Thesis (M.Sc.) - Swinburne University of Technology, Brain Sciences Institute, 2008. / A thesis submitted for M.Sc by Research, Brain Sciences Institute, Swinburne University of Technology - 2008. Typescript. Includes bibliographical references (p. 117-153)

Personas con discapacidad motora presentan inconvenientes en el desarrollo de actividades tales como caminar, correr, comer. Además, en su mayoría, la visión y el intelecto no se ven afectados. Estas deficiencias no le permiten al manipular dispositivos tecnológicos que podrían ayudarlo a mejorar su calidad de vida como los smartphones. Presentamos una solución que permite superar esta limitación apoyada en la tecnología Brain Computer Interface). / Revisión por pares

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Orientadores: Marilisa Mantovani Guerreiro, Maria Augusta Montenegro / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-16T12:47:22Z (GMT). No. of bitstreams: 1 Preto_PaulaMaria_M.pdf: 6934972 bytes, checksum: e8531a69068b5848bc523e1dce28ee1c (MD5) Previous issue date: 2010 / Resumo: A Epilepsia Mioclônica Grave da Infância ou Síndrome de Dravet (SDr) e a Epilepsia Miclônico-Astática ou Síndrome de Doose (SDo) são epilepsias raras da infância, que cursam com crises epilépticas refratárias, nas quais há predomínio das mioclonias, e que podem levar à deterioração do desenvolvimento neuropsicomotor. Em aproximadamente 2/3 dos pacientes com SDr encontra-se mutação da subunidade alfa do canal de sódio (SCN1A). Nosso objetivo neste estudo foi de avaliar as características clínicas e eletrencefalográficas na SDr e SDo. Avaliamos 14 pacientes com SDr, com idade de início das crises entre três e 18 meses (média: 9 ± 4 meses), sendo quatro do sexo masculino e 10 do sexo feminino. Avaliamos também 13 pacientes com Sdo, com idade de início das crises entre dois e seis anos (média: 3,02 ± 1,22 anos), sendo sete do sexo masculino e seis do sexo feminino. Em todos os pacientes foram realizados exame neurológico tradicional, EEG (2 a 8 exames por paciente), RM crânio e Escala de Vineland, que estabelece o nível de maturidade social e psicomotora da criança, para permitir a avaliação do comportamento adaptativo nas áreas relacionadas à comunicação, atividade de vida diária, socialização e habilidades motoras fina e grossa. Foram encontradas alterações no exame neurológico em todos os pacientes com SDr e quatro pacientes com SDo. Ocorreu deterioração do comportamento adaptativo em todos os pacientes com SDr e oito pacientes com SDo. Nosso estudo encontrou ataxia, sinais leves de liberação piramidal, hiperatividade, espectro autístico nos pacientes com SDr e SDo. Foi observada lentificação da atividade de base e atividade epileptiforme no EEG em dez pacientes com SDr e ritmo de Doose em nove pacientes com SDo, além de atividade epileptiforme em todos os pacientes com SDo. Observamos alterações epileptiformes focais e generalizadas na SDr e alterações epileptiformes predominantemente generalizadas na SDo. A pesquisa da mutação da subunidade alfa do canal de sódio (SCN1A) foi realizada em 10 pacientes com SDr e em 10 pacientes com SDo e foi encontrada a mutação em seis pacientes com SDr, sendo normal nos demais. Nas SDr e SDo os nossos dados concordaram com os achados da literatura em relação aos achados clínicos, exame neurológico, EEG, exames de imagem, genotipagem e tratamento; no entanto, foi discordante da literatura quanto à distribuição quanto ao sexo na SDr, o que pode ser justificado pela nossa casuística modesta. A aplicação da Escala de Vineland foi dado inovador nos estudos da SDr e SDo. Acreditamos que nossa pesquisa permitiu melhor caracterização dessas duas síndromes epilépticas e mostrou resultados semelhantes aos estudos europeus, onde foram originalmente descritos / Abstract: Severe Myoclonic Epilepsy of Infancy or Dravet syndrome (SMEI) and Mioclonic-Astatic Epilepsy or Doose Syndrome (MAE) are rare childhood epilepsies, which occur with refractory seizures, where there is a predominance of myoclonic seizures. Deterioration of the neuropsychomotor development usually occurs. Approximately two thirds of patients of the patients with SMEI may have mutation of the alpha subunit of the sodium channel (SCN1A). Our objective was to evaluate the clinical and electroencephalographic features of SMEI and MAE. We evaluated 14 patients with seizure onset between three and 18 months of age with SMEI (mean age: 9 ± 4 months). Four were male and 10 female. We also evaluated 13 patients with seizure onset between two and six years with MAE (mean age: 3, 02 ± 1, 22 years). Seven were male and six female. We performed traditional neurological examination, EEG (2-8 exams per patient), cerebral MRI and Vineland Scale, that establishes the level of psychomotor and social maturity of the child to allow an assessment of the adaptive behavior in areas related to communication, activity of daily living, socialization and fine and gross motor skills. Our study found changes in the neurological examination of 14 patients with SMEI and four patients with MAE. We observed slowing of background activity and epileptiform activity in 10 patients with SMEI. Doose rhythm was detected in nine patients with MAE and epileptiform activity in all patients with MAE. Deterioration of adaptive behavior occurred in all patients with SMEI and eight patients with MAE. Our study showed ataxia, mild signs of pyramidal liberation, hyperactivity and autistic spectrum in patients with SMEI and MAE. We observed focal and generalized epileptiform discharges in patients with SMEI and disturbance was predominantly generalized in patients with MAE. The study of mutation of the alpha subunit of the sodium channel (SCN1A) was performed in 10 patients with SMEI and 10 patients with MAE and the mutation was found in six patients with SMEI and the remaining examination was normal. In SMEI and EMA our data are in keeping with the findings of the literature regarding clinical, neurological examination, EEG, cerebral MRI, genotyping and treatment; except for gender distribution in the SMEI, which can be attributed to the small study group. The assessment with Vineland scale brought a new light to the understanding of SMEI and MAE. We believe that our research has enabled better characterization of these two epileptic syndromes, showing that the results are similar to those from Europe, where they were originally described / Mestrado / Neurologia / Mestre em Ciências Médicas

M.A. / Himmehoch (1984, 1987) in discussion of major mood disorders related to epilepsy, describes an affective condition termed subictal mood disorder. Patients with subictal mood disorder are divided into manic-depressive and dysthymic subtypes, the former resembling an atypical, usually rapid-cycling bipolar mood disorder. The latter dysthymic group, are characterised by a baseline dysthymia, severe recurrent depressive episodes, and transient euphorias. In addition, these dysthymic patients are described as being especially prone to impulsive suicide attempts, extreme irritability, rage outbursts and deliberate self-harm. Himmelhoch (1984, 1987) postulates temporolimbic dysfunction with both ictal and subictal (subclinical) changes as the underlying aetiology. Temporolimbic phenomena such as anamnesic, dissociative and perceptive distortions are important aspects of neuropsychiatric phenomenology. Clinical evidence, however, suggests that these occurrences are not routinely sought for or uncovered during the clinical evaluation of patients and their relevance for atypical affective presentations not clearly understood. The aim of this clinical survey was to evaluate the presence and nature of both temporolimbic dysfunction and subictal mood disorder among a subpopulation of private psychiatric patients. Furthermore in order to explicate a possible association between the above, the electroencephalographic records of these patients were examined. Records of 761 patients who attended a private practice over a two-year period were retrospectively reviewed. 546 patients had been questioned in sufficient detail and were deemed reliable in their responses. Of the 546 patients reviewed 128 (23,4%) were found to have experienced significant temporolimbic phenomena. The most common features were dissociative states, deja vu, premonitions, jamais vu and tactile hallucinations. 150 (27,5%) patients met Himmelhoch's criteria for the presence of subictal mood disorder. Of those 150, 100 (66,7%) demonstrated significant temporolimbic phenomena. EEG results, with the exclusion of 16 patients (the appropriate records not being available), highlighted 64 iY (76,2%) ofthe probands as having met the criteria for significant temporolimbic phenomena and subictal mood disorder and demonstrating unequivocal abnormality onEEG. Taking into account the sample bias of this particular private practice, and the obvious flaws of a retrospective, naturalistic survey of this nature, the concept of sub ictal mood disorder is discussed. Case vignettes are used to illustrate the phenomenological presentation ofthese patients and the potential benefits of the addition of anticonvulsants in their management.

Orientador: Marilisa Mantovani Guerreiro / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-22T07:18:22Z (GMT). No. of bitstreams: 1 Capelatto_LiviaLucenadeMedeiros_D.pdf: 6633660 bytes, checksum: 2c203cf41487511bbd4f62288b5f851f (MD5) Previous issue date: 2013 / Resumo: A Epilepsia focal benigna da infância com paroxismos centro-temporais (EBICT), ou epilepsia rolândica (ER), é a forma mais frequente de epilepsia idiopática da infância. Os objetivos deste estudo foram aprofundar o exame neurológico através da detecção de sinais menores e avaliar criteriosamente as anormalidades neurofisiológicas de pacientes com ER. Para atingirmos o primeiro objetivo aplicamos o QNST II e WISC III em um grupo de pacientes com ER que foram comparados a um grupo-controle composto por crianças normais. Para atingirmos o segundo objetivo, analisamos os EEGs de um grupo de pacientes com ER que foram comparados a um grupo de pacientes com epilepsia sintomática e descargas na área rolândica. A primeira parte do estudo incluiu 40 sujeitos durante o período de Março de 2007 a Dezembro de 2009. As crianças eram de ambos os gêneros e faixa etária de 9 a 15 anos (média de idade de 12 anos) e foram subdivididos em dois grupos: G1 (Grupo 1) - 20 pacientes com ER (8 meninas), 85% controladas; G2 (Grupo 2) - 20 sujeitos do grupo controle (10 meninas), sem queixas neurológicas e pareados por idade e sexo. Os resultados demostraram que entre os grupos quanto ao QI de execução e total houve com melhor desempenho das crianças com epilepsia rolândica (p = 0,001 e p = 0,004, respectivamente). Houve proporcionalidade entre dados obtidos do QNST II e o WISC III pela análise de correlação de Spearmann, tanto diante do QI total (p=0,015), QI execução (p=0.045) como do QI verbal (p=0.031). Concluímos que crianças com epilepsia rolândica em fase de controle de crises podem não apresentar sinais neurológicos menores, sendo o QNST II uma instrumento confiável para este tipo de avaliação. Na segunda parte do estudo, foram selecionados e analisados 45 EEGs de pacientes, sendo subdivididos em dois grupos: G1 (Grupo 1) - 21 pacientes com ER (13 meninas), com idade média de 9,2 anos ( + 2,6); G2 (Grupo 2) - 24 pacientes com epilepsia sintomática (16 meninas), com idade média de 10,7 ( +3,5). Os traçados foram realizados entre Janeiro de 2001 e Março de 2009. Em relação à atividade epileptiforme, as variáveis estudadas e comparadas foram dipolo horizontal, fenômeno de dupla ponta, extensão das descargas além da área rolândica e atividade de base. Os resultados não mostraram diferença estatisticamente significativa entre os dois grupos, a não ser em relação à atividade de base (p=0,008). Concluímos que as características eletrencefalográficas avaliadas neste estudo refletem, na realidade, um distúrbio elétrico da área rolândica / Abstract: The benign epilepsy of childhood with centrotemporal spikes (BECTS), or rolandic epilepsy (RE), is the most frequent form of idiopathic epilepsy of childhood. The aims of this study were to deep the neurological examination by searching for soft signs and to evaluate carefully the neurophysiological abnormalities of patients with RE. To achieve the first aim we applied the QNST II and WISC III in a group of patients with RE that were compared to a control group composed of normal children. To achieve the second aim we analyzed the EEGs of a group of patients with RE that were compared to a group of patients with symptomatic epilepsy and discharges in rolandic area. The first part of the study included 40 subjects during the period of March 2007 to December 2009. Children of both genders and aging from 9-15 years were included and divided into two groups: G1 (Group 1) - 20 patients with RE, 85% were controlled; G2 (Group 2) - 20 subjects in the control group without any neurological complaint, and matched with G1 by age and sex. Results showed that a significant difference between the groups against the run and total IQ with better performance in children with rolandic epilepsy. There was correlation between the data obtained QNST II with WISC III (total IQ, verbal and executive), both compared to the total IQ (p = 0.015), executive IQ (p = 0.045) and verbal IQ (p = 0.031). We conclude that children with rolandic epilepsy under control seizures may not have neurological soft signs, QNST II being a reliable tool for this type of evaluation. In the second part of the study we selected and analyzed EEGs of 45 patients, divided into two groups: G1 (Group 1) - 21 patients with RE, G2 (Group 2) - 24 patients with symptomatic epilepsy and rolandic discharges. The tracings were performed between January 2001 and March 2009. The studied variables in epileptiform activity were horizontal dipole, double spike phenomenon, extent of the discharges beyond the rolandic area and background activity. The results showed no statistically significant difference between the two groups, except in relation to background activity (p = 0.008). We concluded that the neurophysiological features assigned to the RE reflect in fact an electrical disturbance of rolandic area and they can be found in any form of epilepsy that involves this region / Doutorado / Neurologia / Doutora em Ciências Médicas

The present study aimed at quantifying the topographic distribution of spectral power as measured with electroencephalogram (EEG) in patients with opioid use disorder (OUD) across five broad band frequencies (δ, θ, α, β, and γ). Through comparative groups of healthy controls, patients with methamphetamine use disorder, and patients with alcohol use disorder, it was determined that OUD EEG spectral power was globally increased in the δ frequency, and more region-specific in others (frontal lobes in θ and β frequencies). α frequency was reduced in occipital lobes in OUD. The observed changes are discussed in terms of the microcircuit-level changes in the cortex. Based on these findings, EEG may prove to be a valuable tool for diagnostic and prognostic evaluation of OUD. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection

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Individuals who display high levels of reward sensitivity are motivated by and respond to reward related cues, thus exhibiting more approach-motivated behaviors. A majority of the research on physiological indices of reward sensitivity in relation to self-regulatory abilities has focused on adults or adolescents, with relatively little work examining these associations in children. Thus, the current study sought to examine whether a common neural measure of reward sensitivity, left frontal electroencephalogram (EEG) asymmetry, assessed in early childhood was predictive of children’s later self-regulation abilities in the context of reward delay. Emerging inhibitory control skills were also examined as a potential moderator of the association between reward sensitivity and self-regulation. The frontal asymmetry measure of reward sensitivity was assessed at Time 1, when children were between the ages of 4 and 7 years old. The Time 2 visit occurred 18-24 months later, at which point children completed a flanker task to assess inhibitory control and a lock-box task to measure two components of self-regulation: behavioral control (i.e., task effort and attentional focus) and emotion regulation (i.e., expressions of anger). Children with average levels of reward sensitivity showed the highest levels of overall effort (collapsed across low, moderate, and high effort scores) and the lowest levels of weak effort. Additionally, inhibitory control iv moderated the relation between reward sensitivity and effort such that children with low reward sensitivity and strong inhibitory control showed the highest levels of overall and moderate effort as well as the lowest levels of weak effort. There were no significant associations between reward sensitivity, inhibitory control, and attentional focus or anger expression. These results suggest that EEG frontal asymmetry is a useful physiological marker of reward sensitivity when predicting specific types of regulatory abilities in children.

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