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Thématique :
- Foie
Originalité :
Très original
Solidité :
Très solide
Doit faire évoluer notre pratique :
Dans certains cas
 
 
Nom du veilleur :
Professeur Christine SILVAIN
Coup de coeur :
 
 
Hepatology
  2016/05  
 
  2016 May;63(5):1651-9  
  doi: 10.1002/hep.28477  
 
  A low-cost, user-friendly electroencephalographic recording system for the assessment of hepatic encephalopathy.  
 
  Schiff S, Casa M, Di Caro V, Aprile D, Spinelli G, De Rui M, Angeli P, Amodio P, Montagnese S  
  http://www.ncbi.nlm.nih.gov/pubmed/26833704  
 
 

Electroencephalography (EEG) is useful to objectively diagnose/grade hepatic encephalopathy (HE) across its spectrum of severity. However, it requires expensive equipment, and hepatogastroenterologists are generally unfamiliar with its acquisition/interpretation. Recent technological advances have led to the development of low-cost, user-friendly EEG systems, allowing EEG acquisition also in settings with limited neurophysiological experience. The aim of this study was to assess the relationship between EEG parameters obtained from a standard-EEG system and from a commercial, low-cost wireless headset (light-EEG) in patients with cirrhosis and varying degrees of HE. Seventy-two patients (58 males, 61 ± 9 years) underwent clinical evaluation, the Psychometric Hepatic Encephalopathy Score (PHES), and EEG recording with both systems. Automated EEG parameters were calculated on two derivations. Strong correlations were observed between automated parameters obtained from the two EEG systems. Bland and Altman analysis indicated that the two systems provided comparable automated parameters, and agreement between classifications (normal versus abnormal EEG) based on standard-EEG and light-EEG was good (0.6 < κ < 0.8). Automated parameters such as the mean dominant frequency obtained from the light-EEG correlated significantly with the Model for End-Stage Liver Disease score (r = -0.39, P < 0.05), fasting venous ammonia levels (r = -0.41, P < 0.01), and PHES (r = -0.49, P < 0.001). Finally, significant differences in light-EEG parameters were observed in patients with varying degrees of HE.

CONCLUSION:

Reliable EEG parameters for HE diagnosing/grading can be obtained from a cheap, commercial, wireless headset; this may lead to more widespread use of this patient-independent tool both in routine liver practice and in the research setting. (Hepatology 2016;63:1651-1659).

 
Question posée
 
Comparer les paramètres obtenus avec un EEG standard et un système d’EEG commercial peu couteux sans fil avec casque (“EEG-léger” : Emotiv EPOC) chez des patients cirrhotiques avec différents degrés d’encéphalopathie hépatique.
 
Question posée
 
Très bonne corrélation entre les 2 systèmes avec une corrélation significative avec le MELD, l’ammoniémie à jeun et le score psychométrique PHES. L’EEG léger permet de différencier les différents stades d’encéphalopathie.
 
Commentaires

Un outil facile et efficace pour l’évaluation de l’encéphalopathie même minime pour un appareillage réutilisable à 800 dollars !

 
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