Spectral versus visual EEG analysis in mild hepatic encephalopathy

Spectral EEG analysis has been claimed to reduce subjective variability in EEG assessment of hepatic encephalopathy and to allow the detection of mild encephalopathy. To test such assumptions, 43 digital EEG were recorded in 32 cirrhotics without overt encephalopathy or with grade 1 overt encephalop...

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Published in:Clinical neurophysiology Vol. 110; no. 8; pp. 1334 - 1344
Main Authors: Amodio, P., Marchetti, P., Del Piccolo, F., de Tourtchaninoff, M., Varghese, P., Zuliani, C., Campo, G., Gatta, A., Guérit, J.M.
Format: Journal Article
Language:English
Published: Shannon Elsevier Science 01.08.1999
Subjects:
Adult
Biological and medical sciences
Electrodiagnosis. Electric activity recording
Electroencephalography
Female
Hepatic Encephalopathy - physiopathology
Humans
Image Processing, Computer-Assisted
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Nervous system
Reproducibility of Results
Human
Nervous system diseases
Hepatic disease
Psychometrics
Electroencephalography
Spectral analysis
Cerebral disorder
Electrodiagnosis
Liver failure
Encephalopathy
Central nervous system disease
Digestive diseases
Power spectrum
ISSN:1388-2457
Online Access:Get full text
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Summary:Spectral EEG analysis has been claimed to reduce subjective variability in EEG assessment of hepatic encephalopathy and to allow the detection of mild encephalopathy. To test such assumptions, 43 digital EEG were recorded in 32 cirrhotics without overt encephalopathy or with grade 1 overt encephalopathy; 7 patients were re-tested (2-5 times) in their follow up. All patients underwent psychometric assessment. Nineteen controls were considered. EEG were blindly evaluated by two electroencephalographers and by spectral EEG analysis performed according to 3 different techniques. The reliability of the classification based on spectral analysis (biparietal technique) was higher than that based on a three-degree qualitative visual reading (concordance/discordance = 58/4 versus 46/16 P < 0.01) and comparable with that of semiquantitative visual assessment based on posterior basic rhythm (concordance/discordance = 55/7 P = 0.5). The accuracy of spectral EEG analysis was higher than that of qualitative visual EEG readings alone (90 versus 75%) and comparable to semi-quantitative visual assessment (87%), however, statistical significance was not reached. In the follow-up, the variations of theta and delta relative power were found to be significantly correlated with psychometric variations. In conclusion, spectral EEG analysis may improve the assessment of mild hepatic encephalopathy by decreasing inter-operator variability and providing reliable parameters correlated with mental status.
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ISSN:1388-2457
DOI:10.1016/S1388-2457(99)00076-0