title: Source localization of intermittent rhythmic delta activity in a patient with acute confusional migraine: cross-spectral analysis using standardized low-resolution brain electromagnetic tomography (sLORETA).
abstract: Acute confusional migraine (ACM) shows typical electroencephalography (EEG) patterns of diffuse delta slowing and frontal intermittent rhythmic delta activity (FIRDA). The pathophysiology of ACM is still unclear but these patterns suggest neuronal dysfunction in specific brain areas. We performed source localization analysis of IRDA (in the frequency band of 1-3.5 Hz) to better understand the ACM mechanism. Typical IRDA EEG patterns were recorded in a patient with ACM during the acute stage. A second EEG was obtained after recovery from ACM. To identify source localization of IRDA, statistical non-parametric mapping using standardized low-resolution brain electromagnetic tomography was performed for the delta frequency band comparisons between ACM attack and non-attack periods. A difference in the current density maximum was found in the dorsal anterior cingulated cortex (ACC). The significant differences were widely distributed over the frontal, parietal, temporal and limbic lobe, paracentral lobule and insula and were predominant in the left hemisphere. Dorsal ACC dysfunction was demonstrated for the first time in a patient with ACM in this source localization analysis of IRDA. The ACC plays an important role in the frontal attentional control system and acute confusion. This dysfunction of the dorsal ACC might represent an important ACM pathophysiology.
authors: Department of Pediatrics, College of Medicine, Catholic University of Korea, Songeui Campus, 222 Banpo-daero, Seoul, 137-701, Republic of Korea.
authors: Dae-Eun
authors: DE
authors: Kim
authors: Department of Pediatrics, College of Medicine, Catholic University of Korea, Songeui Campus, 222 Banpo-daero, Seoul, 137-701, Republic of Korea.
authors: Jung-Hyun
authors: JH
authors: Shin
authors: Department of Pediatrics, College of Medicine, Catholic University of Korea, Songeui Campus, 222 Banpo-daero, Seoul, 137-701, Republic of Korea.
authors: Young-Hoon
authors: YH
authors: Kim
authors: Department of Pediatrics, College of Medicine, Catholic University of Korea, Songeui Campus, 222 Banpo-daero, Seoul, 137-701, Republic of Korea. good1976@hanmail.net.
authors: Tae-Hoon
authors: TH
authors: Eom
authors: Department of Neurology, College of Medicine, Catholic University of Korea, Songeui Campus, 222 Banpo-daero, Seoul, 137-701, Republic of Korea.
authors: Sung-Hun
authors: SH
authors: Kim
authors: Department of Internal Medicine, Sanggye Paik Hospital, College of Medicine, Inje University, 1342 Dongil-ro, Seoul, 139-707, Republic of Korea.
authors: Jung-Min
authors: JM
authors: Kim
mesh_terms: D000208:Acute Disease; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods; D002648:Child; D003700:Delta Rhythm / Q000502:physiology*; D004569:Electroencephalography / Q000379:methods; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000503:physiopathology*
keywords: Acute confusional migraine; Electroencephalography; Intermittent rhythmic delta activity (IRDA); Source localization; Standardized low-resolution brain electromagnetic tomography (sLORETA)