title: Hypoglycemia-Induced Decrease of EEG Coherence in Patients with Type 1 Diabetes.
abstract: BACKGROUND
  Hypoglycemic events in patients with type 1 diabetes (T1D) are associated with measurable electroencephalography (EEG) changes. Previous studies have, however, evaluated these changes on a single EEG channel level, whereas multivariate analysis of several EEG channels has been scarcely investigated. The aim of the present work is to use a coherence approach to quantitatively assess how hypoglycemia affects mutual connectivity of different brain areas.
  
  
  METHODS
  EEG multichannel data were obtained from 19 patients with T1D (58% males; mean age, 55 ± 2.4 years; diabetes duration, 28.5 ± 2.6 years; glycated hemoglobin, 8.0 ± 0.2%) who underwent a hyperinsulinemic-hypoglycemic clamp study. The information partial directed coherence (iPDC) function was computed through multivariate autoregressive models during eu- and hypoglycemia in the theta and alpha bands.
  
  
  RESULTS
  In passing from eu- to hypoglycemia, absolute values of the iPDC function tend to decrease in both bands in all combinations of the considered channels. In particular, the scalar indicator [Formula: see text], which summarizes iPDC information, significantly decreased (P < 0.01) in 17 of 19 subjects: from T5-A1A2 to C3-A1A2 from O1-A1A2 to C4-A1A2 and from O2-A1A2 to Cz-A1A2 in the theta band and from O1-A1A2 to T4-A1A2 and from O1-A1A2 to C4-A1A2 in the alpha band.
  
  
  CONCLUSIONS
  The coherence decrease measured by iPDC in passing from eu- to hypoglycemia is likely related to the progressive loss of cognitive function and altered cerebral activity in hypoglycemia. This result encourages further quantitative investigation of EEG changes in hypoglycemia and of how EEG acquisition and real-time processing can support hypoglycemia alert systems.
authors.affiliation: 1 Department of Information Engineering, University of Padova , Padova, Italy .
authors.forename: Maria
authors.initials: M
authors.lastname: Rubega
authors.affiliation: 1 Department of Information Engineering, University of Padova , Padova, Italy .
authors.forename: Giovanni
authors.initials: G
authors.lastname: Sparacino
authors.affiliation: 2 Department of Cardiology, Nephrology and Endocrinology, Nordsjællands University Hospital , Hillerød, Denmark .
authors.forename: Anne S
authors.initials: AS
authors.lastname: Sejling
authors.affiliation: 3 Hyposafe , Lyngsby, Denmark .|4 Hospital of South West Jutland , Department of Medicine, Esbjerg, Denmark .
authors.forename: Claus B
authors.initials: CB
authors.lastname: Juhl
authors.affiliation: 1 Department of Information Engineering, University of Padova , Padova, Italy .
authors.forename: Claudio
authors.initials: C
authors.lastname: Cobelli
mesh_terms: D000465:Algorithms; D000513:Alpha Rhythm / Q000187:drug effects; D058070:Asymptomatic Diseases; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000175:diagnosis*; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000209:etiology*; D007004:Hypoglycemic Agents / Q000009:adverse effects; D061386:Insulin, Regular, Human / Q000009:adverse effects / Q000235:genetics; D061266:Insulin, Short-Acting / Q000009:adverse effects / Q000235:genetics; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D011994:Recombinant Proteins / Q000009:adverse effects; D013826:Theta Rhythm / Q000187:drug effects
chemical_list: D007004:Hypoglycemic Agents; D061386:Insulin, Regular, Human; D061266:Insulin, Short-Acting; D011994:Recombinant Proteins