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for identifying the coupling strength and directionality between different brain cor-
tical regions are described in Section 19.3. The quantitative analysis, statistical tests,
and results are presented in Section 19.4. The conclusion and discussion are given
in Section 19.5.
19.2 Data Information
EEG recordings were acquired using a Nicolet BMSI recording system and the in-
ternational 10-20 electrode placement system (Fp1, Fp2, F3, F4, C3, C4, A1, A2,
P3, P4, O1, O2, F7, F8, T3, T4, T5, T6, Fz, Cz, and Pz). The EEG recordings
were band-pass filtered at 0.1-70 Hz. The sample frequency was set to 250 Hz. An
additional 60 Hz notch filter was applied to reduce the artifact induced by city alter-
nating current. One hour EEG recordings were obtained before and after an add-on
AED treatment. All the EEG recordings were reviewed by a board certified elec-
troencephalographer and artifact-free baseline EEG segments were selected for the
quantitative analysis. The clinical information about the ULD patients in this study
is summarized in Table 19.1. One set of EEG recordings was acquired before treat-
ment started and the other set was acquired after at least 8 weeks of treatment with
an adjunctive AED. All EEG recordings were recorded approximately at the same
time of day after the first dose of treatment with subjects lying supine in a relaxed
state.
Table 19.1: Patient information and UMRS scores
Patient
Gender
Age
ULD
UMRS
UMRS
Onset age
Score (before)
Score (after)
1
Female
47
9
98
48
2
ale
45
10
80
65
3
ale
50
12
50
66
4
ale
51
11
68
54
In this study, the severity of the ULD patients was clinically evaluated by per-
forming the unified myoclonus rating scale (UMRS), a statistically validated clini-
cal rating instrument for evaluating individuals with myoclonus. Low UMRS score
indicates less severity of ULD and vice versa. UMRS in patient 2 to patient 4 was
bed ridden and no points for arising, standing, or walking was included in their
UMRS scores. Baseline UMRS scores suggested that patient 1 had the highest dis-
ease severity followed by patient 2, patient 4, and patient 3, respectively. After
treatment, the UMRS scores indicated that severity was highest in patient 3 fol-
lowed by patient 4, patient 2, and patient 1. However, clinical observations indi-
cated that patient 1 had the mildest severity of disease before and after the treat-
ment in this study. We speculated that EEG dynamical analysis might reconcile this
discrepancy too.
