10 – 20 electrode placement

Unit 2
 EEG
• The electroencephalogram (EEG) is a
recording of the electrical activity of the
brain from the scalp.
• The first recordings were made by Hans
Berger in 1929
Origin of EEG waves (fyi)
 Electroencephalogram
• EEG is the record of electrical activity of
brain( superficial layer i.e. the dendrites of
pyramidal cells) by placing the electrodes
on the scalp.
Generation of large EEG signals by synchronous
activity (fyi)
 Electroencephalography
• Electroencephalograp • On the surface of the
hy deals with the brain , these voltages
recording and study are about 10 mv.
of electrical activity of • Due to the
the brain. propagation through
• Electrodes are skull bones they are
attached to the skull attenuated tto levels
and the brain waves from 1 to 100 μV
are picked up.
 Contd…
• These potentials vary • An Electroencephalogram
with respect to is the record of the brain
waves made by an
position of the
electroencephalography
electrode on the
surface of skull.
• The electrodes are
placed around the
frontal, parietal,
temporal and occipital
lobes of the brain
EEG
Action potentials of brain
Resting potential
2. Propagation of the Action
Potential
 Web
Animation
 How does an electrical signal jump to the next
neuron? -> Synapse

A. What is a synapse?
– The space between neurons (synaptic cleft)
– Presynaptic cell = transmitting cell
– Postsynaptic cell = receiving cell
B. Chemicals called neurotransmitters are
used to pass on the message
 Web
Animation
 Source of EEG Activity
• Scalp EEG measures summated activity of
post-synaptic currents.
• An action potential in a pre-synaptic axon
causes the release of neurotransmitter into
the synapse.
 Contd
• The neurotransmitter diffuses across the
synaptic cleft and binds to receptors in a
post-synaptic dendrite.
• The activity of many types of receptors
results in a flow of ions into or out of the
dendrite. This leads to the current in the
extra cellular space.
 Contd..
• Surface EEG is the summation of the
synchronous activity of thousands of
neurons that have similar spatial
orientation, radial to the scalp.
• Currents that are tangential to the scalp
are not picked up by the EEG. The EEG
therefore benefits from the parallel, radial
arrangement of dendrites in the cortex.
 contd
• Activity from deep sources is more difficult
to detect than currents near the skull.
• Scalp EEG activity is comprised of multiple
oscillations.
• These have a different characteristic
frequencies, spatial distributions and
associations with different states of brain
functioning (such as awake vs. asleep).
 C. EPSP and IPSP
1. EPSP (excitatory postsynaptic potential)
• Has a depolarizing effect, meaning it drives
a membrane closer to threshold
2. IPSP (inhibitory postsynaptic potential)
• Has a hyperpolarizing effect, thus drives the
membrane away from threshold and help
maintains resting state.
Inhibitory post synaptic potential
• If neuro transmitter substance is Inhibitory
, the receptor membrane potential
increases in a negative direction. so that
the receptor neuron is less likely to
discharge and produces a spike potential.
This induced change is called Inhibitory
post synaptic potential.
 Excitatory post synaptic
potential.
• If neuro transmitter substance is Excitatory
, the receptor membrane potential
increases in a positive direction. so that
the receptor neuron is more likely to
discharge and produces a spike potential.
This induced change is called Excitatory
post synaptic potential.
D. Summation (fyi)
 Graded Potential
• Pre synaptic spike potential ( positive
potential resulting from presynatic
depolarization)
• EPSP
• Spike Potential (sudden 2 ms positive
discharge of 10 to 30 Mv.
• After hyper polarization prolonged positive
potential
 Contd…
• IPSP (Negative Potential associated with
neuronal inhibitory )
• Individually epsp and ipsp are small.
• Resistance and conductance.
• Ipsp – resistance increase.
• When an EPSP reaches the threshold the
neuron fires.
Contd..
Lobes and functions (fyi)
Contd..
Contd..
 Different Types of Waveform
• Alpha waves - 8-13 Hz
• Beta waves - Greater than 13 Hz
• Theta waves – 4 -7.5 Hz
• Delta waves - 3 Hz or less
1 sec - EEG
Different Waves
 Frequency bands
Type of Amplitude Frequency
wave
Alpha Less than 8 to 13 hz
10μV
Beta Less than 13 to 22 hz
20 μV
Theta and Less than 4 to 8
delta 200 μV hz,0.5 to 4
hz
Gamma 2 μV High
frequency
Alpha
• Frequency : 8 to 13
hz
• Amp : 20 to 200 μV
• Recorded site: Most
intensely in Occipital
region. Can be
recorded in frontal
and parietal region of
the scalp
 Alpha
• Alpha rhythms are reported to be derived from
the white matter of the brain. The white matter
can be considered the part of the brain that
connects all parts with each other.
• Alpha is a common state for the brain and
occurs whenever a person is alert (it is a marker
for alertness and sleep), but not actively
processing information.
• They are strongest over the occipital (back of
the head) cortex and also over frontal cortex..
 Alpha..
• Alpha brainwaves are slower, and higher in
amplitude.
• Alpha waves generally are seen in all age
groups but are most common in adults.
• They occur rhythmically on both sides of the
head but are often slightly higher in amplitude on
the non dominant side, especially in right-
handed individuals.
• They are prominent with closed eyes and with
relaxation
 Contd…
• Alpha activity disappears normally with
attention (eg, mental arithmetic, stress,
opening eyes). In most instances, it is
regarded as a normal waveform.
 Effect of Alpha
• When your alpha is with in normal ranges
we tend to also experience good moods,
see the world truthfully, and have a sense
of calmness.

• You can increase alpha by closing your

eyes or deep breathing or decrease alpha
by thinking or calculating.
 Biofeedback
• Alpha-Theta training can create an increase in
sensation, abstract thinking and self-control.
• When Alpha predominates most people feel at
ease and calm. Alpha appears to bridge the
conscious to the subconscious.
• It is the major rhythm seen in normal relaxed
adults - it is present during most of life especially
beyond the thirteenth year when it dominates
the resting tracing.
Beta
• Freq: Above 13 hz
• Recorded site:
Parietal and frontal
region of the scalp
• Beta 1 and Beta 2.
 Beta
• Beta activity is 'fast' activity. It reflects
desynchronized active brain tissue.
• It is most evident in frontal region. It may
be absent or reduced in areas of cortical
damage.
• It is generally regarded as a normal
rhythm and is the dominant rhythm in
those who are alert or anxious or who
have their eyes open.
 Beta
• It is the state that most of brain is in when
we have our eyes open , listening and
thinking during analytical problem solving,
judgment, decision making, processing
information about the world around us.
 Contd…
• Beta 1 is twice the • Beta 2 they appear
alpha frequency they during intense
are affected by the activation of the CNS
mental activity. and during tension.
 BETA
• The beta band has a relatively large range, and
has been divided into low, midrange and high.

Low Beta (12-15 Hz), formerly "SMR":

• Subjective feeling states: relaxed yet

focused, integrated
 BETA
• Midrange Beta (15-18 Hz)
• Subjective feeling states: thinking,
aware of self & surroundings
Physiological correlates: alert, active,
but not agitated
Associated tasks & behaviors: mental
activity
 BETA
• High Beta (above 18 Hz):
• Subjective feeling states: alertness,
agitation
Physiological correlates: general
activation of mind & body functions.
• Associated tasks & behaviors: mental
activity, e.g. math, planning, etc.
Gamma Waves
 Gamma (above 36 Hz)
• Gamma is measured between 36 – 44 (Hz) and
is the only frequency group found in every part
of the brain.
• When the brain needs to simultaneously
process information from different areas, its
hypothesized that the 40Hz activity consolidates
the required areas for simultaneous processing.
• A good memory is associated with well-
regulated and efficient 40Hz activity, whereas a
40Hz deficiency creates learning disabilities.
 Gamma (40 Hz):

Subjective feeling states: thinking;

integrated thoughts
Associated tasks & behaviors: high-
level information processing, "binding"
Physiological correlates: associated with
information-rich task processing
Theta
• Freq : 4 to 8 hz
• Recorded site :
parietal and temporal
region in children.
• But they also occur
during emotional
stress in some adults,
particularly during the
period of
disappointment and
frustration.
 Theta (4-8 Hz)
• Theta activity as "slow" activity.
• It is seen in connection with creativity, intuition,
daydreaming, and fantasizing and is a repository
for memories, emotions, sensations.
• Theta waves are strong during internal focus,
meditation, prayer, and spiritual awareness. It
reflects the state between wakefulness and
sleep. Relates to subconscious.
Delta
• Freq: below 4 hz.
• Sometimes these
waves occur only
once every 2 or 3 s.
• They occur in deep
sleep in infancy and
in serious organic
brain disease.
• They occur solely
within cortex.
 Delta
• The lowest frequencies are delta.

• These occur in deep sleep and in some abnormal

processes also during experiences of "empathy state".

• Delta waves are involved with our ability to integrate and

let go. It reflects unconscious mind.

• It is the dominant rhythm in infants up to one year of age

and it is present in stages 3 and 4 of sleep.

• It tends to be the highest in amplitude and the slowest

waves.
 ADD
• However, most individuals diagnosed with
Attention Deficit Disorder, naturally
increase rather than decrease Delta
activity when trying to focus.
• The inappropriate Delta response often
severely restricts the ability to focus and
maintain attention. It is as if the brain is
locked into a perpetual drowsy state.
 Delta
• Delta (0.1- 4 Hz)
• Distribution: generally broad or diffused may be
bilateral, widespread
Subjective feeling states: deep, dreamless
sleep, non-REM sleep, trance, unconscious
Associated tasks & behaviors: lethargic, not
moving, not attentive
Physiological correlates: not moving, low-level
of arousal
 Contd..
• The normal EEG varies by age. The
neonatal EEG is quite different from the
adult EEG. The EEG in childhood is
generally comprised of slower frequency
oscillations than the adult EEG.
EEG
Sleep pattern
 Stages of sleep
Eyes are closed , produce a large amount of
Drowsy rhymic activity in the range of 8 to 13 hz

Amp & freq of the waveform decreased

Fall asleep

Light sleep Large amplitude low frequency waveform emerges

Deeper Sleep Freq even low and higher amplitude waveform

Sleep Stage Patterns During One Night
 EEG also varies depending on state..

• Stage I sleep (equivalent to drowsiness in some

systems) appears on the EEG as drop-out of the
posterior basic rhythm. There can be an
increase in theta frequencies.
• Stage II sleep is characterized by sleep
spindles--transient runs of rhythmic activity in the
12-14 Hz range (sometimes referred to as the
"sigma" band) that have a frontal-central
maximum.
• Most of the activity in Stage II is in the 3-6 Hz
range.
 Sleep
• Stage III and IV sleep are defined by the
presence of delta frequences and are often
referred to collectively as "slow-wave sleep.“

• Stages I-IV are comprise non-REM (or "NREM")

sleep.

• The EEG in REM (rapid eye movement) sleep

appears somewhat similar to the awake EEG.
Segment of EEG activity during wakefulness. Alpha rhythm
(a continuous activity between 8 and 13 Hz) appears
During light sleep alpha rhythm disappears and from time to time sleep
spindles (a spindle-shaped waveform of limited duration at around 13hz
When sleep becomes deeper, slow
waves dominate the record.
EEG Stages in Wakefulness and Sleep
 REM
• A period of high frequency that occur
during sleep is called Paradoxical sleep
,because the EEG is more like that of an
awake alert person than one who is
asleep.
• REM sleep is associated with high
frequency EEG is a large amount of Rapid
Eye Movement beneath the closed
eyelids.
 Contd…
• When people sleep, they experience periods of
Rapid Eye Movement.
• During this stage, which is associated with
dreaming, the brain becomes very active.
• REM sleep and dreaming are triggered by the
pons and neighboring structures in the
brainstem.
• During REM sleep, the brain transfers short-term
memories in the motor cortex to the temporal
lobe to become long-term memories.
 CONTD
• REM sleep in adult humans typically
occupies 20-25% of total sleep, lasting
about 90-120 minutes.
• During a normal night of sleep, humans
usually experience about 4 or 5 periods of
REM sleep; they are quite short at the
beginning of the night and longer toward
the end.
 Contd…
• A newborn baby spends more than 80% of
total sleep time in REM.
• During REM, the summed activity of the
brain's neurons is quite similar to that
during waking hours; for this reason, the
phenomenon is often called paradoxical
sleep.
Different Stages of sleep
Contd
 Picture of K Complex
• K complex • K complex waves are
large-amplitude delta
frequency waves,
sometimes with a
sharp apex.
• Sometimes
Associated with
Sharp Components
and followed by 14
hz.
• Amplitude is 200 μv.
 Contd…

• They can occur throughout the brain and usually

are higher in amplitude.
• They occur each time the patient is aroused
partially from sleep.
• Semi arousal often follows brief noises; with
longer sounds, repeated K complexes can
occur.
• K complexes sometimes are followed by runs of
generalized rhythmic theta waves; the whole
complex is termed an arousal burst.
 Example of either lambda or positive
occipital sharp transients of sleep
• Lambda • These are
Monophasic, positive
sharp waves that
occur in the Occipital
location .
• Amplitude : less than
50μV
• They are related to
eye movement.
 POSTS
• POSTS are triangular waves that occur in the
bilateral occipital regions as positive (upgoing)
waves.
• They can be multiple and usually are symmetric.
• POSTS occur in sleeping patients and are said
to be most evident in stage 2 of sleep, although
they are not uncommon in stage 1.
• POSTS are similar or identical to lambda waves
both morphologically and in the occipital
distribution.
Example of mu waveforms.
• Mu waves are runs of
rhythmic activity that have
a specific shape.
• They are rounded in one
direction with a sharp
side in the other direction
• Freq: 7-11hz with arcade
or comb shape in the
central location.
• Amp: less than 50μV
 Mu waves…
• They are blocked or attenuated by contralateral
movement, thought of movement, readiness to move, or
tactile stimulation.
• Unlike alpha activity, they are not blocked by eye
opening.
• They often are asymmetric.
• Mu waves are seen best when the cortex is exposed or if
bone defects (eg, post surgical) are present in the skull.
• They tend to be more evident over the motor cortex.
 Example of small sharp spikes, also known as
benign epileptiform transients of sleep (BETS)

• Bets • These are recognized

by their height, their
sharp top, and their
narrow base.
• Spikes and sharp
waves usually are
abnormal.
 Contd….

• They can be normal in the following settings:

Small, sharp spikes of sleep or benign epileptiform transients of
sleep (BETS) are nonpathologic.
– They occur in the temporal regions. They do not have slow-
following waves as do most of the pathologic spikes of epilepsy.

– Numerous artifacts resemble spikes, but they are distinguished

by other waves that may be present, by observation of the
patient while they are occurring, and by experience.
 Benign epileptic transients of
sleep
• These sharp, usually small waves occur on one
or both sides (usually asynchronously),
especially in the temporal and frontal regions.
• BETS are rare in children but are more frequent
in adults and elderly persons.
• Although they can occur in epileptic patients,
BETS often are seen in individuals without
epilepsy and can be regarded as a probable
normal variant
 V- Waves
• V waves are sharp waves that occur
during sleep.
• V waves tend to occur especially during
stage 2 sleep and may be multiple.
• Often, they occur after sleep disturbances
(eg, brief sounds) and, like K complexes,
may occur during brief semi arousals.
• V waves are easy to recognize.
 EEG in the States of Vigilance
Frequency
Ranges

Beta: 14 – 30 Hz
Alpha: 8 – 13
Hz
Theta: 5 – 7 Hz
Delta: 1–4
Hz
 EEG Amplitude
• Ranges from 1 to 100 μV peak to peak at
low frequencies(0.5 to 100 hz) at cranial
surface.
• At the surface of the cerebrum signals
may be 10 times stronger
• Brain stem signals measured are 0.25 μV
peak to peak(100 to 1000 hz).
EEG Waveform
EEG Waveform
 Two types of recording
• Bipolar – both the • Unipolar – one
electrodes are at electrode is active
active site and the other is
indifferent kept at ear
lobe.
(A) Bipolar and (B) unipolar
measurements
Electrode
contd
 EEG Electrodes
• Each electrode site is labeled with a letter and a
number.
• The letter refers to the area of brain underlying the
electrode
e.g. F - Frontal lobe and T - Temporal lobe.
• Even numbers denote the right side of the head
and
• Odd numbers the left side of the head.
 EEG
• The amplitude , phase and frequency of
EEG depend on electrode placement.
• The placement is based on Frontal,
Parietal, temporal and occipital areas .
• One of the most popular schemes is the
10-20 EEG Placement System established
by the International Federation of EEG
socities.
 Contd…
• In this setup, the head is mapped by four
standard points.
• The nasion , the inion and the left and right
pre auricular points.
• Nineteen electrodes plus one for
grounding the subject are used.
 Contd…
• Electrodes are placed on the scalp by
measuring the nasion-inion distance and
marking the points on the head 10% 20%
20% 20% and 10%.
 Montage
• Different sets of electrode arrangement on
the scalp by 10 – 20 system is known as
montage.
• 21 electrodes are attached to give 8 or 16
channels recording.
 10 – 20 electrode placement

The international 10-20 system seen from (A) left and (B) above the head.
(Fyi)
The International 10/20 System
 Terminology: 10/20 System

Nasion: point between the forehead and the skull

Inion: bump at the back of the skull
Location: Frontal, Temporal, Parietal, Occipital, Central
z for the central line
Numbers: Even numbers (2,4,6) right hemisphere, odd (1,3,5) left
 EEG channels

Channel: Recording from a pair of electrodes (here with a

common reference: A1 – left ear)
Multichannel EEG recording: up to 40 channels recorded in
parallel
 Participants with Electrodes

EEG in clinical diagnostics EEG in scientific research

 ELECTRODE PLACEMENT
• It is called the 10-20 system, because the
electrodes are placed at sites that are 10%
or 20% of a measured length from a
known landmark on the skull.
• Percentages are used, because different
individuals have different skull sizes.
• The 10-20 system insures that electrode
sites and EEG recordings can be
compared across laboratories worldwide.
 Contd..
• The 10-20 system identifies electrode sites
through careful measurements taken using
standardized procedures.
• The labeling of electrode sites is also
standardized.
• Sites located over the frontal lobes are labeled
`F,' those along the midcoronal plane are
labeled `C,' while those over the parietal,
occipital, and temporal lobes are labeled `P,' `O,'
and `T' respectively.
 Contd…
• Electrodes located along the mid sagittal
plane have the subscript "z" as in `Cz,.„
• Electrodes located on the left side of the
skull receive odd numbers, for example,
T5. , while electrode sites on the right side
of the head have even-numbered
subscripts (e.g., P4).
 A = Ear lobe, C = central,
Pg = nasopharyngeal, P = parietal,
F = frontal, Fp = frontal polar, O = occipital
Contd..
• Step 1. Measure the
distance in centimeters
from the nasion bridge
of the nose, to the
inion, base of the skull.
This is the nasion to
inion distance.
• Step 2. Record your
measurement,
cm ( nasion to
inion)
 Contd..
• Step 3. Calculate 10% of • Step 5. Beginning at
the nasion-inion the nasion, measure
measurement. toward the top of the
• Step 4. Beginning at the skull (vertex) to place a
inion, and measuring mark at 10% of the
toward the top of the nasion-inion length.
skull (the vertex), place • This mark locates FP.
a mark at 10% of the
nasion-inion distance,
the value calculated in
Step 3. This mark
locates Oz.
 Contd…
• Step 6. To locate the • Step 6. This locates
next site, CZ, divide the CZ, which is half
nasion-inion
way between the
measurement by 2 to
determine 50% of the nasion and the
nasion-inion inion.
measurement. • FP, CZ, and OZ are
marked
 Contd..
• Step 7. measure (ear-to- • Step 10. To locate C 3,
ear) measurements. place a mark that is
(Make certain that the 20% of the ear-to-ear
tape goes through your distance from CZ.
CZ mark.) • From C3, continuing
toward the left ear and
• Step 8. Record your along the same plane,
ear-to-ear measure the number of
distance_______cm. centimeters calculated
in Step 9 to mark T3
• Step 9. Calculate 20% of
the ear-to-ear distance.
• To Place a mark at
T4 (repeating same
on the right side of
the skull).
Contd (fyi)
 Electrodes Arrangement
• Either unipolar or bipolar arrangement.
• A unipolar arrangement is composed of
number scalp leads connected to the
common point such as ear lobe.
• A bipolar arrangement is achieved by
interconnection of scalp electrodes.
• for eg: The difference of voltage between
Fp2 and Fp8 are measured.
LEADS
 What is Montages
• Montages are patterns of connections
between electrodes and recording
channels.
• All of these combinations have inputs to
three-lead differential amplifier and use a
third connection for the reference (two
ears, forehead or nose)
 Bipolar montage
• Bipolar montage
– Each channel (i.e., waveform) represents the
difference between two adjacent electrodes. The
entire montage consists of a series of these channels.
– For example, the channel "Fp1-F3" represents the
difference in voltage between the Fp1 electrode and
the F3 electrode.
– The next channel in the montage, "F3-C3," represents
the voltage difference between F3 and C3, and so on
through the entire array of electrodes.
 Referential montage

• Referential montage
– Each channel represents the difference
between a certain electrode and a designated
reference electrode.
– There is no standard position at which this
reference is always placed; it is, however, at a
different position than the "recording"
electrodes
 Average reference montage

• Average reference montage

– The outputs of all of the amplifiers are
summed and averaged, and this averaged
signal is used as the common reference for
each channel
Bipolar , unipolar and average
 EEG Diagnostic Uses
• EEG changes are also apparent in
patients with sleep disorders such as
insomnia , narcolepsy (re occuring ,
uncontrollable sleep episodes),
• chronic hypersomnia (excessive sleep or
sleepiness )
• Sleep paralysis ( inability to move during
full consciousness ) , nightmares
 Contd..
• EEG Pattern changes are also present
with changes in behavior.
• Depression of EEG peaks in alcoholics
• Sporadic runs of slow waves in drug
addicts
 Types of electrodes
• Scalp : silver pads, discs or cups, stainless
steel rods and chlorided silver wires.
• Sphenoidal :alternating silver and bare
wire and chlorided tip inserted through
muscle tissue by a needle.
• Nasopharyngeal : silver rod with silver ball
at the tip inserted through the nostrils.
 Contd… (fyi)
• Electrocorticographic: cotton wick soaked
in the saline solution that rests on the
brain surface.
• Intracerebral : sheaves of teflon-coated
gold or platinum wires cut at various
distance from the sheaf tip and used to
electrically stimulate the brain.
 Contd…(fyi)
• Reusable scalp disc or cup electrodes are
placed on the head using electrolyte.
• remove oil
• Contact resistance below 10 k Ω.
 Multi channel EEG recording
systems
• Typically 8 , 16 or 32 channels.
• Gain control or sensitivity pot (overall gain)
• High pass filter switch – selects low
frequency cutoff 0.16,0.53,1 and 5.3 hz
• Low pass filter switch – selects high
frequency cutoff usually 15,35,50,70,100
hz.
• Notch filter
 External controls
• Calibration push button 5 to 1000 μv.
• Baseline pot
• Individual electrode selection switch
• Event marker push button
• Chart speed 10,15,30 and 60 mm/s
EEG Multi channel
EEG
EEG
 contd
• It is these extra cellular currents which are
responsible for the generation of EEG
voltages.
• While it is post-synaptic potentials which
generate the EEG signal, it is not possible
to determine the activity within a single
dendrite or neuron from the scalp EEG.
 Evoked potential
• Evoked potentials are the potentials
developed in the brain as the responses to
external stimuli like sound , light etc.
• The external stimuli are detected by the
sense organs which cause changes in the
electrical activity of the brain.
• This is also called as Event – Related
Potential.
 EP
• Evoked Potential (EP) tests are used to
check the condition of the nerve
pathways.
• They measure the brain's electrical
response to the signals sent by the
nerves.
• EP tests help diagnose nervous
system abnormalities, hearing loss,
and assess neurological functions.
 Major Types of Evoked
Potentials
• Brainstem Auditory Evoked Potential -
Checks the pathway from the ear to the
brain. The BAEP test may help uncover
the cause of hearing and balance
problems, and other symptoms.
• Visual Evoked Potential - Checks the
pathway from the eyes to the brain. May
help find the cause of certain vision
problems and other conditions.
• Somatosensory Evoked Potential -
Checks the pathway from the nerves in the
limbs to the brain. It is a way to study the
function of the nerves, the spinal cord and
brain
 EP

• If light is flashed in the eye or a small electrical pulse

given to the skin over a nerve in an arm or leg, a
characteristic response - the evoked potential - can be
recorded from the brain using electrodes placed on the
scalp.

• There will be a very short delay - measured in fractions

of a second - between the delivery of the stimulus and
the appearance of the electrical response in the brain.
 CONTD..
• This delay corresponds to the time that it
takes for the signal to pass from the eye or
skin to the brain, along the nerve
pathways.
• If there is a delay in the appearance of the
evoked potential in the brain, this may
mean that something is wrong somewhere
in the nerve pathways.
 CONTD..
• For example, if there is a delay in the
appearance of the response over the scalp after
a light is flashed in one eye, this may be due to
disease affecting the optic nerve - the large
nerve connecting the retina at the back of the
eye with the brain.
• Similarly, if there is a delay in the appearance of
the response in the brain after a small electrical
pulse is applied over a nerve in a leg, there may
be problem a with the spinal cord.
 CONTD..
• Delays of this kind may be produced by a wide
variety of different problems - disease within the
optic nerve or spinal cord itself, or tumours
pressing on these structures from outside them
and so on.
• In the past, evoked potentials were most
commonly used in the diagnosis of multiple
sclerosis.
• This is a disease of the central nervous system
in which there is loss of the fatty insulation
(“myelin sheath”) around the nerves, causing
them to malfunction.
 CONTD
• Loss of this fatty insulating sheath
(demyelination) causes a delay in the
conduction of signals along the nerve pathway,
and this will be seen as a delay in the
appearance of the evoked potentials at the scalp
if the affected nerve pathway is stimulated.
• Evoked potential testing will also reveal whether
the optic nerve, the brainstem and the spinal
cord have been affected by the disease.
 EVENT RELATED STUDIES
• Initial recording at rest. eyes open and
closed)
• Hyperventilation
• Photic Stimulation
• Auditory stimulation
• Different stages of sleep
 Event related potential (ERP)
• Auditory evoked potentials (AEPs) are a
subclass of ERPs. For AEPs, the "event"
is a sound.
• AEPs (and ERPs) are very small electrical
voltage potentials originating from the
brain recorded from the scalp in response
to an auditory stimulus (such as different
tones, speech sounds, etc.).
 Evoked potentials- Auditory
Brainstem Response
• When a brief acoustic
• Auditory brainstem stimulus (e.g., a click
response (ABR) or short tone burst) is
testing is used to presented to the ear
measure the function there is a
of the central auditory synchronized burst of
pathways. action potentials
• Recording electrodes generated in the
taped to the skull auditory nerve which
record the electrical spreads up the
activity of the brain central auditory
(EEG). pathway
 Contd…
• When such methods
• Because of its very are employed the
low amplitude (in the complex waveform
microvolt range) this recorded is called the
wave of activity is auditory evoked
generally buried in the potential and it
EEG and can only be includes contributions
recovered using from many sites that
computerized signal- are activated
averaging techniques. sequentially in time
along the auditory
pathway.
 Contd…
• An averaged • The time period most
waveform has commonly studied
multiple peaks and covers the first 10
valleys stretched out msec after the
over a period of stimulus is presented
several hundred to the ear and
milliseconds after the represents the
presentation of the electrical activity
acoustic stimulus. evoked in neurons
in the auditory nerve
and brain stem
 Contd

• This technique is very • It is also helpful in

useful in studying documenting the
hearing loss of central hearing loss in
auditory origin, as infants who cannot
may be caused by a cooperate with a
lesion affecting the behavioral-based
brainstem (e.g., audiometric exam.
acoustic neuroma or
multiple sclerosis).
ABR
ABR

149
 AEP
• The AEPs that are recorded from the top of the
head originate from structures within the brain
(e.g., the auditory cortex, the auditory brainstem
structures, the auditory VIIIth cranial nerve).
• They are very low in voltage: from 2-10
microvolts for cortical AEPs to much less than 1
microvolt from the deeper brainstem structures.
• Their low voltage combined with relatively high
background electrical noise requires the use of
highly sensitive amplifiers and computer
averaging equipment
AEP
 Contd…
• The Auditory Brainstem
Response ("ABR"; 1.5-15 ms
post stimulus), which
originates in the VIIIth cranial
nerve (waves I and II) and
brainstem auditory structures
The Middle Latency
Response ("MLR", 25-50 ms
poststimulus), includes waves
Na (negative wave following
ABR wave V, originates in
upper brainstem and/or
auditory cortex) and Pa
(positive wave at about 30 ms,
originates in the auditory
cortex bilaterally).
 Contd..
• The "Slow" cortical
auditory ERPs, which
include the P1-N1-P2
sequence (50-200 ms
poststimulus; originating
in auditory cortex).
• N1 is the large negative
wave that occurs about
80-100 ms after the
stimulus. It originates
primarily in the auditory
cortex bilaterally.
 Visual Evoked Potentials (VEP)
• Visual evoked potential (VEP) tests
evaluate how the visual system responds
to light. VEP tests are used to evaluate
optic neuritis, optic tumors, retinal
disorders, and demyelenating diseases
such as multiple sclerosis .
• The patient is then asked to stare at a
strobe light or checkerboard pattern on a
television screen.
 VEP
• For visual evoked potential (VEP), you are placed in front of a
computer screen, which shows a pattern of white and black squares
like a chessboard, and a red dot in the middle that you are supposed
to focus your eyes on with minimal movement.
• The procedure is done one eye at a time, with the eye that is not
being tested blocked off with an eye patch. During the actual
procedure, these squares alternate (white ones become black, black
ones become white) at a rate of several times a second, which
produces responses in the visual cortex, which is picked up by your
skull electrodes.
• Since the computer controls the exact timing of the changes of the
square colors, and receives the exact timing of the electric response
in the corresponding electrodes, it is able to determine precisely the
amount of time it takes for the visual stimulus to reach the visual
cortex.
 Somato sensory evoked potentials
(SEP)
• For the upper SEP (arms), two • Similar to the VEP, the
stimulus electrodes are computer times the electric
attached on the inside wrist, pulses (which come at a rate of
closer to the thumb. These several times a second) and
electrodes will receive timed gets the responses from the
electric pulses that will appropriate skull electrode,
produce an involuntary twitch thus determining the exact
of the thumb. time it takes for the stimulus to
• An additional sensor electrode reach the intermediate point on
is applied on the back of your your shoulder, and then the
shoulder, close to the brain.
attachment point of the • The same is repeated for the
clavicle. other arm.
 Lower (SEP)
• For the lower SEP (legs), • Electric pulses are then
two stimulus electrodes sent at a rate of several
are attached to the inside times a second, and the
of your ankle, in such a responses are recorded
way as to produce an in the same manner as
involuntary twitch of the above.
big toe.
• Additional sensor
electrodes are placed at
the back of the knee
(closer to the outside), on
the spine of the lower
back, and on the spine of
the upper back.
Evoked potential
Response