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Biomedical subjects

J Gotman

Publications and source records attributed to J Gotman.

112 records · Page 7Linked to original sources

Duration of sodium amytal effect: behavioral and EEG measures.

In performance of an intracarotid sodium amytal test duration of action is a critical factor since measurements obtained after cessation of action are invalid. Duration of action is often monitored by measuring handstrength contralateral to injection or by visual inspection of amytal-induced EEG slow waves ipsilateral to injection. We describe new objective methods of monitoring drug effect: quantified EEG and sensory discrimination. In a first study of patients with scalp electrodes, the two traditional and the two new measures were compared in 40 injections. Results indicated that the two EEG measures did not differ significantly and estimated a shorter drug effect than the two behavioral measures, which were also not significantly different. The two new measures had a smaller SD, indicating that they may be less erratic. In a second study of 14 patients, using intracerebral electrodes, we showed that slow waves in the frontocentral region lasted as long as the motor and sensory effects, but also that slow waves in the medial temporal region dissipated earlier than the motor and sensory deficits. Our results suggest that motor and sensory measures may overestimate the time in which valid testing can occur if hippocampal function is at issue.

Amobarbital↗

Effect of anterior callosotomy on bilaterally synchronous spike and wave and other EEG discharges.

We analyzed pre- and postoperative interictal and ictal EEG patterns in relation to seizure outcome in 29 patients with intractable epilepsy who had undergone anterior callosotomy. Twenty-two patients had generalized bilaterally synchronous sharp or spike and slow wave discharges (GSW) and 7 did not: Postoperatively, patients with preoperative GSW showed disruption of synchrony, increased amplitude asymmetry, and a decreased amount of GSW. No significant decrease was noted in the amount of total epileptic discharge after operation. There was a significant relation between seizure outcome and decrease in amount of GSW. The degree of disruption of synchrony, total amount of epileptic discharge, and pre- and postoperative EEG patterns were not good indicators of seizure outcome. Postoperative changes in lateralization of epileptic foci consisted either of increased lateralization, less lateralization but increased independent discharges in the previously nonpredominant hemisphere, or appearance of some lateralization. There appears to be a spectrum of GSW: Both secondary bilateral synchrony and secondarily generalized corticoreticular epileptic discharges are distributed along this spectrum.

Adult↗

Automated EEG monitoring in defining a chronic epilepsy model.

There has been a recent surge of interest in chronic animal models of epilepsy. Proper assessment of these models requires documentation of spontaneous seizures by EEG, observation, or both in each individual animal to confirm the presumed epileptic condition. We used the same automatic seizure detection system as that currently used for patients in our institution and many others. Electrodes were implanted in 43 rats before intraamygdalar administration of kainic acid (KA). Animals were monitored intermittently for 3 months. Nine of the rats were protected by anticonvulsants [pentobarbital (PB) and diazepam (DZP)] at the time of KA injection. Between 1 and 3 months after KA injection, spontaneous seizures were detected in 20 of the 34 unprotected animals (59%). Surprisingly, spontaneous seizures were also detected during the same period in 2 of the 9 protected animals that were intended to serve as nonepileptic controls. Although the absence of confirmed spontaneous seizures in the remaining animals cannot exclude their occurrence, it indicates that, if present, they are at least rare. On the other hand, definitive proof of epilepsy is invaluable in the attempt to interpret pathologic data from experimental brains.

Amygdala↗

EEG slow waves and memory performance during the intracarotid amobarbital test.

During intracarotid sodium amobarbital (ISA) testing, EEG slow waves appear in the injected hemisphere and usually also contralaterally. They are frequently used to estimate duration of drug effect and thus the window of valid memory testing, but the relationship between slow waves and memory performance is not established. In 50 tests, we examined recognition for stimuli presented after amobarbital injection in relation to the quantified EEG. Performance was compared for injection ipsilateral versus contralateral to epileptic focus, with slow waves present bilaterally, unilaterally, or dissipated. Results showed that memory was impaired after injections contralateral to the focus when slow waves were present on the side of the focus (contralateral to injection). Injection contralateral to focus did not interfere with memory if slow waves were not also present, and slow waves contralateral to injection did not interfere with memory if the focus was not also present. This result emphasizes the functional significance of slow waves, which probably reflect decreased neuronal functioning.

Adolescent↗