Tools and Techniques in Neuroscience Research

Brain imaging methods allow neuroscientists to see inside the living brain. These
methods help neuroscientists:
o Understand the relationships between specific areas of the brain and
what function they serve.
o Locate the areas of the brain that are affected by neurological disorders.
o Develop new strategies to treat brain disorders.

Computed Tomography Scan (CT Scan)

CT scans use a series of X-ray beams passed through the head. The images are
then developed on sensitive film. This method creates cross-sectional images of
the brain and shows the structure of the brain, but not its function.

Positron Emission Tomography (PET)

A scanner detects radioactive material that is injected or inhaled to create an
image. Commonly used radioactively-labeled material includes oxygen, fluorine,
carbon and nitrogen. When this material gets into the bloodstream, it goes to
areas of the brain that use it. So, oxygen and glucose accumulate in brain areas
that are metabolically active. When the radioactive material breaks down, it
gives off a neutron and a positron. When a positron hits an electron, both are
destroyed and two gamma rays are released. Gamma ray detectors record the
brain area where the gamma rays are emitted. This method provides scientists
with an idea of the function of the brain.
Advantages:
1. Provides an image of brain activity.
Disadvantages:
1. Expensive to use.
2. Radioactive material used.

Magnetic Resonance Imaging (MRI)

MRI uses the detection of radio frequency signals produced by displaced radio
waves in a magnetic field. It provides an anatomical view of the brain.
Advantages:
1. No X-rays or radioactive material is used.
2. Provides detailed view of the brain in different dimensions.
3. Safe, painless, non-invasive.
4. No special preparation (except the removal of all metal objects) is
required from the patient. Patients can eat or drink anything before the
procedure.
Disadvantages:
1. Expensive to use.
2. Cannot be used in patients with metallic devices, like pacemakers.
3. Cannot be used with uncooperative patients because the patient must lie
still.
4. Cannot be used with patients who are claustrophobic (afraid of small
places). However, new MRI systems with a more open design are now
available.

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Functional Magnetic Resonance Imaging (fMRI)
Functional MRI detects changes in blood flow to particular areas of the brain. It
provides both an anatomical and a functional view of the brain.

Angiography
Angiography involves a series of X-rays after dye is injected into the blood. This
method provides an image of the blood vessels of the brain.

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Positron-emission tomography (PET) is a nuclear medicine functional imaging
technique that is used to observe metabolic processes in the body. The system
detects pairs of gamma rays emitted indirectly by a positron-emitting
radionuclide (tracer), which is introduced into the body on a biologically active
molecule. Three-dimensional images of tracer concentration within the body are
then constructed by computer analysis. In modern PET-CT scanners, three-
dimensional imaging is often accomplished with the aid of a CT X-ray scan
performed on the patient during the same session, in the same machine.

If the biologically active molecule chosen for PET is fludeoxyglucose (FDG), an

analogue of glucose, the concentrations of tracer imaged will indicate tissue
metabolic activity as it corresponds to the regional glucose uptake. Use of this
tracer to explore the possibility of cancer metastasis (i.e., spreading to other
sites) is the most common type of PET scan in standard medical care (90% of
current scans). However, although on a minority basis, many other radioactive
tracers are used in PET to image the tissue concentration of other types of
molecules of interest. One of the disadvantages of PET scanners is their
operating cost.

PET scanning with the tracer fluorine-18 (F-18) fluorodeoxyglucose (FDG),

called FDG-PET, is widely used in clinical oncology. This tracer is a glucose
analog that is taken up by glucose-using cells and phosphorylated by hexokinase
(whose mitochondrial form is greatly elevated in rapidly growing malignant
tumors). A typical dose of FDG used in an oncological scan has an effective
radiation dose of 14 mSv. Because the oxygen atom that is replaced by F-18 to
generate FDG is required for the next step in glucose metabolism in all cells, no
further reactions occur in FDG. Furthermore, most tissues (with the notable
exception of liver and kidneys) cannot remove the phosphate added by
hexokinase. This means that FDG is trapped in any cell that takes it up, until it
decays, since phosphorylated sugars, due to their ionic charge, cannot exit from
the cell. This results in intense radiolabeling of tissues with high glucose uptake,
such as the brain, the liver, and most cancers. As a result, FDG-PET can be used
for diagnosis, staging, and monitoring treatment of cancers, particularly in
Hodgkin's lymphoma, non-Hodgkin lymphoma, and lung cancer.

Brain positron emission tomography:

Neurology: PET neuroimaging is based on an assumption that areas of high
radioactivity are associated with brain activity. What is actually measured
indirectly is the flow of blood to different parts of the brain, which is, in general,
believed to be correlated, and has been measured using the tracer oxygen-15.
However, because of its 2-minute half-life, O-15 must be piped directly from a
medical cyclotron for such uses, which is difficult. In practice, since the brain is
normally a rapid user of glucose, and since brain pathologies such as Alzheimer's
disease greatly decrease brain metabolism of both glucose and oxygen in
tandem, standard FDG-PET of the brain, which measures regional glucose use,
may also be successfully used to differentiate Alzheimer's disease from other
dementing processes, and also to make early diagnosis of Alzheimer's disease.

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The advantage of FDG-PET for these uses is its much wider availability. PET
imaging with FDG can also be used for localization of seizure focus: A seizure
focus will appear as hypometabolic during an interictal scan. Several
radiotracers (i.e. radioligands) have been developed for PET that are ligands for
specific neuroreceptor subtypes such as [11C] raclopride, [18F] fallypride and
[18F] desmethoxyfallypride for dopamine D2/D3 receptors, [11C] McN 5652 and
[11C] DASB for serotonin transporters, [18F] Mefway for serotonin 5HT1A
receptors, [18F] Nifene for nicotinic acetylcholine receptors or enzyme substrates
(e.g. 6-FDOPA for the AADC enzyme). These agents permit the visualization of
neuroreceptor pools in the context of a plurality of neuropsychiatric and
neurologic illnesses.

The development of a number of novel probes for noninvasive, in vivo PET

imaging of neuroaggregate in human brain has brought amyloid imaging to the
doorstep of clinical use. The earliest amyloid imaging probes included 2-(1-{6-
[(2-[18F]fluoroethyl)(methyl)amino]-2-naphthyl}ethylidene)malononitrile
([18F]FDDNP) developed at the University of California, Los Angeles and N-
methyl-[11C]2-(4'-methylaminophenyl)-6-hydroxybenzothiazole (termed
Pittsburgh compound B) developed at the University of Pittsburgh. These
amyloid imaging probes permit the visualization of amyloid plaques in the brains
of Alzheimer's patients and could assist clinicians in making a positive clinical
diagnosis of AD pre-mortem and aid in the development of novel anti-amyloid
therapies. [11C]PMP (N-[11C]methylpiperidin-4-yl propionate) is a novel
radiopharmaceutical used in PET imaging to determine the activity of the
acetylcholinergic neurotransmitter system by acting as a substrate for
acetylcholinesterase. Post-mortem examination of AD patients have shown
decreased levels of acetylcholinesterase. [11C]PMP is used to map the
acetylcholinesterase activity in the brain, which could allow for pre-mortem
diagnosis of AD and help to monitor AD treatments. Avid Radiopharmaceuticals
of Philadelphia has developed a compound called 18F-AV-45 that uses the
longer-lasting radionuclide fluorine-18 to detect amyloid plaques using PET
scans.
Neuropsychology / Cognitive neuroscience: To examine links between
specific psychological processes or disorders and brain activity.
Psychiatry: Numerous compounds that bind selectively to neuroreceptors of
interest in biological psychiatry have been radiolabeled with C-11 or F-18.
Radioligands that bind to dopamine receptors (D1, D2 receptor, reuptake
transporter), serotonin receptors (5HT1A, 5HT2A, reuptake transporter) opioid
receptors (mu) and other sites have been used successfully in studies with
human subjects. Studies have been performed examining the state of these
receptors in patients compared to healthy controls in schizophrenia, substance
abuse, mood disorders and other psychiatric conditions.
Stereotactic surgery and radiosurgery: PET-image guided surgery facilitates
treatment of intracranial tumors, arteriovenous malformations and other
surgically treatable conditions.

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Magnetic resonance imaging (MRI) is a medical imaging technique used in
radiology to form pictures of the anatomy and the physiological processes of the
body in both health and disease. MRI scanners use strong magnetic fields, radio
waves, and field gradients to generate images of the organs in the body. MRI
does not involve x-rays, which distinguishes it from computed tomography (CT
or CAT).

While the hazards of x-rays are now well-controlled in most medical contexts,
MRI still may be seen as superior to CT in this regard. MRI is widely used in
hospitals and clinics for medical diagnosis, staging of disease and follow-up
without exposing the body to ionizing radiation. MRI often may yield different
diagnostic information compared with CT. There may be risks and discomfort
associated with MRI scans. Compared with CT, MRI scans typically take greater
time, are louder, and usually require that the subject go into a narrow, confined
tube. In addition, people with some medical implants or other non-removable
metal inside the body may be unable to undergo an MRI examination safely.

MRI is based upon the science of nuclear magnetic resonance (NMR). Certain
atomic nuclei are able to absorb and emit radio frequency energy when placed in
an external magnetic field. In clinical and research MRI, hydrogen atoms are
most often used to generate a detectable radio-frequency signal that is received
by antennas in close proximity to the anatomy being examined. Hydrogen atoms
exist naturally in people and other biological organisms in abundance,
particularly in water and fat. For this reason, most MRI scans essentially map the
location of water and fat in the body. Pulses of radio waves excite the nuclear
spin energy transition, and magnetic field gradients localize the signal in space.
By varying the parameters of the pulse sequence, different contrasts may be
generated between tissues based on the relaxation properties of the hydrogen
atoms therein.

Since its early development in the 1970s and 1980s, MRI has proven to be a
highly versatile imaging technique. While MRI is most prominently used in
diagnostic medicine and biomedical research, it also may be used to form images
of non-living objects. MRI scans are capable of producing a variety of chemical
and physical data, in addition to detailed spatial images. The sustained increase
in demand for MRI within the healthcare industry has led to concerns about cost
effectiveness and overdiagnosis.

Physics of magnetic resonance imaging:

In most medical applications, protons (hydrogen atoms) in tissues containing
water molecules create a signal that is processed to form an image of the body.
First, energy from an oscillating magnetic field temporarily is applied to the
patient at the appropriate resonance frequency. The excited hydrogen atoms
emit a radio frequency signal, which is measured by a receiving coil. The radio
signal may be made to encode position information by varying the main
magnetic field using gradient coils. As these coils are rapidly switched on and off
they create the characteristic repetitive noise of an MRI scan. The contrast
between different tissues is determined by the rate at which excited atoms

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return to the equilibrium state. Exogenous contrast agents may be given
intravenously, orally, or intra-articularly.

The major components of an MRI scanner are: the main magnet, which polarizes
the sample, the shim coils for correcting inhomogeneities in the main magnetic
field, the gradient system which is used to localize the MR signal and the RF
system, which excites the sample and detects the resulting NMR signal. The
whole system is controlled by one or more computers.

MRI requires a magnetic field that is both strong and uniform. The field strength
of the magnet is measured in teslas and while the majority of systems operate
at 1.5 T, commercial systems are available between 0.2 and 7 T. Most clinical
magnets are superconducting magnets, which require liquid helium. Lower field
strengths can be achieved with permanent magnets, which are often used in
"open" MRI scanners for claustrophobic patients.[4] Recently, MRI has been
demonstrated also at ultra-low fields, i.e., in the microtesla-to-millitesla range,
where sufficient signal quality is made possible by prepolarization (on the order
of 10-100 mT) and by measuring the Larmor precession fields at about 100
microtesla with highly sensitive superconducting quantum interference devices
(SQUIDs).

MRI of brain and brain stem

MRI is the investigative tool of choice for neurological cancers, as it has better
resolution than CT and offers better visualization of the posterior fossa. The
contrast provided between grey and white matter makes MRI the best choice for
many conditions of the central nervous system, including demyelinating
diseases, dementia, cerebrovascular disease, infectious diseases, and epilepsy.
Since many images are taken milliseconds apart, it shows how the brain
responds to different stimuli, enabling researchers to study both the functional
and structural brain abnormalities in psychological disorders.[42] MRI also is
used in mri-guided stereotactic surgery and radiosurgery for treatment of
intracranial tumors, arteriovenous malformations, and other surgically treatable
conditions using a device known as the N-localizer.

Functional MRI

Functional MRI (fMRI) measures signal changes in the brain that are due to
changing neural activity. It is used to understand how different parts of the brain
respond to external stimuli or passive activity in a resting state, and has
applications in behavioral and cognitive research, and in planning neurosurgery
of eloquent brain areas. Researchers use statistical methods to construct a 3-D
parametric map of the brain indicating the regions of the cortex that
demonstrate a significant change in activity in response to the task. Compared to
anatomical T1W imaging, the brain is scanned at lower spatial resolution but at a
higher temporal resolution (typically once every 23 seconds). Increases in
neural activity cause changes in the MR signal via T*2 changes; this mechanism
is referred to as the BOLD (blood-oxygen-level dependent) effect. Increased
neural activity causes an increased demand for oxygen, and the vascular system

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actually overcompensates for this, increasing the amount of oxygenated
hemoglobin relative to deoxygenated hemoglobin. Because deoxygenated
hemoglobin attenuates the MR signal, the vascular response leads to a signal
increase that is related to the neural activity. The precise nature of the
relationship between neural activity and the BOLD signal is a subject of current
research. The BOLD effect also allows for the generation of high resolution 3D
maps of the venous vasculature within neural tissue.

While BOLD signal analysis is the most common method employed for
neuroscience studies in human subjects, the flexible nature of MR imaging
provides means to sensitize the signal to other aspects of the blood supply.
Alternative techniques employ arterial spin labeling (ASL) or weighting the MRI
signal by cerebral blood flow (CBF) and cerebral blood volume (CBV). The CBV
method requires injection of a class of MRI contrast agents that are now in
human clinical trials. Because this method has been shown to be far more
sensitive than the BOLD technique in preclinical studies, it may potentially
expand the role of fMRI in clinical applications. The CBF method provides more
quantitative information than the BOLD signal, albeit at a significant loss of
detection sensitivity.

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Computed Tomography Scan (CT Scan)
A CT scan makes use of computer-processed combinations of many X-ray
measurements taken from different angles to produce cross-sectional
(tomographic) images (virtual "slices") of specific areas of a scanned object,
allowing the user to see inside the object without cutting. Other terms include
computed axial tomography (CAT scan) and computer aided tomography.

Digital geometry processing is used to further generate a three-dimensional

volume of the inside of the object from a large series of two-dimensional
radiographic images taken around a single axis of rotation. Medical imaging is
the most common application of X-ray CT. Its cross-sectional images are used for
diagnostic and therapeutic purposes in various medical disciplines. The rest of
this article discusses medical-imaging X-ray CT; industrial applications of X-ray
CT are discussed at industrial computed tomography scanning.

The term "computed tomography" (CT) is often used to refer to X-ray CT,
because it is the most commonly known form. But, many other types of CT exist,
such as positron emission tomography (PET) and single-photon emission
computed tomography (SPECT). X-ray tomography, a predecessor of CT, is one
form of radiography, along with many other forms of tomographic and non-
tomographic radiography.

CT produces a volume of data that can be manipulated in order to demonstrate

various bodily structures based on their ability to absorb the X-ray beam.
Although, historically, the images generated were in the axial or transverse
plane, perpendicular to the long axis of the body, modern scanners allow this
volume of data to be reformatted in various planes or even as volumetric (3D)
representations of structures. Although most common in medicine, CT is also
used in other fields, such as nondestructive materials testing. Another example is
archaeological uses such as imaging the contents of sarcophagi. Individuals
responsible for performing CT exams are called radiographers or radiologic
technologists.

Medical use
Since its introduction in the 1970s, CT has become an important tool in medical
imaging to supplement X-rays and medical ultrasonography. It has more recently
been used for preventive medicine or screening for disease, for example CT
colonography for people with a high risk of colon cancer, or full-motion heart
scans for people with high risk of heart disease. A number of institutions offer
full-body scans for the general population although this practice goes against the
advice and official position of many professional organizations in the field
primarily due to the radiation dose applied.
Head
CT scanning of the head is typically used to detect infarction, tumors,
calcifications, haemorrhage and bone trauma. Of the above, hypodense (dark)
structures can indicate edema and infarction, hyperdense (bright) structures
indicate calcifications and haemorrhage and bone trauma can be seen as
disjunction in bone windows. Tumors can be detected by the swelling and
anatomical distortion they cause, or by surrounding edema. Ambulances

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equipped with small bore multi-sliced CT scanners respond to cases involving
stroke or head trauma. CT scanning of the head is also used in CT-guided
stereotactic surgery and radiosurgery for treatment of intracranial tumors,
arteriovenous malformations and other surgically treatable conditions using a
device known as the N-localizer.

Magnetic resonance imaging (MRI) of the head provides superior information as

compared to CT scans when seeking information about headache to confirm a
diagnosis of neoplasm, vascular disease, posterior cranial fossa lesions,
cervicomedullary lesions, or intracranial pressure disorders. It also does not
carry the risks of exposing the patient to ionizing radiation. CT scans may be
used to diagnose headache when neuroimaging is indicated and MRI is not
available, or in emergency settings when hemorrhage, stroke, or traumatic brain
injury are suspected. Even in emergency situations, when a head injury is minor
as determined by a physician's evaluation and based on established guidelines,
CT of the head should be avoided for adults and delayed pending clinical
observation in the emergency department for children.

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Electromyography (EMG)
Electromyography (EMG) is an electrodiagnostic medicine technique for
evaluating and recording the electrical activity produced by skeletal muscles.
EMG is performed using an instrument called an electromyograph to produce a
record called an electromyogram. An electromyograph detects the electric
potential generated by muscle cells when these cells are electrically or
neurologically activated. The signals can be analyzed to detect medical
abnormalities, activation level, or recruitment order, or to analyze the
biomechanics of human or animal movement.

Medical uses

EMG testing has a variety of clinical and biomedical applications. EMG is used as
a diagnostics tool for identifying neuromuscular diseases, or as a research tool
for studying kinesiology, and disorders of motor control. EMG signals are
sometimes used to guide botulinum toxin or phenol injections into muscles. EMG
signals are also used as a control signal for prosthetic devices such as prosthetic
hands, arms, and lower limbs.

EMG then an acceleromyograph may be used for neuromuscular monitoring in

general anesthesia with neuromuscular-blocking drugs, in order to avoid
postoperative residual curarization (PORC).

Except in the case of some purely primary myopathic conditions EMG is usually
performed with another electrodiagnostic medicine test that measures the
conducting function of nerves. This is called a nerve conduction studies (NCS).
Needle EMG and NCSs are typically indicated when there is pain in the limbs,
weakness from spinal nerve compression, or concern about some other
neurologic injury or disorder. Spinal nerve injury does not cause neck, mid back
pain or low back pain, and for this reason, evidence has not shown EMG or NCS
to be helpful in diagnosing causes of axial lumbar pain, thoracic pain, or cervical
spine pain. Needle EMG may aid with the diagnosis of nerve compression or
injury (such as carpal tunnel syndrome), nerve root injury (such as sciatica), and
with other problems of the muscles or nerves. Less common medical conditions
include amyotrophic lateral sclerosis, myasthenia gravis, and muscular
dystrophy.

Research:
EMG can be used to sense isometric muscular activity where no movement is
produced. This enables definition of a class of subtle motionless gestures to
control interfaces without being noticed and without disrupting the surrounding
environment. These signals can be used to control a prosthesis or as a control
signal for an electronic device such as a mobile phone or PDA.

EMG signals have been targeted as control for flight systems. The Human Senses
Group at the NASA Ames Research Center at Moffett Field, CA seeks to advance
man-machine interfaces by directly connecting a person to a computer. In this
project, an EMG signal is used to substitute for mechanical joysticks and

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keyboards. EMG has also been used in research towards a "wearable cockpit,"
which employs EMG-based gestures to manipulate switches and control sticks
necessary for flight in conjunction with a goggle-based display.

Unvoiced speech recognition recognizes speech by observing the EMG activity of

muscles associated with speech. It is targeted for use in noisy environments, and
may be helpful for people without vocal cords and people with aphasia.

EMG has also been used as a control signal for computers and other devices. An
interface device based on EMG could be used to control moving objects, such as
mobile robots or an electric wheelchair. This may be helpful for individuals that
cannot operate a joystick-controlled wheelchair. Surface EMG recordings may
also be a suitable control signal for some interactive video games.

In 1999 an EMG program called Echidna was used to enable a man with locked in
syndrome to send a message to a computer. That program, now called
NeuroSwitch, developed by Control Bionics enables people with severe
disabilities to communicate by text, email, SMS, computer-generated voice and to
control computer games and programs, and - through the internet - Anybots
telepresence robots.

A joint project involving Microsoft, the University of Washington in Seattle, and

the University of Toronto in Canada has explored using muscle signals from hand
gestures as an interface device. A patent based on this research was submitted
on June 26, 2008.

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Electrocardiography

Electrocardiography (ECG) is the process of recording the electrical activity of

the heart over a period of time using electrodes placed on the skin. These
electrodes detect the tiny electrical changes on the skin that arise from the heart
muscle's electrophysiologic pattern of depolarizing and repolarizing during each
heartbeat. It is a very commonly performed cardiology test.

In a conventional 12-lead ECG, ten electrodes are placed on the patient's limbs
and on the surface of the chest. The overall magnitude of the heart's electrical
potential is then measured from twelve different angles ("leads") and is recorded
over a period of time (usually ten seconds). In this
way, the overall magnitude and direction of the
heart's electrical depolarization is captured at each
moment throughout the cardiac cycle. The graph of
voltage versus time produced by this noninvasive
medical procedure is referred to as an
electrocardiogram.

During each heartbeat, a healthy heart has an

orderly progression of depolarization that starts
with pacemaker cells in the sinoatrial node, spreads
out through the atrium, passes through the
atrioventricular node down into the bundle of His
and into the Purkinje fibers, spreading down and to the left throughout the
ventricles. This orderly pattern of depolarization gives rise to the characteristic
ECG tracing. To the trained clinician, an ECG conveys a large amount of
information about the structure of the heart and the function of its electrical
conduction system. Among other things, an ECG can be used to measure the rate
and rhythm of heartbeats, the size and position of the heart chambers, the
presence of any damage to the heart's muscle cells or conduction system, the
effects of cardiac drugs, and the function of implanted pacemakers.

Medical uses
The overall goal of performing electrocardiography is to obtain information
about the structure and function of the heart. Medical uses for this information
are varied and generally relate to having a need for knowledge of the structure
and/or function. Some indications for performing electrocardiography include:

Suspected myocardial infarction (heart attack) or new chest pain

Suspected pulmonary embolism or new shortness of breath
A third heart sound, fourth heart sound, a cardiac murmur or other
findings to suggest structural heart disease
Perceived cardiac dysrhythmias either by pulse or palpitations
Monitoring of known cardiac dysrhythmias
Fainting or collapse
Seizures
Monitoring the effects of a heart medication (e.g. drug-induced QT
prolongation)

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 Assessing severity of electrolyte abnormalities, such as hyperkalemia
Hypertrophic cardiomyopathy screening in adolescents as part of a sports
physical out of concern for sudden cardiac death (varies by country)
Perioperative monitoring in which any form of anesthesia is involved (e.g.
monitored anesthesia care, general anesthesia); typically both
intraoperative and postoperative
As a part of a pre-operative assessment some time before a surgical
procedure (especially for those with known cardiovascular disease or
who are undergoing invasive or cardiac, vascular or pulmonary
procedures, or who will receive general anesthesia)
Cardiac stress testing
Computed tomography angiography (CTA) and Magnetic resonance
angiography (MRA) of the heart (ECG is used to "gate" the scanning so
that the anatomical position of the heart is steady)
Biotelemetry of patients for any of the above reasons and such
monitoring can include internal and external defibrillators and
pacemakers

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Electroencephalography (EEG) is an electrophysiological monitoring method
to record electrical activity of the brain. It is typically noninvasive, with the
electrodes placed along the scalp, although invasive electrodes are sometimes
used such as in electrocorticography. EEG measures voltage fluctuations
resulting from ionic current within the neurons of the brain. In clinical contexts,
EEG refers to the recording of the brain's spontaneous electrical activity over a
period of time, as recorded from multiple electrodes placed on the scalp.
Diagnostic applications generally focus either on event-related potentials or on
the spectral content of EEG. The former investigates potential fluctuations time
locked to an event like stimulus onset or button press. The latter analyses the
type of neural oscillations (popularly called "brain waves") that can be observed
in EEG signals in the frequency domain.

EEG is most often used to diagnose epilepsy, which causes abnormalities in EEG
readings. It is also used to diagnose sleep disorders, depth of anesthesia, coma,
encephalopathies, and brain death. EEG used to be a first-line method of
diagnosis for tumors, stroke and other focal brain disorders, but this use has
decreased with the advent of high-resolution anatomical imaging techniques
such as magnetic resonance imaging (MRI) and computed tomography (CT).
Despite limited spatial resolution, EEG continues to be a valuable tool for
research and diagnosis. It is one of the few mobile techniques available and
offeres millisecond-range temporal resolution which is not possible with CT, PET
or MRI.

Derivatives of the EEG technique include evoked potentials (EP), which involves
averaging the EEG activity time-locked to the presentation of a stimulus of some
sort (visual, somatosensory, or auditory). Event-related potentials (ERPs) refer
to averaged EEG responses that are time-locked to more complex processing of
stimuli; this technique is used in cognitive science, cognitive psychology, and
psychophysiological research.

Medical use
A routine clinical EEG recording typically lasts 2030 minutes (plus preparation
time) and usually involves recording from scalp electrodes. Routine EEG is
typically used in the following clinical circumstances:

to distinguish epileptic seizures from other types of spells, such as psychogenic

non-epileptic seizures, syncope (fainting), sub-cortical movement disorders and
migraine variants.
to differentiate "organic" encephalopathy or delirium from primary psychiatric
syndromes such as catatonia
to serve as an adjunct test of brain death
to prognosticate, in certain instances, in patients with coma
to determine whether to wean anti-epileptic medications

At times, a routine EEG is not sufficient, particularly when it is necessary to

record a patient while he/she is having a seizure. In this case, the patient may be
admitted to the hospital for days or even weeks, while EEG is constantly being
recorded (along with time-synchronized video and audio recording). A recording

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of an actual seizure (i.e., an ictal recording, rather than an inter-ictal recording of
a possibly epileptic patient at some period between seizures) can give
significantly better information about whether or not a spell is an epileptic
seizure and the focus in the brain from which the seizure activity emanates.

Epilepsy monitoring is typically done:

to distinguish epileptic seizures from other types of spells, such as psychogenic

non-epileptic seizures, syncope (fainting), sub-cortical movement disorders and
migraine variants.
to characterize seizures for the purposes of treatment
to localize the region of brain from which a seizure originates for work-up of
possible seizure surgery

Additionally, EEG may be used to monitor certain procedures:

to monitor the depth of anesthesia

as an indirect indicator of cerebral perfusion in carotid endarterectomy
to monitor amobarbital effect during the Wada test

EEG can also be used in intensive care units for brain function monitoring:

to monitor for non-convulsive seizures/non-convulsive status epilepticus

to monitor the effect of sedative/anesthesia in patients in medically induced
coma (for treatment of refractory seizures or increased intracranial pressure)
to monitor for secondary brain damage in conditions such as subarachnoid
hemorrhage (currently a research method)

If a patient with epilepsy is being considered for resective surgery, it is often

necessary to localize the focus (source) of the epileptic brain activity with a
resolution greater than what is provided by scalp EEG. This is because the
cerebrospinal fluid, skull and scalp smear the electrical potentials recorded by
scalp EEG. In these cases, neurosurgeons typically implant strips and grids of
electrodes (or penetrating depth electrodes) under the dura mater, through
either a craniotomy or a burr hole. The recording of these signals is referred to
as electrocorticography (ECoG), subdural EEG (sdEEG) or intracranial EEG
(icEEG)--all terms for the same thing. The signal recorded from ECoG is on a
different scale of activity than the brain activity recorded from scalp EEG. Low
voltage, high frequency components that cannot be seen easily (or at all) in scalp
EEG can be seen clearly in ECoG. Further, smaller electrodes (which cover a
smaller parcel of brain surface) allow even lower voltage, faster components of
brain activity to be seen. Some clinical sites record from penetrating
microelectrodes.[1] EEG may be done in all pediatric patients presenting with
first onset afebrile or complex febrile seizures.[13] EEG is not indicated for
diagnosing headache.[14] Recurring headache is a common pain problem, and
this procedure is sometimes used in a search for a diagnosis, but it has no
advantage over routine clinical evaluation.

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