A. Fuglsang-Frederiksen

Standardized computer-based organized reporting of EEG: SCORE.

The electroencephalography (EEG) signal has a high complexity, and the process of extracting clinically relevant features is achieved by visual analysis of the recordings. The interobserver agreement in EEG interpretation is only moderate. This is partly due to the method of reporting the findings in free‐text format. The purpose of our endeavor was to create a computer‐based system for EEG assessment and reporting, where the physicians would construct the reports by choosing from predefined elements for each relevant EEG feature, as well as the clinical phenomena (for video‐EEG recordings). A working group of EEG experts took part in consensus workshops in Dianalund, Denmark, in 2010 and 2011. The faculty was approved by the Commission on European Affairs of the International League Against Epilepsy (ILAE). The working group produced a consensus proposal that went through a pan‐European review process, organized by the European Chapter of the International Federation of Clinical Neurophysiology. The Standardised Computer‐based Organised Reporting of EEG (SCORE) software was constructed based on the terms and features of the consensus statement and it was tested in the clinical practice. The main elements of SCORE are the following: personal data of the patient, referral data, recording conditions, modulators, background activity, drowsiness and sleep, interictal findings, “episodes” (clinical or subclinical events), physiologic patterns, patterns of uncertain significance, artifacts, polygraphic channels, and diagnostic significance. The following specific aspects of the neonatal EEGs are scored: alertness, temporal organization, and spatial organization. For each EEG finding, relevant features are scored using predefined terms. Definitions are provided for all EEG terms and features. SCORE can potentially improve the quality of EEG assessment and reporting; it will help incorporate the results of computer‐assisted analysis into the report, it will make possible the build‐up of a multinational database, and it will help in training young neurophysiologists.

Current status on electrodiagnostic standards and guidelines in neuromuscular disorders

The aim of this review is to present the status of electrodiagnostic standards and guidelines in neuromuscular disorders. Electrodiagnostic guidelines are developed on the background of medical technology assessment, wherefore a short presentation of medical technology assessment is given covering: (1) Evidence-based medicine, i.e. to do the right thing, describing practice parameters and the STARD initiative which introduces evidence-based medicine in electrodiagnostic medicine, (2) Continuous quality improvement, i.e. to do the thing right, describing variation among laboratories in methods and interpretation of tests, and the need for medical audit and implementation of electrodiagnostic guidelines, (3) Outcome studies, i.e. is it worthwhile to do the right thing right?. In electrodiagnostic medicine there are very few outcome studies. Standards and guidelines described in the literature for different neuromuscular disorders are presented, often as figures or tables. These cover guidelines developed in detail for CIDP by expert consensus multicentre groups by AAN, INCAT, EFNS/PNS and for other inflammatory demyelinating neuropathies are described, as well as guidelines differentiating between demyelinating pathophysiology and axonal loss by motor and sensory nerve conduction studies. Furthermore, electrodiagnostic guidelines for ALS as detailed in the El Escorial, the modified El Escorial and the recent supplementary Awaji criteria are described and presented in a comprehensive table. Only few electrodiagnostic guidelines are published for nerve entrapment, cervical radiculopathy and neuromuscular transmission failure whereas none are known for myopathy. If no electrodiagnostic criteria for a given disorder exist, criteria for the electrodiagnostic examination are described if present. It is concluded that future research is needed in order to develop more electrodiagnostic guidelines in neuromuscular disorders by international expert consensus groups. Such research should use an evidence-based medicine approach and medical technology assessment and include continuous quality development and outcome studies.

Standardized computer-based organized reporting of EEG: SCORE – Second version

Standardized terminology for computer-based assessment and reporting of EEG has been previously developed in Europe. The International Federation of Clinical Neurophysiology established a taskforce in 2013 to develop this further, and to reach international consensus. This work resulted in the second, revised version of SCORE (Standardized Computer-based Organized Reporting of EEG), which is presented in this paper. The revised terminology was implemented in a software package (SCORE EEG), which was tested in clinical practice on 12,160 EEG recordings. Standardized terms implemented in SCORE are used to report the features of clinical relevance, extracted while assessing the EEGs. Selection of the terms is context sensitive: initial choices determine the subsequently presented sets of additional choices. This process automatically generates a report and feeds these features into a database. In the end, the diagnostic significance is scored, using a standardized list of terms. SCORE has specific modules for scoring seizures (including seizure semiology and ictal EEG patterns), neonatal recordings (including features specific for this age group), and for Critical Care EEG Terminology. SCORE is a useful clinical tool, with potential impact on clinical care, quality assurance, data-sharing, research and education.

P968: Motor unit number estimation in diabetes mellitus patients with and without polyneuropathy

s of Poster Presentations / Clinical Neurophysiology 125, Supplement 1 (2014) S1–S339 S305 117, range 65–182) were significantly lower than control MUNIX (mean 215, range 131–391) and MPS (mean 329, range 165–503) (p<0.01). Similarly in CIDP patients both MUNIX (mean 64, range 19–139) and MPS (mean 98, range 15–223) were lower than controls (p<0.01). In CIDP patients MUSIX (mean 90, range 61–136) and sMUP (mean 50, range 29–69) were significantly higher than control MUSIX (mean 58, range: 40–89) and sMUP (mean 35, range 22–61) (p<0.05). In contrast, no significant difference was found for MUSIX (mean 65, range 48–104) and sMUP (mean 40, range 18–58) in AIDP patients compared to controls (p>0.05). When AIDP and CIDP groups were combined a sensitivity of 84.62% for MPS and 69.23% for MUNIX were estimated. Conclusions: Decreased MPS and MUNIX suggest presence of axonal loss both in AIDP and CIDP. Increased motor unit size in CIDP patients indicates compensatory reinnervation. Moreover, MPS is shown to be a more sensitive MUNE method than MUNIX in inflammatory demyelinating neuropathies. P967 Two novel HSJ1 mutations in a cohort of distal hereditary motor neuropathy patients B. Gess1, A. Schirmacher1, M. Auer-Grumbach2, J. Senderek3, P. Young1 1University Hospital Muenster, Sleep Medicine and Neuromuscular Disorders, Muenster, Germany; 2University Hospital Vienna, Neurology, Vienna, Austria; 3Friedrich-Baur-Institute, Munich, Germany Distal hereditary motor neuropathies (dHMN) form a rare group of hereditary neuropathies characterized by distal motor symptoms. HSJ1 was recently found as the causative gene of a recessive dHMN in a Moroccan Jewish kindred. In this study, we undertook genetic testing for mutations in the HSJ1 gene in a cohort of dHMN patients from Germany and Austria. We found four patients, two each in two families, with HSJ1 mutations. Both HSJ1 mutations were novel and homozygous. One mutation was a splice-site-, the other a missense-mutation. The splice-site mutation was shown to lead to inclusion of an intron into the transcript, causing reduced expression of HSJ1 protein in patient fibroblast cultures. Patients showed distal-symmetric pareses of the legs and the hands. Nerve conduction studies showed axonal neuropathy with signs of acute and chronic denervation in electromyography. In one family, there was mild sensory involvement in clinical and electrophysiological testing. Taken together, we show a low frequency of HSJ1 mutations and present two novel mutations in our cohort of dHMN patients. P968 Motor unit number estimation in diabetes mellitus patients with and without polyneuropathy M.-M. Kallestrup1,2, S. Paramanathan1, H. Andersen2, A. Fuglsang-Frederiksen1, H. Tankisi1 1Aarhus University Hospital, Dept. of Clinical Neurophysiology, Aarhus, Denmark; 2Aarhus University Hospital, Dept. of Neurology, Aarhus, Denmark Question: What is the utility of Motor Unit Number Estimation (MUNE) methods in quantifying the degree of axonal loss in Diabetes Mellitus patients with and without polyneuropathy? Methods: Twenty-two Type I and Type II diabetic patients were prospectively included. Patients were divided into neuropathic (10) (mean age: 66, range: 47-78) and non-neuropathic group (12) (mean age: 64, range: 41-78), based on clinical examination and nerve conduction studies in dominant median motor and sensory, bilateral peroneal and tibial motor and bilateral sural nerves. Multipoint Stimulation MUNE (MPS) and Motor Unit Number Index (MUNIX) examinations on Abductor Pollicis Brevis by stimulating the median nerve were conducted. Motor unit size was calculated as surface motor unit potential (sMUP) and Motor unit size index (Musix). The results were compared with twenty untrained healthy control subjects (mean age: 46.7, range: 23-67). Results: In neuropathic patients MUNIX (mean: 122, range: 34-308) and MPS were (mean: 100, range: 63-262) significantly lower than control MUNIX (mean: 215, range: 131-391) and MPS (mean: 329, range: 162-503) (p<0.05). Similarly, in non-neuropathic diabetic patients, MUNIX (mean: 147, range: 65-306) and MPS (mean: 147, range: 61-304) were lower than controls (p<0.01). sMUP was significantly higher both in neuropathic (mean: 71, range: 38-120) and non-neuropathic (mean: 64, range: 39-130) patients than controls (mean: 35, range: 22-61) (p<0.05). In contrast, there was no difference in Musix between controls (mean: 58, range: 40-89) and neuropathic (mean: 67, range: 34-122) or non-neuropathic (mean: 65, range: 43-112) diabetic patients (p>0.05). Conclusions: Decreased MPS and Munix values together with increased sMUP suggest presence of axonal loss not only in neuropathic but also in non-neuropathic diabetic patients which probably could not be determined by routine NCSs due to compensatory reinnervation. However, further studies should be conducted with larger patient groups and older control subjects. P969 New evidence suggesting high fasting glycemia as a cause of peripheral neuropathy in non-diabetic subjects B.I. Tiftikcioglu1, T. Duksal1, S. Bilgin1, S. Kose2, Y. Zorlu1 1Tepecik Research and Education Hospital, Neurology, Izmir, Turkey; 2Tepecik Research and Education Hospital, Infectious Diseases and Clinical Microbiology, Izmir, Turkey Question: Impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) have been referred to as “pre-diabetes” and represent an increased risk for diabetes. Although several groups have mentioned the necessity of evaluation of patients with IGT for neuropathy, IFG patients have not been studied yet. Microvascular inflammation is one of the major pathogenetic mechanisms in diabetic peripheral neuropathy (DPN). However, the relationship between inflammation and nerve conduction studies (NCS) abnormalities has not been studied extensively. We aimed to investigate the associations between the serum biomarkers of inflammation and endothelial dysfunction and the most distal sensory NCSs in the very early phases of diabetes, namely IFG and IGT. Methods: NCSs including sural, medial dorsal cutaneous (MDC), dorsal sural (DS) and medial plantar (MP) sensory nerves, were performed on 44 controls, 25 IFG and 25 IGT patients. Symptoms and examination were scored using Neuropathy Symptom Score (NSS) and Neuropathy Disability Score (NDS). Serum vWF and sE-selectin levels were analyzed for endothelial dysfunction, inflammation was assessed through an IL-6 assay. Results: Compared with controls, IL-6 levels were higher in IFG and IGT; vWF and sE-selectin levels were higher in IGT (p<0.001). Compared with IFG patients, levels of all biomarkers were higher in IGT (p<0.05). Increase in IL-6 levels was related to increase in NSS and NDS. Both IFG and IGT patients showed significant abnormalities in MDC, DS and MP sensory NCSs, even in patients with preserved sural NCSs. Increase in biomarkers of inflammation and endothelial dysfunction were correlated with various NCS abnormalities in MDC, DS, and MP sensory NCSs (p<0.05). Conclusions: Our results indicate that neuropathy might begin in individuals as early as IFG stage. This is confirmed by both clinically, through increased NSS and NDS, and electrophysiologically, through impaired NCSs of the most distal sensory nerves. Besides, the marked elevation in IL-6 indicates the on-going inflammation process in IFG patients. Abnormalities in the most distal sensory NCSs were associated with biomarkers of inflammation and endothelial dysfunction. Our findings highlight the importance of evaluating individuals with IFG, as well as IGT, in terms of peripheral neuropathy. P970 Distinctive patterns of sonographic nerve enlargement in CharcotMarie-Tooth type 1A and hereditary neuropathy with pressure palsies S. Goedee, G. Brekelmans, L. van den Berg, L. Visser UMC Utrecht, Neurology, Utrecht, Netherlands Objective: We systematically investigated main arm and leg nerves in CMT-1A and HNPP patients to determine whether nerve sonography is able to discriminate between HNPP and CMT-1A. Background: Sonographic detection of morphologic abnormalities in polyneuropathies is a relatively new research area. The most prominently encountered pathological features are nerve enlargement, increased fascicle size, hypo-echogenicity and intraneural vascularization. There are only a few case reports and case series, mentioning nerve enlargement in CMT and HNPP patients. However, no systematic investigation has been performed yet. Methods: We recruited 9 patients fulfilling the international criteria on CMT-1A and 9 with DNA proven HNPP. Medical Research Council sumscore was determined. A standardized sonographic protocol was applied.

P236: Neurophysiological changes in CIDP patients treated with subcutaneous immunoglobulin

s of Poster Presentations / Clinical Neurophysiology 125, Supplement 1 (2014) S1–S339 S111 Methods: We report the clinical and neurophysiological findings in three patients with CMT and neprhopathy and a follow-up of ten years. Results: The probands, a 29 year old woman and her brother, aged 27, reported gait imbalance and feet deformities since infancy. Both had developed end-stage renal disease, steppage gait, severe atrophy of distal muscles of the forearm and legs and areflexia. Nerve conduction studies (NCS) revealed absent sensory nerve action potentials (SNAPs), absent motor potentials in lower limbs and intermediate motor nerve conduction velocities (MNCV) in upper limbs. The brother died of sepsis at age 39. His elder son, evaluated at age 6, had frequent falls and NCS revealed slight reduction of SNAPs amplitudes and conduction velocities. After ten years, he developed feet deformities, steppage gait and renal failure. Kidney biopsy revealed diffuse glomerular sclerosis. All SNAPS were absent and MNCV was reduced to intermediate range. No mutations were found in PMP22, MPZ, EGR2 or GJB1. Conclusions: The mechanisms underlying neurological and renal disease in CMT/FSGS are currently unknown, although both diseases seem to progress together in an inexorable way to end-stage renal failure and severe neurological compromise. P235 Cervical myelopathy masked by sensorymotor polyneuropathy S. Kostic Dedic, T. Smiljkovic, R. Sujic, V. Cvijanovic, V. Nikolic, D. Jovanovic, J. Malovic, A. Gavrilovic chc zvezdara, Neurology, belgrade, Serbia Background: Peripheral nerve disorders due to polyneuropathy can alter the signs of myelopathy. Methods: This study is a case description and analysis of 4 consecutive cases with the diagnosis of cervical myelopathy coexisting peripheral nerve disorder identified during the sixth years. Results: All our 4 cases had compressive cervical myelopathy due to disc herniation C4-5 in assotiation with sensorymotor polyneuropathy, in three cases with diabetes melltus and in one case with hypothireoidism. There were three man and one woman, average age of 59 year. They suffered from weakness and numbness legs during one or two years. Previously present data for diabetes mellitus and hypothyroidism. Neurological examination revealed hipotrophy of legs, enhanced one or both PR while AR were reduced. Extensor plantar response in three patients but asymmetrical and flexor in one patient. Electrophysiologic fundings showed markedly reduced amplitude of the distal sensory and motor evoked response of both peroneus and tibialis nerves with reduced motor and sensitive conduction velocity, without signs of denervation (EMNG) and reduced amplitude with prolonged distal latency of N9 and asymmetricaly dicrease amplitude of N13 (SSEP n medianus). Cervical spine MRI showed herniates disc C4-5 and signs of myelopathia with stenosis of spinal canal. Conclusion: It is important to continually question whether the working diagnosis of peripheral nerve disorder explains the clinical findings. Electrodiagnostic tests and neuroimaging methods can identified myelopathy whose adequate treatment offers a better outcome. P236 Neurophysiological changes in CIDP patients treated with subcutaneous immunoglobulin M. Otto1, H. Tankisi1, L. Markvardsen2, A. Fuglsang-Frederiksen1 1Aarhus University Hospital, Dept. of Clinical Neurophysiology, Aarhus, Denmark; 2Aarhus University Hospital, Dept. of Neurology, Aarhus, Denmark Question: Do electroneurographic parameters and Motor Unit Number and Size Index (MUNIX, MUSIX) change during treatment with subcutaneous immunoglobulin (SCIG) in patients with chronic inflammatory demyelinating polyneuropathy (CIDP)? Methods: We analyzed neurophysiologic data from a randomized, placebocontrolled, double-blind parallel-group trial, testing SCIG in 30 patients with CIDP (Markvardsen et. al 2013). This trial had showed an improvement in isokinetic muscle strength in the SCIG group. Neurophysiological evaluation was performed before and after the 12 weeks treatment period. We assessed the distal motor latency (DML), motor conduction velocity (mCV), amplitude and duration of the compound muscle action potential (CMAP) as well as F-wave minimum latency in one peroneal, median and ulnar nerve. MUNIX and MUSIX were assessed in the abductor pollicis brevis muscle. Results: Data from 23 patients could be analyzed. Changes in MUNIX were greater in the SCIG treated group compared to placebo (p<0.05), with higher MUNIX values in the end of the treatment period. We found no change in MUSIX neither during SCIG or placebo. There was a trend towards an increase in CMAP amplitudes during SCIG treatment (p=0.05). On the other hand, DML, mCV and F-wave latencies remained unchanged. Conclusion: MUNIX values increased during treatment with SCIG. This might be due to an increase in CMAP amplitudes. There were no changes in DML, mCV or F-wave latencies during treatment with SCIG. P237 Neuropathic complications in patients after unilateral varicectomy – comparing the yield in neurography, clinical sensory tests and subjective symptoms L. Puksa1, J. Lieberg2, S. Jaeaeskelaeinen2,3, S. Laaksonen3 1Tartu University of Tartu, Department of neurology, Tartu, Estonia; 2Tartu University Hospital, department of vascular surgey, Tartu, Finland; 3Turku University Hospital, Department Of Neurophysiology, Turku, Finland Question: The aim of the study was to investigate occurrence and risk factors of sensory nerve injuries and neuropathic pain in patients undergoing varicectomy, and to evaluate the diagnostic sensitivity of sensory neurography and clinical sensory tests in detecting the neuropathic complications. Methods: All 38 patients (33 women) were prospectively studied before and within 30 days after varicectomy. The patients who showed neuropathic symptoms or signs were further investigated after 3 and 6 months. Symptoms were evaluated using a symptom chart drawing and Visual Analogue Scale (0-100) for pain. Clinical sensory tests included warm/cold discrimination using thermal rolls (Somedic) and tactile as well as mechanical pain detection thresholds measured with Semmes-Weinstein monofilaments and method of limits. Pain wind-up was tested with the monofilament giving the first slight sensation of pricking pain. Sensory neurography of the sural, saphenous, and superficial peroneal nerves was done bilaterally with standardized protocol. Results: Five of the 38 patients (13.2%) reported postoperative neuropathic symptoms: neuropathic pain and altered sensibility: two patients within saphenous, one within superficial peroneal and saphenous, and two patients in all 3 studied nerve distributions. In 4 patients, sensory alterations and pain symptoms disappeared by 6 months after surgery. In one patient (2.6%), neuropathic pain persisted after severe partial axonal saphenous nerve lesion. Neurography findings were in line with subjective symptoms and confirmed all nerve injuries (demyelinating), severity of the lesion was moderate/severe), while clinical sensory tests were able to detect 3 out of 7 injured nerves. Conclusion: Varicectomymay cause neuropathic complications but it rather infrequently gives rise to persistent neuropathic pain. Subjective sensory symptoms should be verified with neurophysiologic recordings as clinical sensory testing may remain falsely negative in these iatrogenic injuries. Poster session 14. Neurorehabilitation P238 Does cross-training balance strength asymmetry in healthy subjects? A proof-of-concept trial A. Manca1, E. Ortu1,2, F. Ginatempo1,2, F. Pisanu1, E. Tolu1, F. Deriu1 1University of Sassari, Department of Biomedical Sciences, Sassari, Italy; 2National Health Institute-S.S.N. ASL 1 Sassari, Neurology, Ozieri, Italy Question: We investigated whether a unilateral, maximal isokinetic strength training of the stronger leg may balance strength asymmetry between sides, inducing in the contralateral untrained side a worthy strength-transfer, i.e. a cross-training effect (CT) as well as cortico-spinal adaptations. Methods: Ten healthy volunteers (25.2±4.3yrs) underwent: i) bilateral measurements of the tibialis anterior (TA) strength with isokinetic dynamometry; ii) assessment of both cortical and spinal drives to the untrained TA, through recordings of central motor conduction time, input-output curve, short-interval intracortical inhibition, intracortical facilitation, shortinterval intracortical facilitation, cortical silent period (cSP), short-latency afferent inhibition, H-reflex, V-wave and M-wave. Dynanometric and neu-

Poster session 49. Free topicsP875: Pelvic floor electrophysiology in spinal cord injury

There exists a way of invading physically the area of game in football stadium. We can modify his acoustic field. The pretension is to study the stimuli generated by the principal sources of the sound: the supporters from the terraces. The exhibition to these sonorous stimuli well could unleash feelings euphoria, lessen the physical weariness, to free from inhibitions, improve the skill ambidextrous, modify the relation temporary space, alter the perception or diminish the time of response. Another application may be to reduce the recovery time of injuries, allowing to reduce the perception of effort and pain if not relevant. Similarly, the music has been used to reduce the length of stay in hospital care units. Along the investigation have been registered the sonorous environments of six matches. Also there have been processed some other sonorous stimuli of equal duration and claimed emotional load but without any relation with the sport. Finally fans have been exposed to these stimuli in order to value, by means of the response format named SELF ASSESSMENT MANIKIN. We answer about arousal, valence and other variables. Also, we used Electrodermal Group Activity (EDAg) for study lateral answer of brain and compare with previously qualitative results. This measurement technique is possible with machine named Sociograph®. Of this form we will be able to discriminate against the variable of belonging or not to the sports activity as fundamental characteristic of the stimulus to study the consequences in the brain.

W8.2 SCORE: an overview of the software

W8.2 SCORE: an overview of the software H. Aurlien1, S. Beniczky2, A. Fuglsang-Frederiksen3, A. Martinsda-Silva4, E. Trinka5, G. Visser6, G. Rubboli7, H. Hjalgrim2, H. Stefan8, I. Rosén9, J. Zarubova10, J. Dobesberger5, J. Alving2, K.V. Andersen11, M. Fabricius11, M.D. Atkins2, M. Neufeld12, P. Plouin13, P. Marusic10, R. Lees14, R. Pressler15, R. Hopfengärtner8, J.C. Brøgger2, R. Mameniskiene16, W. van Emde Boas17, P. Wolf2 1Department of Neurology, University of Bergen, Norway, 2Department of Clinical Neurophysiology, Danish Epilepsy Centre, Dianalund, Denmark, 3Department of Clinical Neurophysiology, University of Aarhus, Denmark, 4Neurological Department, University of Porto, Portugal, 5Department of Neurology, Paracelsus Medical University, Salzburg, Austria, 6Department of Clinical Neurophysiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands, 7Department of Neurological Sciences, University of Bologna, Italy, 8University Hospital Erlangen, Epilepsy Center, Neurological Clinic, Erlangen, Germany, 9Department of Clinical Neurophysiology, University of Lund, Sweden, 10Neurology Department, Charles University, Prague, Czech Republic, 11Department of Clinical Neurophysiology, Glostrup Hospital, University of Copenhagen, Denmark, 12EEG and Epilepsy Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Israel, 13Clinical Neurophysiology Department, Hôpital Saint-Vincent de Paul, Paris, France, 14Department of Clinical Neurophysiology, Helsinki University, Finland, 15Great Ormond Street Hospital for Children, NHS Trust, London, England, UK, 16Department of Neurology, Vilnius University Santariskiu Klinikos Hospital, Lithuania, 17Dutch Epilepsy Clinics Foundation, S.E.I.N., Heemstede, The Netherlands

W8.3 SCORE: background activity, sleep and non-ictal findings

W8.2 SCORE: an overview of the software H. Aurlien1, S. Beniczky2, A. Fuglsang-Frederiksen3, A. Martinsda-Silva4, E. Trinka5, G. Visser6, G. Rubboli7, H. Hjalgrim2, H. Stefan8, I. Rosen9, J. Zarubova10, J. Dobesberger5, J. Alving2, K.V. Andersen11, M. Fabricius11, M.D. Atkins2, M. Neufeld12, P. Plouin13, P. Marusic10, R. Lees14, R. Pressler15, R. Hopfengartner8, J.C. Brogger2, R. Mameniskiene16, W. van Emde Boas17, P. Wolf2 1Department of Neurology, University of Bergen, Norway, 2Department of Clinical Neurophysiology, Danish Epilepsy Centre, Dianalund, Denmark, 3Department of Clinical Neurophysiology, University of Aarhus, Denmark, 4Neurological Department, University of Porto, Portugal, 5Department of Neurology, Paracelsus Medical University, Salzburg, Austria, 6Department of Clinical Neurophysiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands, 7Department of Neurological Sciences, University of Bologna, Italy, 8University Hospital Erlangen, Epilepsy Center, Neurological Clinic, Erlangen, Germany, 9Department of Clinical Neurophysiology, University of Lund, Sweden, 10Neurology Department, Charles University, Prague, Czech Republic, 11Department of Clinical Neurophysiology, Glostrup Hospital, University of Copenhagen, Denmark, 12EEG and Epilepsy Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Israel, 13Clinical Neurophysiology Department, Hopital Saint-Vincent de Paul, Paris, France, 14Department of Clinical Neurophysiology, Helsinki University, Finland, 15Great Ormond Street Hospital for Children, NHS Trust, London, England, UK, 16Department of Neurology, Vilnius University Santariskiu Klinikos Hospital, Lithuania, 17Dutch Epilepsy Clinics Foundation, S.E.I.N., Heemstede, The Netherlands

W8.5 SCORE: normal variants, artefacts, polygraphic channels and interpretation

R. Pressler1, S. Beniczky2, H. Aurlien3, A. Fuglsang-Frederiksen4, A. Martins-da-Silva5, E. Trinka6, G. Visser7, G. Rubboli8, H. Hjalgrim2, H. Stefan9, I. Rosén10, J.C. Brøgger3, J. Zarubova11, J. Dobesberger6, J. Alving2, K.V. Andersen12, M. Fabricius12, M.D. Atkins2, M. Neufeld13, P. Plouin14, P. Wolf2, P. Marusic11, R. Lees15, R. Mameniskiene16, R. Hopfengärtner9, W. van Emde Boas17 1Great Ormond Street Hospital for Children, NHS Trust, London, England, UK, 2Department of Clinical Neurophysiology, Danish Epilepsy Centre, Dianalund, Denmark, 3Department of Neurology, University of Bergen, Norway, 4Department of Clinical Neurophysiology, University of Aarhus, Denmark, 5Neurological Department, University of Porto, Portugal, 6Department of Neurology, Paracelsus Medical University, Salzburg, Austria, 7Department of Clinical Neurophysiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands, 8Department of Neurological Sciences, University of Bologna, Italy, 9University Hospital Erlangen, Epilepsy Center, Neurological Clinic, Erlangen, Germany, 10Department of Clinical Neurophysiology, University of Lund, Sweden, 11Neurology Department, Charles University, Prague, Czech Republic, 12Department of Clinical Neurophysiology, Glostrup Hospital, University of Copenhagen, Denmark, 13Department of Neurology, Tel-Aviv Sourasky Medical Center, Israel, 14Clinical Neurophysiology Department, Hôpital Saint-Vincent de Paul, Paris, France, 15Department of Clinical Neurophysiology, Helsinki University, Finland, 16Department of Neurology, Vilnius University Santariskiu Klinikos Hospital, Lithuania, 17Dutch Epilepsy Clinics Foundation, S.E.I.N., Heemstede, The Netherlands

W8.1 SCORE: ictal findings

N400 component of linguistic ERPs. It represents the cerebral response to a semantic violation and its amplitude is larger to incongruous words than to congruous words within the semantic context (Kutas e Hillyard 1984; Friederici A 1997; Kutas M et al 2000). The N400 amplitude is a very sensitive marker of semantic processing demands in MCI and may be considered a reliable tool in the early detection of incipient Alzheimer’s disease (AD) (Olichney JM et al 2002, 2006, 2008). Objective: To evaluate semantic processing deficits in patients with MCI by using the N400 wave. Patients and Methods: We studied 15 MCI patients and 15 elderly normal controls using a simple word-pair reading paradigm. Semantically congruous (60%) and semantically incongruous (40%) adjective-pairs were selected according to the frequency of word-use, cloze probability and length-word. A number of 30 channel ERPs were recorded in patients and controls. A selective neuropsychological battery was administered to assess general cognitive status, shortand long-term verbal memory, episodic memory, constructional praxia. Results: No significant differences between the N400 amplitude to incongruous words and congruous words were found in 12/15 of MCI patients. Significant lower N400 amplitude to incongruous words were recorded between MCI patients and control group. No significant correlations emerged between N400 amplitude with age and depression. Conclusions: Abnormal N400 amplitude represents a useful electrophysiological index to evaluate semantic memory deficits in MCI patients. Longitudinal studies are needed to assess the predictive value of N400 on the progression from MCI to AD.