We report on a stroke patient who showed recovery of hypersomnia concurrent with the recovery of an injured ascending reticular activating system (ARAS), which was demonstrated by diffusion tensor tractography (DTT). A 70-year-old female patient underwent coiling of the left ruptured posterior communicating artery after subarachnoid hemorrhage and both extraventricular drainage for management of an intraventricular hemorrhage. At 2 months after onset, when she started rehabilitation, she exhibited intact consciousness, with the full score on the Glasgow Coma Scale: 15. However, she showed severe hypersomnia: she always fell asleep without external stimulation and the Epworth Sleepiness Scale (EPS) score was 24 (full score: 24, cut off for hypersomnia: 10). She underwent comprehensive rehabilitative therapy, including neurotropic drugs, physical therapy, and occupational therapy. Her hypersomnia has shown improvement as 14 (3 months after onset), 11 (4 months after onset), 7 (12 months after onset), and 6 (24 months after onset), respectively. On 2-month DTT, narrowing of both lower dorsal and ventral ARASs was observed on both sides: in particular, among 4 neural tracts of the lower ARAS, the right lower ventral ARAS was the narrowest. By contrast, on 24-month DTT, the 4 narrowed neural tracts of both lower dorsal and ventral ARASs were thickened compared with those of 2-month DTT. Recovery of hypersomnia with recovery of an injured lower ARAS on DTT was observed in a stroke patient. Our results suggest that evaluation of the lower ARAS using DTT might be useful for stroke patients with hypersomnia.
Contralateral primary sensori-motor cortex (SM1) activation by passive movement was investigated by functional MRI (fMRI) at the early stage of stroke, to determine whether SM1 activation can be used to predict the degree of motor recovery of the hemiplegic hand.We studied 17 stroke patients who showed complete paralysis of a hemiplegic hand at onset. The motor function of the hemiplegic hand was assessed on 4 separate occasions (at onset, at fMRI evaluation (performed < 4 weeks after onset), and 3 and 6 months after onset). Significant motor recovery was defined as recovery of the affected hand to the extent of it being able to prehend an object against gravity at least at 6 months after onset.The patients having an activated contralateral SM1 showed better motor recovery than those who did not. Only a fourth of the patients with an activated contralateral SM1 experienced a significant motor recovery, whereas none of the patients with an inactivated SM1 showed an improvement 6 months after onset, however, the incidence of significant motor recovery was not significantly difference between the two groups.It appears that contralateral SM1 activation by passive movement in the early stage of stroke has a low predictive value for the motor recovery of the hemiplegic hand, because the activation of the contralateral SM1 by passive movement appears to be mediated by somatosensory input to the cortex from the thalamus rather than from the motor pathway.
Introduction: The diagnosis of frontotemporal dementia (FTD) is difficult due to its overlapping clinical syndromes. Quantitative electroencephalography (EEG) has been investigated as a promising diagnostic tool for FTD, but several studies have yielded contradictory results concerning individual spectral power. The current study aims to determine an EEG index to discriminate patients with FTD from healthy individuals. Methods: We used open-access EEG data from OpenNeuro to investigate the theta/alpha ratio (TAR) in the resting state of 23 patients with FTD and 29 healthy controls. Infinity reference and average reference were compared. Spectral data were extracted using a Fast Fourier Transform in the theta (4–8 Hz) and alpha band (8–13 Hz). Results: TAR was larger in patients with FTD than in healthy controls in every lobe. In addition, receiver operating characteristic curve analyses indicated that each lobar TAR could successfully differentiate FTD from controls (AUC > 0.7). Multiple logistic regression analysis revealed that frontal TAR was the only variable that significantly predicted FTD. The cutoff point, sensitivity, specificity, PPV, and NPV at the maximized Youden Index are also presented. Conclusion: TAR can be used to effectively distinguish patients with FTD from healthy controls. This study provides the foundation for future research on developing a more accurate and less expensive diagnostic tool for FTD.
Background and Objectives: Frontotemporal dementia (FTD) is the second most common form of presenile dementia; however, its diagnosis has been poorly investigated. Previous attempts to diagnose FTD using quantitative electroencephalography (qEEG) have yielded inconsistent results in both spectral and functional connectivity analyses. This study aimed to introduce an accurate qEEG marker that could be used to diagnose FTD and other neurological abnormalities. Materials and Methods: We used open-access electroencephalography data from OpenNeuro to investigate the power ratio between the frontal and temporal lobes in the resting state of 23 patients with FTD and 29 healthy controls. Spectral data were extracted using a fast Fourier transform in the delta (0.5 ≤ 4 Hz), theta (4 ≤ 8 Hz), alpha (8-13 Hz), beta (>13-30 Hz), and gamma (>30-45 Hz) bands. Results: We found that the spectral power ratio between the frontal and temporal lobes is a promising qEEG marker of FTD. Frontal (F)-theta/temporal (T)-alpha, F-alpha/T-theta, F-theta/F-alpha, and T-beta/T-gamma showed a consistently high discrimination score for the diagnosis of FTD for different parameters and referencing methods. Conclusions: The study findings can serve as reference for future research focused on diagnosing FTD and other neurological anomalies.
Frontotemporal dementia (FTD) is the second most common form of presenile dementia; however, its diagnosis has been poorly investigated. Previous attempts to diagnose FTD using quantitative electroencephalography (qEEG) have yielded inconsistent results in both spectral and functional connectivity analyses. This study aimed to introduce an accurate qEEG marker that could be used to diagnose FTD and other neurological abnormalities. We used open-access electroencephalography data from OpenNeuro to investigate the power ratio between the frontal and temporal lobes in the resting state of 23 patients with FTD and 29 healthy controls. Spectral data were extracted using a Fast Fourier Transform in the delta (1–4 Hz), theta (4–8 Hz), alpha (8–13 Hz), beta (13–32 Hz), and gamma (32–45 Hz) bands. We found that the spectral power ratio between the frontal and temporal lobes is a promising qEEG marker of FTD. Frontal/temporal (F/T) theta/alpha, alpha/theta, al-pha/gamma, and gamma/alpha showed a consistently high discrimination score for the diagnosis of FTD for different parameters and referencing methods. The study findings can serve as reference for future research focused on diagnosing FTD and other neurological anomalies.
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