QEEG and qSpike: brain indicator of temperature manipulation after cardiac arrest

描述（由申请人提供）：最近的临床研究表明，温度扰动，无论是低温还是高温，对心脏骤停后的脑损伤和恢复都有深远的影响。虽然通过降低体温或退烧来预防高热的温度控制在临床实践中很普遍，但温度对脑损伤的确切影响尚不完全清楚。事实上，没有方法可以直接滴定低体温治疗的疗效，例如开始治疗的时间，更理想的范围或持续时间。温度调节对皮质功能的影响也不清楚。在我们的初步研究中，我们已经观察到神经电反应，反映在实时神经元放电和皮层神经活动，即脑电图（EEG），直接受到温度的影响。这两种测量方法结合在一起，可以实时评估大脑的反应，从一个有限但特定的区域（尖峰）到大脑的大块或整体区域（脑电图）。该项目的两个目标是：(1)通过定量脑电图（QEEG）方法研究神经电反应，作为大脑对温度操纵反应的实时、无创电标记；(2)评估大脑皮层下（spike activity）和皮层QEEG反应对温度操纵的相互作用。通过该项目获得的概念证明将首先导致临床相关工具无创监测和滴定心脏骤停后的低温神经保护。此外，这项可行性研究将为在神经元水平上对低温或热疗的影响进行更基础的研究以及旨在优化人类治疗的临床研究打开大门。

DESCRIPTION (provided by applicant): Recent clinical studies have shown that temperature perturbation either as hypothermia or hyperthermia has a profound effect on brain injury and recovery after cardiac arrest. While the temperature manipulation, either by hypothermia or fever reduction to prevent hyperthermia is widespread in clinical practice, the precise effect of temperature on brain injury is not fully known. Indeed, no methods to directly titrate the efficacy of hypothermia treatment, such as the time to initiate therapy, more optimal range or duration, are available. Effect of temperature manipulation on cortical function is not known either. In our preliminary studies we have observed that the neuroelectrical response, as reflected in the real time neuronal firing and the cortical neural activity, namely electroencephalogram (EEG), is directly affected by temperature. Together these two measurements can provide a real-time assessment of these brain responses from a limited yet specific area (spikes) to bulk or global areas of the brain (EEG). The two aims of this project are (1) to study the neuro- electrical response by quantitative EEG (QEEG) methods serving as a real time, non-invasive, electrical marker of the brain's response to temperature manipulation, and (2) to evaluate the interaction of the subcortical (spike activity) and cortical QEEG responses of the brain to temperature manipulation. Proof of concept obtained through this project will first of all lead to a clinically relevant tool to noninvasively monitor and titrate hypothermic neuroprotection following cardiac arrest. In addition, this feasibility study will open the door to more fundamental research on effects of hypothermia or hyperthermia at neuronal level as well as clinical investigations designed to optimize the therapy in humans.