![activate neuro programmer 2 review activate neuro programmer 2 review](https://upload.wikimedia.org/wikipedia/commons/thumb/c/cc/Comparison_image_neural_networks.svg/480px-Comparison_image_neural_networks.svg.png)
In our laboratory, a particular EEG activation protocol that we call `neuropsychological EEG activation' (NPA) ( Okuma et al., 1980 Matsuoka et al., 1981), which tests for various mental activities, has been carried out as part of routine EEG examination for patients with epilepsy. It remains unclear how much higher mental activities have an impact on each epilepsy or seizure type, since standard EEG examination usually includes only sleep, hyperventilation, photic stimulation and opening and closing of the eyes, but not systematic cognitive tasks.
![activate neuro programmer 2 review activate neuro programmer 2 review](https://ars.els-cdn.com/content/image/1-s2.0-S1074761320300881-gr1.jpg)
It has been reported, however, that various daily mental activities can facilitate or inhibit seizure occurrence beyond expectation in patients with epilepsy ( Fenwick, 1998). For example, standard EEG recordings at the Mayo Clinic in the USA included mental arithmetic calculation tasks, and only one patient showed an EEG effect out of patients screened in over 100 000 recordings ( Wiebers et al., 1979). Reflex epilepsies and seizures induced by higher mental activities such as reading, calculation, speaking, writing and thinking have been described in the literature ( Bickford et al., 1956 Ingvar and Nyman, 1962 Asbury and Prensky, 1963 Geschwind and Sherwin, 1967 Wilkins et al., 1982), but such triggers are considered to be uncommon. For elucidating the pathophysiology of epilepsy in any patient, it is important to know the relationship between seizure-precipitating factors and the epilepsy subtype or seizure type. Seizure-precipitating factors have varying influences upon the diverse epilepsies and epileptic syndromes because of close relationships between these factors and the underlying pathophysiological characteristics that differentiate the various forms of epilepsy. In the management of epilepsy, not only anti-epileptic drug therapy but also identification and regulation of seizure-precipitating factors are important for achieving successful treatment. These results suggest that NPA is a useful tool for examining the relationship between cognitive function and epileptic seizures, and that the IGE patients with myoclonic seizures are vulnerable to higher mental activities requiring action-programming or thinking.ĬAE = childhood absence epilepsy, GMA = grand mal epilepsy on awakening, GTCS = generalized tonic–clonic seizure, IGE = idiopathic generalized epilepsy, ILAE = International League Against Epilepsy, JAE = juvenile absence epilepsy, JME = juvenile myoclonic epilepsy, NPA = neuropsychological EEG activation, TLE = temporal lobe epilepsy, WAIS-R = Wechsler Adult Intelligence Scale-Revised IntroductionĪ close relationship between seizures and ongoing brain activity has been stressed ( Brown and Fenwick, 1989 Fenwick and Brown, 1989) and behavioural or psychological treatment may be helpful for patients with epilepsy who are resistant to conventional drug therapy ( Dahl et al., 1985, 1987). In our IGE patients, the provocative effects of NPA were related to myoclonic seizures rather than absence or generalized tonic–clonic seizures.
ACTIVATE NEURO PROGRAMMER 2 REVIEW SERIES
Regarding the classification of epilepsies proposed by the International League Against Epilepsy, seizure-precipitating mental activities in our series were almost exclusively (in 36 out of the 38 patients) related to idiopathic generalized epilepsies (IGEs) including juvenile myoclonic epilepsy, juvenile absence epilepsy, grand mal epilepsy on awakening and childhood absence epilepsy, and were rarely (in only two out of the 38 patients) related to temporal lobe epilepsy.
![activate neuro programmer 2 review activate neuro programmer 2 review](https://els-jbs-prod-cdn.jbs.elsevierhealth.com/cms/attachment/af390083-d394-40d9-9f92-31abd6ced4f9/gr1_lrg.jpg)
Detailed examination of the precipitating events revealed action-programming type activities to be the most crucial in 32 out of the 38 patients (84.2%), followed by thinking type activities in four patients (10.5%). writing (68.4%), written calculation (55.3%) and spatial conction (63.2%), provoked the most discharges, followed by mental calculation (7.9%) and reading (5.3%). Among the cognitive tasks, mental activities mainly associated with use of the hands, i.e. The NPA tasks provoked epileptic discharges in 38 patients (7.9%) and were accompanied by myoclonic seizures in 15 patients, absence seizures in eight and simple partial seizures in one. NPA tasks consisted of reading, speaking, writing, written arithmetic calculation, mental arithmetic calculation and spatial construction.
![activate neuro programmer 2 review activate neuro programmer 2 review](https://media.springernature.com/full/springer-static/image/art%3A10.1038%2Fs42256-018-0006-z/MediaObjects/42256_2018_6_Fig1_HTML.png)
To examine the effects of higher mental activity on the EEG, 480 Japanese patients with different types of epilepsy were subjected to potentially provocative cognitive tasking, termed `neuropsychological EEG activation' (NPA), during standard EEG recordings.