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Abstract: Objective: Scalp-derived human somatosensory evoked potentials (SEPs) contain high-frequency oscillations (600Hz; ‘sigma-burst’) reflecting concomitant bursts of spike responses in primary somatosensory cortex that repeat regularly at 600Hz. Notably, recent human intracranial SEP have revealed also 1kHz responses (‘kappa-burst’), possibly reflecting non-rhythmic spiking summed over multiple cells (MUA: multi-unit activity). However, the non-invasive detection of EEG signals at 1kHz typical for spikes has always been limited by noise contributions from both, amplifier and body/electrode interface. Accordingly, we developed a low-noise recording set-up optimised to map non-invasively 1kHz SEP components. Methods: SEP were recorded upon 4Hz left median nerve stimulation in 6 healthy human subjects. Scalp potentials were acquired inside an electrically and magnetically shielded room using low-noise custom-made amplifiers. Furthermore, in order to reduce thermal Johnson noise contributions from the sensor/skin interface, electrode impedances were adjusted to ⩽1kΩ. Responses averaged after repeated presentation of the stimulus (n =4000 trials) were evaluated by spatio-temporal pattern analyses in complementary spectral bands. Results: Three distinct spectral components were identified: N20 (<100Hz), sigma-burst (450–750Hz), and kappa-burst (850–1200Hz). The two high-frequency bursts (sigma, kappa) exhibited distinct and partially independent spatiotemporal evolutions, indicating subcortical as well as several cortical generators. Conclusions: Using a dedicated low-noise set-up, human SEP ‘kappa-bursts’ at 1kHz can be non-invasively detected and their scalp distribution be mapped. Their topographies indicate a set of subcortical/cortical generators, at least partially distinct from the topography of the 600Hz sigma-bursts described previously. Significance: The non-invasive detection and surface mapping of 1kHz EEG signals presented here provides an essential step towards non-invasive monitoring of multi-unit spike activity. [Copyright &y& Elsevier]

Aims The aim of the present study was to determine the diagnostic accuracy of the Neuropad sudomotor test for diabetic cardiovascular autonomic neuropathy (CAN) and diabetic polyneuropathy (DPN), the latter assessed using a multi-level diagnostic approach. Methods In 51 diabetic patients, CAN, symptoms and signs of DPN, vibration perception threshold (VPT), cold (CTT) and warm thermal perception thresholds (WTT) were measured. Neuropad response was determined as normal (complete colour change) or abnormal (absent or incomplete colour change). The time until the complete colour change (CCC time) was recorded. Results CCC time showed significant correlations with all the neurological parameters, the strongest of which were with Valsalva ratio (ρ = −0.64, P < 0.0001), symptoms of DPN (ρ = 0.66, P < 0.0001), postural hypotension (ρ = 0.54, P = 0.0001) and CTT (ρ = −0.54, P = 0.0001). CCC time showed moderate diagnostic accuracy for both CAN and DPN: the areas under the receiver operating characteristic (ROC) curves were 0.71 and 0.76, respectively. The diagnostic characteristics of three cut-off values of CCC time, identified by ROC analysis (i.e. 10, 15 and 18 min), were analysed. Compared with 10 min, the 15-min cut-off value provided better specificity (from 27% to 52% and from 31% to 62% for CAN and DPN, respectively) and a better likelihood ratio for negative result (from 0.67 to 0.34 and from 0.58 to 0.33) without lowering sensitivity (from 82% to 82% and from 85% to 80%). Conclusions Neuropad is a reliable diagnostic tool for both CAN and DPN, albeit of only moderate accuracy. Extending the observation period to 15 min provides greater diagnostic usefulness. [ABSTRACT FROM AUTHOR]

Introduction Human high-frequency EEG responses evoked by median nerve stimulation are non-invasive markers of cortical population spikes. For long, their reliable detection required averaging thousands of trials. Recently, low-noise EEG amplifiers combined with extensive electro-magnetic shielding allowed for a sensitive single-trial non-invasive detection of human high-frequency SEP. Here, using as few as 8 standard surface electrodes we demonstrate how specialized neurotechnology and offline analysis can achieve single-trial hf-SEP recordings without elaborate shielding. Methods In 6 healthy male subjects, 8 sintered Ag/AgCl surface EEG electrodes (reference at nose) were distributed above the left somatosensory cortex with impedances at about 1 kOhm. EEG was recorded upon right median nerve stimulation using a custom-built CE-certified low-noise EEG amplifier, specifically engineered to insulate the EEG from electromagnetic interferences. The signal was filtered spectrally and spatially (canonical correlation analysis variant) and transformed to the time–frequency domain (S transform). Results Bursting activity at about 600 Hz (‘ σ -burst’) in response to median nerve stimulation was detectable in all six subjects, both in the average SEP and in the average time–frequency-transform of single-trial responses. Moreover, this approach allowed to analyze the intrinsic single-trial variability of the hf-SEP. Significance Using tailor-made neurotechnology, evoked human cortical population spikes can be measured non-invasively in single-trial EEG without elaborate shielding and using a small number of standard surface electrodes, thus enabling clinical applicability. [ABSTRACT FROM AUTHOR]