2Medisch Spectrum Twente, Clinical Neurophysiology, Enschede, Netherlands ... Twente, Intensive Care, Enschede, Netherlands; 5Rijnstate Hospital, Intensive.
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Abstracts of Oral Presentations / Clinical Neurophysiology 125, Supplement 1 (2014) S1–S339
O31 EEG monitoring for early outcome prediction in patients with postanoxic coma treated with mild therapeutic hypothermia M. Tjepkema-Cloostermans 1,2 , J. Hofmeijer 1,3 , R.J. Trof 4 , M.J. Blans 5 , A. Beishuizen 4,6 , M.J.A. van Putten 1,2 1 Univeristy of Twente, Clinical Neurophysiology, Enschede, Netherlands; 2 Medisch Spectrum Twente, Clinical Neurophysiology, Enschede, Netherlands; 3 Rijnstate Hospital, Neurology, Arnhem, Netherlands; 4 Medisch Spectrum Twente, Intensive Care, Enschede, Netherlands; 5 Rijnstate Hospital, Intensive Care, Arnhem, Netherlands; 6 VU University Medical Center, Intensive Care, Amsterdam, Netherlands Question: What is the value of continuous EEG for prediction of outcome of comatose patients after cardiac arrest treated with mild therapeutic hypothermia (MTH)? Methods: In a prospective cohort study, we included subsequent patients with postanoxic encephalopathy after cardiac arrest, all treated with MTH. Continuous EEG was recorded during the first five days of ICU admission. Visual classification of EEG patterns was performed in 5 minute epochs at 12 and 24 hours after cardiac arrest by two observers independently, blinded for patients’ conditions and outcomes. Patterns were classified as isoelectric, low-voltage, epileptiform, burst-suppression, diffusely slowed, or normal. Burst-suppression was subdivided into patterns with and without identical bursts. Primary outcome measure was the neurological outcome based on each patient’s best achieved Cerebral Performance Category (CPC) score within 6 months after inclusion. Results: One-hundred-forty-eight patients were included, initial results of the first 56 patients were recently published [1]. 68 (46%) had favourable outcome (CPC 1-2). In patients with favourable outcome, EEG patterns improved within 24 hours after cardiac arrest, mostly towards diffusely slowed or normal. At 24 hours after cardiac arrest, the combined group of iso-electric, low voltage, and “burst-suppression with identical bursts” was invariably associated with poor outcome (sensitivity 48%, specificity 100%, positive predictive value (PPV) 100%, negative predictive value (NPV) 66%). At 12 hours, normal or diffusely slowed EEG patterns were strongly associated with good outcome (sensitivity 56%, specificity 96%, PPV 93%, NPV 67%).
Aging and dementia: when cortical efficacy matters O32 Magno-cellular streams involvement in Alzheimer’s disease: an evidence of a network diseases F. Sartucci 1,2,3 , T. Bocci 1,4 , E. Giorli 1,4 , P. Orsini 5 , V. Porciatti 6 , N. Origlia 3 , L. Domenici 3,7 1 Unit of Neurology, Department of Clinical and Experimental Medicine, Pisa, Italy; 2 Unit Outpatients Neurological Activity, Department of Clinical and Experimental Medicine, Pisa, Italy; 3 Institute of Neuroscience, CNR, Pisa, Italy; 4 Neurology and Clinical Neurophysiology Section, Department of Neurological and Neurosensorial Sciences, Siena, Italy; 5 Department of Translational Research and New Technologies in Medicine and Surgery, Pisa, Italy; 6 Bascom Palmer Eye Institute, Miami, United States; 7 Department of Biomedical Sciences and Technology, School of Medicine, University of L’Aquila, L’Aquila, Italy Question: Alzheimer’s Disease (AD) impairs visual function early and functional losses are correlated with cognitive level impairment. Recently a primary involvement of the visual magnocellulari visual subsystem as cause of AD has been put forward. To test this hypothesis we evaluated electrophysiologically visual subsystem (magno and parvo) in a group of AD patients, using equiluminant chromatic Pattern Electroretinograms (ChPERGs) and Pattern Visual Evoked Potentials (ChVEPs) in attempt to detect a magnocellular deficit. Methods: Data were obtained from 10 AD pts (mean age+ 1SD 78.7±4.83 yrs) not yet undergoing any treatment, and from 10 age- and sex-matched healthy controls (mean age+ 1SD 71.3±7.2). ChPERGs were recorded monocularly in response to equiluminant red-green (R-G) and blue-yellow (B-Y) stimuli, known to emphasize the contribution of parvo- and konio-cellular streams respectively, and achromatic luminance (Lum) yellow-black horizontal square gratings of 0.3 c/deg and 90% contrast (K), reversed at 1Hz, displayed on a monitor at a viewing distance of24 cm (59.2*59 deg field). ChVEPs were recorded to onset (300 ms) and offset (700ms) equiluminant chromatic sinusoidal gratings of different K (90 and 25%). Diagnosis was clinically and neuro-radiologically established, after having excluded other possible causes of dementia. Results: Our data showed evident abnormalities both in latency and amplitude of Lum PERGs in AD patients compared with controls (p
