jc-GS5vhpbr-eBnHT6M9PlIS4pdva31FrRyEyiKtXSQMDvGQNrFnex1lWUzwmQQ_zlgsePewqB19OKaySowZVS7D/s1600/20180809_152210.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1200" data-original-width="1600" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuhUoiC7Q8MpDfMnUTLl6uIyGyJI1w6C3_Ur7IF7QRUCJ_QTWxJ262Jc-GS5vhpbr-eBnHT6M9PlIS4pdva31FrRyEyiKtXSQMDvGQNrFnex1lWUzwmQQ_zlgsePewqB19OKaySowZVS7D/s320/20180809_152210.jpg" width="320" /></a></div>
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256 brain P50 map and selection of the 4 representatives lines</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4cIWUAhDnrhttZ6E2jb9M_noGnm_n6ZWFgt8WNm2nZ-GTG_Bv5nXnx6ob1up3hE-rZCEEQw3kO56fnr04-_pIq8Dqp_NBjGUJR-WLIM6qHYqLfRbO2pucStoI6b96C2K-1ZzVjT8ixA5I/s1600/Eysteinn+and+Valerio+VAFO.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="801" data-original-width="867" height="295" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4cIWUAhDnrhttZ6E2jb9M_noGnm_n6ZWFgt8WNm2nZ-GTG_Bv5nXnx6ob1up3hE-rZCEEQw3kO56fnr04-_pIq8Dqp_NBjGUJR-WLIM6qHYqLfRbO2pucStoI6b96C2K-1ZzVjT8ixA5I/s320/Eysteinn+and+Valerio+VAFO.JPG" width="320" /></a></div>
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Valerio Gargiulo, Viktor Díar Jónasson, Eysteinn Ívarsson</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiia0K7p6R6E12Aow4q-IA40LdELAFofbr0h9o6gyNO6cB704pF0ayvplB4zCuIfIMkDEG6VYy2P5l_af1gbss99lZxvMyeDazvTyDS_9uM7ipDSBtOXaq2IYpOH6rJpSw-dFf9yNLMsGa8/s1600/Fabio+VAFO.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1200" data-original-width="1600" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiia0K7p6R6E12Aow4q-IA40LdELAFofbr0h9o6gyNO6cB704pF0ayvplB4zCuIfIMkDEG6VYy2P5l_af1gbss99lZxvMyeDazvTyDS_9uM7ipDSBtOXaq2IYpOH6rJpSw-dFf9yNLMsGa8/s320/Fabio+VAFO.jpg" width="320" /></a></div>
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Fabio Barollo</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPbeOhb8TQBfBBfUWzWAGM8TNG9G-s-33CSVO6zd9bwa1Hpd5zZh80fc4B7vsELo6ANWAnwkkSxe2h-bNCws6szPLv6Kt1PL3PrOsJf2UvU8dB5YUP9Pbgq9-eTl2bfsa6WriNwu24Jto0/s1600/Ovi+VAFO+pilot+study.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="1200" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPbeOhb8TQBfBBfUWzWAGM8TNG9G-s-33CSVO6zd9bwa1Hpd5zZh80fc4B7vsELo6ANWAnwkkSxe2h-bNCws6szPLv6Kt1PL3PrOsJf2UvU8dB5YUP9Pbgq9-eTl2bfsa6WriNwu24Jto0/s320/Ovi+VAFO+pilot+study.jpg" width="240" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgFJbkH-fMoqUhC0oq5Ao3MKcdJ8MotLr-_ckgOqFkfBlVyZ_WSNlgnsQuEsc3L53xoM9YWtI9CGFiUSDBH0J0H5GS_n6DE4tqYOeWg2RLIY9SCi-dBISqDctl3U4hASL7dsv964WOQUZW/s1600/P50_pilot.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="927" data-original-width="1434" height="206" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgFJbkH-fMoqUhC0oq5Ao3MKcdJ8MotLr-_ckgOqFkfBlVyZ_WSNlgnsQuEsc3L53xoM9YWtI9CGFiUSDBH0J0H5GS_n6DE4tqYOeWg2RLIY9SCi-dBISqDctl3U4hASL7dsv964WOQUZW/s320/P50_pilot.JPG" width="320" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhKN0ftlbwx2rJlDR8SXIRcMsT4AW4kTCloY6sxE3c95kJ_qFxbl4HEh6bxG8mQW6aKC9FyRexSVI4gXM5qhfzRjPhUMp7JGNVPEarQcol7ak3mgII5C7zoyXhLCiapV2EjTrLucxV3YW6w/s1600/P50_pilot_4elc2.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="906" data-original-width="1420" height="204" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhKN0ftlbwx2rJlDR8SXIRcMsT4AW4kTCloY6sxE3c95kJ_qFxbl4HEh6bxG8mQW6aKC9FyRexSVI4gXM5qhfzRjPhUMp7JGNVPEarQcol7ak3mgII5C7zoyXhLCiapV2EjTrLucxV3YW6w/s320/P50_pilot_4elc2.JPG" width="320" /></a></div>
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P 50 experimental</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-5nsxd_PnwKPFp3VKUXj1sMA_Ffheie7xFYLHmnVZgsxg8JbVkBnnsKwLNFhbzb4ty9RbpAv1KS9MUVrAsj0clu-nbfRCKD3hHgFoVo65n8kDlsPkVqNtV0Whj42DUkJPzJOQgaGLqyrR/s1600/P300_pilot.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="886" data-original-width="844" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-5nsxd_PnwKPFp3VKUXj1sMA_Ffheie7xFYLHmnVZgsxg8JbVkBnnsKwLNFhbzb4ty9RbpAv1KS9MUVrAsj0clu-nbfRCKD3hHgFoVo65n8kDlsPkVqNtV0Whj42DUkJPzJOQgaGLqyrR/s320/P300_pilot.JPG" width="304" /></a></div>
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P300 experimental</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgA_AHPWmOVqquZdtaKOCNts9_ejYs2buzB9MfxlJA-Jsg7aJ2xp3Xi0CZvV3r3DvxRMOd4ES2Ypb6ZPM0tyiUsz-rjVA7phUGbxj26ojfoMWAxha8mfBSkh0BxjUyhM3UVwAD-T6lwJDGe/s1600/Valerio+Ovi+VAFO.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="488" data-original-width="268" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgA_AHPWmOVqquZdtaKOCNts9_ejYs2buzB9MfxlJA-Jsg7aJ2xp3Xi0CZvV3r3DvxRMOd4ES2Ypb6ZPM0tyiUsz-rjVA7phUGbxj26ojfoMWAxha8mfBSkh0BxjUyhM3UVwAD-T6lwJDGe/s320/Valerio+Ovi+VAFO.JPG" width="175" /></a></div>
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256 channel dense array EEG, set-up</div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-216518846069265406.post-27075468395750830602018-05-18T13:34:00.000-07:002018-05-22T06:54:48.089-07:00Yanny and Laurel explanation<div dir="ltr" style="text-align: left;" trbidi="on">
Two days ago a <a href="http://www.bbc.com/news/av/world-44151302/yanny-or-laurel-the-sound-dividing-the-internet" target="_blank">BBC news</a> announce that the computer generated word "Laurel" produced an internet debate if this is heard as "laurel" or "yanny".<br />
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<a href="https://www.nytimes.com/2018/05/15/science/yanny-laurel.html" target="_blank"><img border="0" data-original-height="840" data-original-width="1442" height="186" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgIF9NnxshrzhgHh7_9jldbj79OeHTEVZ-euFOEevEbJIvCHcj2QKrqem00KW9KsnS7WKl4GlW1vHjsem8HRIb_-UZU8VCcUlryKeDSipPrHoOThElg-gY3e0kn9xo6UL2wyptkfXgHV1oi/s320/Yanny+%2526+Laurel.jpg" width="320" /></a></div>
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<a href="https://www.nytimes.com/2018/05/15/science/yanny-laurel.html" target="_blank"><img border="0" data-original-height="238" data-original-width="747" height="101" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhpCERKkbtE5I3p_WccJ-cUzrfUOelwVbU54-SuvTp3TD-6AjlqtbqsSL0Is1BjtfJMVC_5lBL-ueQWU1fD8fF8tBpUeC19h5n913W6Pm56RBxwA3-IFzYkd2cQPBEBcNevS_By2GfXdHBU/s320/Yanny.jpg" width="320" /></a></div>
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The sound specialists run to explain how the humans are losing the higher frequencies listening ability with the age and this why we might listen the world with lower frequencies as is would be "laurel".<br />
I was listening the playback and for two days since the Head of Neurology Department and one colleague told me the story and the new internet debate news, I always had listen the "yanny" word.<br />
30 minutes ago I started to listen "laurel" word.<br />
Yes, I know the word was created by computer and is an artificial voice the human cannot reproduce. The sounds are fake and the frequency differences are very difficult to assess by a computer voice generator. I remember the applications when you press a word text and suddenly you could listen it. This happened more than 6-7 years ago. There was no tonality, no stops or pause between words, no comma. You had to do everything.<br />
But what happened to me? Why did I hear "laurel".<br />
I did something before changes occurred. And I said to me, yes.<br />
The gabaergic neurons from my cortex are weaker (the inhibitory mechanisms of my cortex were diminished by the substance intake) and the sub-cortical areas and temporal lobe auditory cortex or let us say the <a href="https://docs.google.com/presentation/d/1i3g7YOAVvYKhgLsYyjd19NAZvXRF3IYhEnh5Z1aOc2A/edit#slide=id.g2b7b4df0fb_0_408" target="_blank">auditory biological neural network</a> is now a little bit more "awake" and can hear the lower frequency. Or the higher frequencies are perceived with more glutamatergic (excitatory neurons) mechanisms? Is this known?<br />
<a href="http://www.jneurosci.org/content/37/37/8952" target="_blank">Ono <i>et al</i> 2017</a> found that responses to pure tones of both inhibitory and excitatory classes of neurons were similar in their thresholds, response latencies, rate-level functions, and frequency tuning, but GABAergic neurons may have higher spontaneous firing rates.<br />
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<a href="https://docs.google.com/presentation/d/1i3g7YOAVvYKhgLsYyjd19NAZvXRF3IYhEnh5Z1aOc2A/edit#slide=id.p" target="_blank"><img border="0" data-original-height="617" data-original-width="1112" height="177" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhI50TBGB_MKCmke6y30Ft2vkvJG24AcAUFUs05a_nbZRs0A0N_i1xiHZW_WTg-nq8c1fAbNUCCKPbK4JphqpZnFE13ydCVlh5Xomf30u6HD_eNhQUvyneloeLEuy5wxZN2tg7znNGwRWSJ/s320/Auditory+network.jpg" width="320" /></a></div>
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The auditory phantom perception biological neural network (BNN) </div>
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involved in the subjective tinnitus perception</div>
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Conclusion:<br />
The debate is easy: We are in front of unknown auditory perception mechanisms of a fake *artificial* sound. It seems that all is in our brain and that the gabaergic inhibitory mechanisms are involved. As much as you approach the freedom of the deeper brain structures (by forming gaps in the cortex "analytical" system) you will listen differently the word.<br />
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by <a href="https://sites.google.com/view/neurophysiologyplus/home" target="_blank">Neurophysiology Plus Iceland</a>, 18.05.2018<br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-216518846069265406.post-712957882237461542018-02-26T08:22:00.003-08:002018-02-26T08:24:06.492-08:00Cerebellopontine angle (CPA) mass IONM<div dir="ltr" style="text-align: left;" trbidi="on">
<b>by <a href="https://sites.google.com/view/neurophysiologyplus/home" target="_blank">Neurophysiology Plus</a> Iceland © 2018</b><br />
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<div class="MsoNormal" style="text-align: justify;">
IONM in 31 year-old male patient
with 43/41mm right cerebello-pontine angle (CPA) <span style="mso-spacerun: yes;"> </span>tumor</div>
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(e-Bulletin <a href="https://drive.google.com/file/d/1m8Lqs6Aysj6ZuEnHBSlhwLH1dfPco14s/view" target="_blank"><b>report</b></a>)</div>
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We performed the following
modalities:</div>
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Transcranial MEP, Corticogeniculate
MEP (CoMEP), SSEP from both tibialis nerve, EEG, mapping cranial nerves
(accesorius, hypoglossus, glosopharingeal, facialis ), BAEP, TOF, Blink Reflex.</div>
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<b style="mso-bidi-font-weight: normal;">Results: </b>All modalities could be performed with exception of blink
reflex which was not elicited.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></div>
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<b style="mso-bidi-font-weight: normal;">Incidents:</b> At the end of the surgery we observed decrement of right
facialis (<i style="mso-bidi-font-style: normal;">Orbicular oris</i> muscle), CoMEP
decrement of more than 80% which did not recover throughout the rest of the
surgery. Surgeons explained that "there was a bleeding around the
nerve". They started cooling,<span style="mso-spacerun: yes;">
</span>irrigate and "treat" the lesion.<span style="mso-spacerun: yes;"> </span>Mapping showed also partial decrement, but
recovered after 20 minutes when stimulation was performed proximally.</div>
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Our protocol for corticobulbar
MEP was double train: 1st train formed by 5 stimuli with 50 ms duration (ISI
2ms), 2nd train (single pulse 50 ms)<span style="mso-spacerun: yes;"> </span>ITI
(inter-train interval) 40 ms.</div>
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<b style="mso-bidi-font-weight: normal;">LIMIT:</b> The assessment was possible for the right <i style="mso-bidi-font-style: normal;">Orbicularis oris</i> muscle and slightly for
the right <i style="mso-bidi-font-style: normal;">Orbicularis oculi</i> muscle.
No responses were obtained from the left muscles (we didn´t increase the
stimulus intensity to look for the better Threshold-level ) and we consider the
absence of other muscle MEP ipsilaterally (e.g. mentalis) as a serious limit of
interpretation.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSkdSI4xWyeLfZr9-yeZfioeBzjomLGMmpsT8krBI72BNpc4z9jql7X47zplmZ-nXhNAajWmK5ve2A-zLbCQXxcNwUVsSsUgVM6zMa52ngL0fTZHNp1ZLf4Osr84tMEEVf3ln5YNv7C6Pw/s1600/Axial.PNG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="737" data-original-width="707" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSkdSI4xWyeLfZr9-yeZfioeBzjomLGMmpsT8krBI72BNpc4z9jql7X47zplmZ-nXhNAajWmK5ve2A-zLbCQXxcNwUVsSsUgVM6zMa52ngL0fTZHNp1ZLf4Osr84tMEEVf3ln5YNv7C6Pw/s320/Axial.PNG" width="306" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh5MMXO-RWOZ3dME9EIu8h_3qvxoeh5lBNJbHsJ9TSWtF3Jo827PK9HL-2H77jeRdmWSyhxjaj-KyDHZhPMaD4Qkw9u7dno0o8KBoeu7b3-pzG1kbH_dzAOCdr9FrplsLM-5CQCbLl34ot8/s1600/Coronal.PNG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="672" data-original-width="556" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh5MMXO-RWOZ3dME9EIu8h_3qvxoeh5lBNJbHsJ9TSWtF3Jo827PK9HL-2H77jeRdmWSyhxjaj-KyDHZhPMaD4Qkw9u7dno0o8KBoeu7b3-pzG1kbH_dzAOCdr9FrplsLM-5CQCbLl34ot8/s320/Coronal.PNG" width="264" /></a></div>
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<span style="mso-no-proof: yes;"><br /><!--[endif]--></span></div>
<div class="MsoNormal">
Right <i style="mso-bidi-font-style: normal;">Orbicularis oris</i>
Corticogeniculate MEP decrement</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxNeEt7rMd4JgeExR-58fQOmWJKKm3QZIi5Ivmu0Ik0mq7yFNymhhtwWVp9wXJwcs7o5aHw3qPYNSeDbAJxJ-9M6r2DI3cM_semsNtq7EcMZDyy-ZJEurAaM61IBoya3mzBDfyWx2un8MA/s1600/Oris+CoMEP.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="983" data-original-width="1510" height="208" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxNeEt7rMd4JgeExR-58fQOmWJKKm3QZIi5Ivmu0Ik0mq7yFNymhhtwWVp9wXJwcs7o5aHw3qPYNSeDbAJxJ-9M6r2DI3cM_semsNtq7EcMZDyy-ZJEurAaM61IBoya3mzBDfyWx2un8MA/s320/Oris+CoMEP.png" width="320" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0OFVbbFqOzB7qXyUbWfijPZZK-TQeIqKPCrnGCuk5q8bFBoW_jKAfxVOoURYZUKDwnxMvonFKii6cyW9z7CsUSrOgPttzyBI28OGXRBv-G-3m5p1MKywv2TlSyyb3UvPvDQa_OjXrj1k3/s1600/Lost+of+right+oris+CoMep.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="983" data-original-width="1510" height="208" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0OFVbbFqOzB7qXyUbWfijPZZK-TQeIqKPCrnGCuk5q8bFBoW_jKAfxVOoURYZUKDwnxMvonFKii6cyW9z7CsUSrOgPttzyBI28OGXRBv-G-3m5p1MKywv2TlSyyb3UvPvDQa_OjXrj1k3/s320/Lost+of+right+oris+CoMep.png" width="320" /></a></div>
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<span style="mso-no-proof: yes;"><br /><!--[endif]--></span></div>
<div class="MsoNormal">
Mapping with 0,3 mA baseline</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgP7WzKb9M3gznedwYaaoK6-V9LR7sOhyphenhyphenwMW7rKSPXYMUyhC45MQ1GRfc64UjrHeqvU12_S1BDqGJ4MzOzFpb6AfChXHGWhmkbMtS__ndjhre6vJ2lxS3OyEyo1Nbu_rJy7GJHVXBcaDL7A/s1600/Facialis+mapping.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="983" data-original-width="1510" height="208" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgP7WzKb9M3gznedwYaaoK6-V9LR7sOhyphenhyphenwMW7rKSPXYMUyhC45MQ1GRfc64UjrHeqvU12_S1BDqGJ4MzOzFpb6AfChXHGWhmkbMtS__ndjhre6vJ2lxS3OyEyo1Nbu_rJy7GJHVXBcaDL7A/s320/Facialis+mapping.png" width="320" /></a></div>
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<span style="mso-no-proof: yes;"><br /><!--[endif]--></span></div>
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Mapping with 0,86 mA (after the decrement was seen in CoMEP)</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhayhk5VbEjzMDe6KKy3xiC0lJg-VCwosUevhuaeiZbYhu7qRcfkwHt_X60LK4_SI53H_CS2RuWcsXgLUkzG6ECr27QR33i_COoqjrIEtuBCHc2IrDINgKZJ8jKFchpgTyPNKGQOj3hmLvd/s1600/Facialis+mapping+decrement.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="983" data-original-width="1510" height="208" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhayhk5VbEjzMDe6KKy3xiC0lJg-VCwosUevhuaeiZbYhu7qRcfkwHt_X60LK4_SI53H_CS2RuWcsXgLUkzG6ECr27QR33i_COoqjrIEtuBCHc2IrDINgKZJ8jKFchpgTyPNKGQOj3hmLvd/s320/Facialis+mapping+decrement.png" width="320" /></a></div>
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<b style="mso-bidi-font-weight: normal;">Conclusions:<o:p></o:p></b></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "wingdings"; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]-->All
modalities with exception of<span style="mso-spacerun: yes;"> </span>CoMEP
showed similar findings at the end as at the beginning of the surgery. R1
(Trigeminofacial reflex) was not possible to elicit during this surgery.</div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "wingdings"; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]-->Mapping
was useful to drive the surgery moments before debulking and after the surgical
removal of the tumor.<span style="mso-spacerun: yes;"> </span>We expect partial
facial nerve dysfunction (temporary deficit) in the right side.</div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "wingdings"; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]-->24h
after surgery, the patient showed 60% function of facial nerve preserved, Grade
III (of VI) on House-Brackmann. Other VIII, IX and XII monitored cranial nerves
didn´t show deficit 24 h after the surgery.</div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l0 level1 lfo1; text-align: justify; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: "wingdings"; mso-bidi-font-family: Wingdings; mso-fareast-font-family: Wingdings;"><span style="mso-list: Ignore;">Ø<span style="font: 7.0pt "Times New Roman";"> </span></span></span><!--[endif]-->CoMEP
as a measure of corticogeniculate motor tracts with different and variable
assessment protocols should be considered as mandatory when trigeminofacial
reflex (R1) cannot be monitored and the interpretation of the amplitude loss
should be verified with anesthesist, neurosurgeons and with T-L technique
(Calancie B, <a href="https://www.ncbi.nlm.nih.gov/pubmed/28045853">2017</a>).</div>
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<br /></div>
<div class="MsoNormal">
<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span style="font-size: 10.0pt; line-height: 115%;">Reference:<o:p></o:p></span></i></b></div>
<div class="MsoNormal">
<span style="font-size: 10.0pt; line-height: 115%;">Intraoperative
Neuromonitoring of CPA mass by Alba León Jorba & Ovidiu C. Banea (</span><a href="https://drive.google.com/file/d/0B4zMxZO-x5WKN2JJOW8yVVNaUE0/view"><span style="font-size: 10.0pt; line-height: 115%;">Oct 2014 IMGB</span></a><span style="font-size: 10.0pt; line-height: 115%;">)<o:p></o:p></span></div>
<br /></div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-216518846069265406.post-60911569795309798962017-11-20T17:35:00.000-08:002017-11-20T17:38:38.287-08:00 Neurophysiology Plus Iceland is represented at TMS-workshop in Denmark<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-size: x-small;">by Ovidiu C. <a href="mailto:ovidiubanea@gmail.com" target="_blank">Banea</a></span></div>
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<b>Questions for TMS research scientific community in Denmark</b></div>
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From November 22nd to November 24th 2017, Danish Research Center for Magnetic Resonance (DRCMR) will host a new <b><a href="http://drcmr.dk/phd-courses/item/583-transcranial-magnetic-stimulation-workshop" target="_blank">TMS workshop</a> </b>with special focus on multimodal combinations of TMS with other neuroimaging techniques (EEG-TMS, fMRI-TMS). </div>
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<a href="http://www.drcmr.dk/" target="_blank"><b>DRCMR</b></a> is located in Hvidovre Hospital, a university hospital located at 9 km from Copenhagen which is administered by the Capital Region of Denmark.</div>
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Neurophysiology Plus will be represented at this meeting but also during the 20th to 22nd period for a better understanding of the center facilities, protocols used and technical equipment. </div>
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We look mostly to have a valuable and critical analysis input from the team leaded by Prof Dr Hartwig Roman Siebner on the <a href="https://drive.google.com/file/d/0B4zMxZO-x5WKOFAyM1RTVUd1c00/view" target="_blank">Icelandic</a> proposed study. </div>
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In this proposed clinical applied research project members of Neurophysiology Unit and Neurosurgery department from Reykjavik University and National University Hospital of Iceland are trying to analyze if TMS-EEG modality can be used or not to assess functional cortical tissue and brain effective connectivity in patients with brain tumors. </div>
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In Iceland, another simple technique, TMS motor evoked potentials (TMS-EMG) started to be used for preoperative mapping in 2016. We set and marked the position for the intraoperative direct stimulation (IONM) as in the nineties when this technique was described. </div>
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On the beginning of November 2017 neurosurgery department was interested on this procedure of preoperative mapping with neuronavigation. Again we used the available devices and we were able to map motor hotspots of the upper limb and speech area in a healthy subject. On 28th of November the team will investigate and perform motor and speech mapping in two patients with brain tumors located in eloquent areas of the brain. It will be for the first time that neuronavigated mapping is applied and used for the Icelandic brain tumor patients.</div>
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And the question remains: Is there a reason to believe that TEPs (TMS-EEG evoked potentials) can be used to assess better the "non-eloquent" brain cortical tissue and give a better map of the non-affected brain areas in order to avoid new post-intervention neurological deficit in patients with brain tumors ?</div>
</div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-216518846069265406.post-38757419080329085302017-11-02T11:40:00.004-07:002017-11-02T12:15:17.189-07:00Neuronavigated TMS in Iceland<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-size: x-small;">by <a href="https://sites.google.com/view/neurophysiologyplus" target="_blank">Neurophysiology Plus Iceland</a></span></div>
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<span style="font-size: x-small;">2nd of November 2017</span></div>
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<iframe allowfullscreen="" class="YOUTUBE-iframe-video" data-thumbnail-src="https://i.ytimg.com/vi/iRfzcNrBPXM/0.jpg" frameborder="0" height="266" src="https://www.youtube.com/embed/iRfzcNrBPXM?feature=player_embedded" width="320"></iframe></div>
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After 11 months since the first awake craniotomy was performed in Iceland, medical and technical staff from Neurosurgery Department and Clinical Neurophysiology Unit of the Icelandic National University Hospital #Landspitali started new testing protocol for the patients with lesions located in eloquent areas of the brain. </div>
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The neuronavigated transcranial magnetic stimulation (neuronavigated-TMS) was initiated with a pilot study of a healthy subject on 1st of November 2017 to find motor "hot-spots" and "speech area" (by inducing the speech arrest) in total relaxation and safety. </div>
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When the team will perform the test in patients, the functional areas will be saved with Talairach space, a 3-dimensional coordinate system of the brain structures, into the same neuronavigation system used by neurosurgeons in the operating room with the aim to avoid their damage during the surgical procedures.</div>
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On 13th of July 2017 the team tried this set-up on a phantom head in the operating room theater (<a href="https://neurophysiologyplus.blogspot.is/2017/07/preoperative-neuronavigation-with-tms.html" target="_blank">here</a>). </div>
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Many thanks to Dr Ingvar Hákon Ólafsson (Neurosurgery Department) for his interest and collaboration, to Aron Dalin Jónasson (TMS Clinical Neurophysiology Unit technician) to support the MRI procedure and the pilot noninvasive TMS neuronavigation, Ágúst H. Guðmundsson (Intermedica & Medtronic) and to all Neurophysiology Unit medical and technical staff.</div>
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Unknownnoreply@blogger.com0Reykjavík, Iceland64.126520599999992 -21.81743919999996764.0156806 -22.140162699999966 64.237360599999988 -21.494715699999968tag:blogger.com,1999:blog-216518846069265406.post-39976768076261281222017-09-29T13:29:00.000-07:002017-09-29T14:09:38.862-07:00TMS-EEG evoked potentials (TEPs) in Iceland<div dir="ltr" style="text-align: left;" trbidi="on">
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29th of Sept 2017 Reykjavik Iceland</div>
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TMS-EEG evoked potentials (TEP) were performed during a joint meeting of Clinical Neurophysiology Unit team (Neurophysiology <a href="https://sites.google.com/view/neurophysiologyplus/home" target="_blank">Plus</a> Iceland) and Icelandic Center of Clinical Neurophysiology from Reykjavik University.<br />
The meeting was organized by Assist Prof Dr Paolo Gargiulo (Director of <a href="https://en.ru.is/sse/bne" target="_blank">Institute of Biomedical and Neural Engineering</a>, Reykjavik University & Landspitali) and had as participants Dr Magnús Kjartan Gíslason & MSc Thorsteinn Geirsson (<a href="http://www.neckcare.com/neck-pain-assessment-neckcare/" target="_blank">NeckCare</a>), Aron Dalin Jónasson MSc, Hildigunnur Katrinardóttir MSc & Ovidiu C. Banea MD (Neurophysiology Lab Landspitali and Reykjavik University) and Egill Axfjörður Friðgeirsson, PhD Student University of Amsterdam.</div>
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<span style="font-size: x-small;">First TMS-EMG was performed to achieve the correct out of maximum TMS intensity necessary to evoke MEP into hand thenar muscles</span></div>
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<span style="font-size: x-small;">Using 100% RMT TMS-EEG evoked potentials were recorded. This trial was performed on experimental basis within the expert team in a healthy subject who previously accepted the test. Another 15-20 voluntary healthy subjects will be tested on both TMS-EMG and TMS-EEG protocols in accordance with World Medical Association (WMA) Declaration of Helsinki, a statement of ethical principles for medical research involving human subjects.</span></div>
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The future joint applied science clinical study will be developed after two international specific trainings and meetings in <a href="http://www.drcmr.dk/news-events/news/item/732-tms-workshop" target="_blank">Denmark</a> (Nov 2017) and <a href="https://www.ant-neuro.com/neuromeeting2018" target="_blank">France</a> (January 2018). The aim is to assess biological neural networks (BNN) in patients with brain tumors and symptomatic epilepsy as a preoperative safety assessment of the functional brain tissue and effective connectivity in order to improve actual procedures (motor & speech mapping and fMRI) and avoid new neurological deficit. Main collaborators of this challenging Icelandic medical research and clinical study are Neurosurgery Department of National University Hospital of Iceland (Drs Ingvar Hakon Ólafsson & Elfar Ulfarsson) and Neurosurgery Department of del Mar Hospital Barcelona, Spain (Dr Gerard Conesa). Scientific support and research specific feedback is given by Dr Eric Wassermann (NINDS/NIH; Bethesda, United States) and Prof Dr Elías Ólafsson (Head of Neurology Department, National University Hospital of Iceland).</div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-216518846069265406.post-8292163266087970882017-09-04T15:14:00.000-07:002017-09-20T15:47:40.970-07:00Guyon Type II (pure motor), who was Jean Casimir Félix Guyon?<div dir="ltr" style="text-align: left;" trbidi="on">
<span style="font-size: x-small;">by Neurophysiology Plus Iceland</span><br />
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In a 72 year-old male with suspected carpal tunnel syndrome (?) our team was able to identify a rare case of pure motor (type II) Guyon syndrome using nerve conduction studies. Case report (<a href="https://drive.google.com/file/d/0B4zMxZO-x5WKM0YySHpUa1hIQUk/view?usp=sharing" target="_blank">here</a>). The report was corrected and split-hand index (SI) was calculated after a very good comment we received from Dr Giorgio Capoccitti (Università degli Studi di Siena, Tuscany Italy).</div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-216518846069265406.post-69594265296440205192017-07-26T11:08:00.000-07:002017-07-26T11:12:54.778-07:00Mixed silent period (MSP) and cutaneous silent period(CSP) in diagnostic of a severe carpal tunnel syndrome<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: inherit;">Reykjavik 26th of July 2017</span></div>
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<span style="font-family: inherit;">by <span style="font-size: x-small;"><a href="mailto:ovidiubanea@gmail.com" target="_blank">Neurophysiology Plus Iceland</a></span></span></div>
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<span style="font-family: inherit;">Cutaneous silent period can be
preserved in entrapment neuropathies (<a href="http://onlinelibrary.wiley.com/doi/10.1002/mus.10595/epdf">KofIer et al 2003</a>).
It is known that the more severe the neuropathy is, the more impairment of
A-delta fibers can be found (<a href="http://www.medicinabuenosaires.com/PMID/27576280.pdf">Duarte et al 2016</a>).
In patient with severe CTS <b><span style="color: #c00000;">the mean onset latency</span></b> was increased to <b><span style="color: #c00000;">85.0 ms</span></b>
(SD 8.7 ms, <i>P</i> < 0.01) <a href="http://onlinelibrary.wiley.com/doi/10.1002/mus.20496/epdf">Silvpauskaite
et al 2005</a>.</span></div>
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<span style="font-family: inherit;"><b><span style="background: silver; color: #4f6228; font-size: 12.0pt; line-height: 115%;">CASE
REPORT</span></b><b><span style="color: #4f6228; font-size: 12.0pt; line-height: 115%;"> (<a href="https://drive.google.com/file/d/0B4zMxZO-x5WKWGQ5WnZfd2Z3STQ/view" target="_blank">here</a>) </span></b>Patient 66 year-old with motor weakness in hands and
hypoesthesia<b><span style="color: #4f6228; font-size: 12.0pt; line-height: 115%;"><o:p></o:p></span></b></span></div>
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<span style="font-family: inherit;">This case was published in <b>Neurophysiology Plus Iceland</b> informal group e-Bulletin (<a href="https://drive.google.com/file/d/0B4zMxZO-x5WKWGQ5WnZfd2Z3STQ/view?usp=sharing" target="_blank">here</a>)</span></div>
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Right median nerve mixed and cutaneous (palm) silent period</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-x7zPW2xQDLs3gCFTUeyQ36sWBeot3_HHtQwHlZI9Fov-ZlQI-BB2rSn94-_QfY2Oqfs-kEez18DZ-SB9-aaBppyjn-8qv5AsY2Fl0nQuN8a8ESBdHXnLXml8-9baSO6VJP32WxTMXrUe/s1600/CSP+from+2+digit+MN.PNG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="373" data-original-width="608" height="196" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-x7zPW2xQDLs3gCFTUeyQ36sWBeot3_HHtQwHlZI9Fov-ZlQI-BB2rSn94-_QfY2Oqfs-kEez18DZ-SB9-aaBppyjn-8qv5AsY2Fl0nQuN8a8ESBdHXnLXml8-9baSO6VJP32WxTMXrUe/s320/CSP+from+2+digit+MN.PNG" width="320" /></a></div>
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Cutaneous Silent Period from 2 digit sensory branches (ring electrodes)</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgIzteqvXHbG1Y63im9JvxA_jR92gtFOUDAVcb-6vj-QM8StnUUOitVcosS5sVbGjY5YSrdF0aQNJlbLgEoPCDLsOWofDbrNoYNv8oCIcQxI96uRvpHLg5QdMDgZYKbcrFmBid8DOGb7G_H/s1600/Ovi+CSP+APB+II+digit.PNG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="878" data-original-width="1335" height="210" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgIzteqvXHbG1Y63im9JvxA_jR92gtFOUDAVcb-6vj-QM8StnUUOitVcosS5sVbGjY5YSrdF0aQNJlbLgEoPCDLsOWofDbrNoYNv8oCIcQxI96uRvpHLg5QdMDgZYKbcrFmBid8DOGb7G_H/s320/Ovi+CSP+APB+II+digit.PNG" width="320" /></a></div>
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Cutaneous Silent Period from 2 digit sensory branches in examinator (OCB), normal values</div>
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<span style="font-family: inherit;">After we diagnosed very severe
CTS in the right side and severe CTS in the left we performed A-delta & alpha
motorneurons driven CSP from 2 digit and there was no clear inhibition of the
voluntary contraction (<b><span style="color: #c00000;">onset 107ms</span></b>). Then, we checked again from the
palm-thenar region and we observed <b><span style="color: #c00000;">CSP with onset 100ms</span></b>, end 155 ms and 55ms
duration. Also a clear silent period was obtained after stimulation from the
wrist, the mixed median nerve and record from <i>abductor pollicis brevis.<o:p></o:p></i></span></div>
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<span style="font-size: 11pt; line-height: 115%;"><span style="font-family: inherit;">Conclusion: Sensory fibers (small and fast) are
the last in be damaged and the injury do not occurred at the wrist carpal
tunnel as it happened with axonal loss of the large sensory fibers. At this moment there is not clear if those
fibers are only the A-delta or there might be another sensory input by direct
electrical stimulation of other fiber type (proprioceptors?, muscle spindles?)</span></span></div>
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Nerve Conduction Studies: <span style="font-family: inherit;">20</span>17 ©<a href="https://sites.google.com/view/neurophysiologyplus"> Neurophysiology Plus Iceland</a></div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-216518846069265406.post-18472474580766267682017-07-24T13:17:00.000-07:002017-07-24T13:18:10.454-07:00P300 returns to Iceland<div dir="ltr" style="text-align: left;" trbidi="on">
Reykjavik 24.07.2017<br />
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<span style="font-size: x-small;">by <a href="https://sites.google.com/view/neurophysiologyplus" target="_blank">Neurophysiology Plus</a></span><br />
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The P300 (P3) wave is an event related potential (ERP) component elicited in the process of decision making.<br />
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Since the mid-1980s, one of the most discussed uses of ERPs such as the P300 is related to <b>lie detection.</b> In a proposed "guilty knowledge test" (<a href="http://www.brainwavescience.com/Farwell_Smith_Journal_of_Forensic_Sciences_Brain_Fingerprinting.pdf" target="_blank">Farwell & Smith</a>, 2001) a subject is interrogated via the oddball paradigm much as they would be in a typical lie-detector situation. This practice has recently enjoyed increased legal permissibility while conventional polygraphy has seen its use diminish, in part owing to the unconscious and uncontrollable aspects of the P300.</div>
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Photo: Aron Dalin Jónasson</div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-216518846069265406.post-68984825757231507452017-07-20T14:06:00.000-07:002017-07-22T06:00:05.933-07:00Tinnitus experimental treatment with repetitive TMS in Iceland<div dir="ltr" style="text-align: left;" trbidi="on">
20 of July 2017, Reykjavik<br />
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<span style="font-size: x-small;">by <a href="https://sites.google.com/view/neurophysiologyplus/home" target="_blank">Neurophysiology Plus</a></span><br />
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Experimental treatment with repetitive TMS (rTMS) for subjective tinnitus is a challenging option. Preliminary research data on rTMS has yielded mixed results, especially when rTMS patients are compared to patients in a placebo test group (<a href="https://www.ata.org/managing-your-tinnitus/treatment-options/experimental-therapies" target="_blank">American Tinnitus Association</a>). </div>
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Low frequency ( LF 1 Hz) rTMS unilaterally applied to temporal or temporoparietal cortical areas can interact with an abnormal hyperactivity of auditory cortices that may constitute the neural correlate of tinnitus perception. Literature data showed that this type of rTMS protocol has a possible therapeutic efficacy (<b>Level C recommendation</b>) in this clinical condition (J.-P. Lefaucheur et al.2014 / <i>Clinical Neurophysiology</i> 125, <a href="http://www.clinph-journal.com/article/S1388-2457(14)00296-X/pdf" target="_blank">page 2177</a>).</div>
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In Iceland, our first patient started the 10 sessions treatment with 1200 daily pulses 100%RMT applied in 60 series of 20 pulses (1Hz frequency) on 17th of July 2017. Location of coil was set to stimulate between T3 and C3/T5 using 10-20 international EEG system (Lee H.Y. et al 2013). </div>
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We use the same protocol used in Department of Otorhinolaryngology - Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3687063/" target="_blank">Lee H.Y. et al 2013</a>, <i>Clinical and Experimental Otorhinolaryngology</i> Vol. 6, No. 2: 63-67, June 2013). To assess the progression of a possible rTMS effect on tinnitus perception we used Tinnitus Handicap Inventory <a href="https://www.ata.org/sites/default/files/Tinnitus_Handicap_Inventory.pdf" target="_blank">THI</a> questionnaire and Visual Analogue Scale for both tinnitus annoyance and loudness (<a href="https://drive.google.com/file/d/0B4zMxZO-x5WKX0JTcWUxVjh4S3NzY3NrRjhLS2lhdk1hWV84/view?usp=sharing" target="_blank">here</a>). </div>
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Primary Auditory Cortex: In humans, the primary auditory cortex is located in the transverse temporal gyri (of Heschl) of the medial aspect of the superior temporal gyrus. Brodmann’s area 42 is the auditory association area. Together, Brodmann’s areas 41 and 42 are called the A-1 region and receive projections from the medial geniculate nucleus (geniculotemporal fibers or auditory radiations). The tonotopic organization in the auditory relay nuclei is maintained in the auditory cortex as well. One of the secondary auditory areas includes Wernicke’s area, which is important for the interpretation of the spoken word.</div>
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20.07.2017 Clinical Neurophysiology Unit, Reykjavik</div>
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Photo: Aron Dalin Jónasson</div>
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Unknownnoreply@blogger.com12tag:blogger.com,1999:blog-216518846069265406.post-54088619991584738072017-07-18T10:06:00.000-07:002017-07-20T15:15:26.287-07:00Preoperative Neuronavigation with TMS using operating room system in Iceland<div dir="ltr" style="text-align: left;" trbidi="on">
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Reykjavik, 13th of July 2017</div>
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by Neurophysiology Plus</div>
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To avoid a new neurological deficit after a brain growing tumor surgery located in or near eloquent brain areas (speech, motor, visual cortex) the surgeon uses now <a href="https://drive.google.com/file/d/0B4zMxZO-x5WKNENMUDVSZXdLNVU/view" target="_blank">intraoperative neuromonitoring</a> complementary procedures performed together with clinical neurophysiology team in the operating room.</div>
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In 1998, Sawaya et al published the tumor functional grade classification after a scheme developed at the Anderson Cancer Center in Houston Texas based on the tumor location relative to the brain function as following: Grade I <i>non-eloquent</i> brain: Frontal or temporal polar regions, Right parieto-occipital regions, Cerebellar hemispheres lesions; Grade II <i>near eloquent</i> brain: Near motor or sensory cortex, Near calcarine fissure, Near speech center, Corpus callosum, Near dentate nucleus, Near brainstem, including supplementary motor area if was investigated with preoperative magnetic resonance; Grade III <i>eloquent brain</i>: Motor/Sensory cortex, Visual center, Speech center, Internal capsule, Basal ganglia, Hypothalamus/thalamus, Brainstem, Dentate nucleus.</div>
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The preoperative studies used to identify the structure and the "function" of the eloquent brain are MRI, fMRI, CT, DatScan, SPECT, PET, TMS. From all these TMS-EMG and TMS-EEG modalities are used for motor mapping and speech mapping or EEG temporal related evoked potentials. The results, the identified motor hot-spots or speech area are then saved and used in operating room by neurosurgeon.</div>
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<img border="0" data-original-height="605" data-original-width="632" height="306" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPYdFxkNZXF2_zpd4BnXSWGUzc2HFoV1fQuma3_JViApAyn8b0Rri9n1SaCo1doQE5Y4lDuJ4SQNnNlEPkwrjjNGvoTdL4FYmMMfBqlRZdNaEj42LCurwOrlDrC-NYlX_-7Tkozbq_tkTS/s320/s7.jpg" width="320" /></div>
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Source: <a href="http://www.medtronic.com/se-sv/healthcare-professionals/products/neurological/surgical-navigation-imaging/surgical-navigation-systems/systems-software-instruments.html" target="_blank">Medtronic</a></div>
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<b>Neuro-Navigated TMS preoperative mapping using same operating room system</b></div>
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13th of July 2017</div>
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If <i>eloquent brain</i> areas and motor cortex hot-spots with Talairach coordinates are already set on the patient MRI (structural model of the brain) before surgery the neurophysiology and neurosurgery team will use them when proposing the surgery and during the resection of tumors or abnormal (non-functional) tissues.</div>
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In Iceland, preoperative motor mapping started in January 2017 (<a href="https://drive.google.com/file/d/0B4zMxZO-x5WKby1kZG5QY0M4TEE/view" target="_blank">here</a>) and recently a team formed by Ingvar Hakón Ólafsson, Aron Björnsson, Ágúst H. Guðmundsson (Intermedica/Medtronic), David B., Aron Dalin Jónasson and <a href="mailto:ovidiubanea@gmail.com" target="_blank">Ovidiu</a> C. Banea could prove the combination of operating room neuronavigation system (Medtronic) with TMS motor mapping and Intraoperative device (Nim Eclipse Medtronic).</div>
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The pilot study was successful and was performed in surgery room. In close future the preoperative neuro-navigated mapping will be used for the proposed patients before surgery time.</div>
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