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The electroencephalogram (EEG) is a fundamental diagnostic procedure that explores brain function. This manuscript describes the characteristics of a sample of healthy at-term infants. One hundred and three (103) infants from Mexico between 15 days and 12.5 months of age were recorded during physiological sleep. Referential EEG recordings were obtained using linked ear lobes as reference. The amplifier gain was 10,000, the bandwidth was set between 0.3 and 30 Hz, and the sample rate was 200 Hz. Sample windows of 2.56 s were marked for later quantitative analysis. To our knowledge, this is the first dataset of normal infants during the first year of age.

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Prenatal and perinatal risk factors for perinatal brain damage frequently produce brain injuries in preterm and term infants. The early diagnosis and treatment of these infants, in the period of higher brain plasticity, may prevent the neurological and cognitive sequels that accompany these lesions. The Neurodevelopmental Research Unit at the Institute of Neurobiology of the National Autonomous University of Mexico has taken this endeavor. A multidisciplinary approach is followed. Pediatric, neurologic and rehabilitation clinical studies, MRI, EEG, visual and auditory evoked responses, and Bayley II evaluations are carried out initially. Infants are followed up to 8 years, with periodic appointments for evaluation and treatment. Katona's neurohabilitation method is used for initial diagnosis and treatment. Selective visual and auditory attention are explored from 3 months of age. This method was created in the Unit and, if deficiencies are observed, the method also describes the treatment to avoid subsequent alterations of these processes. Deficiencies in the acquisition of language are evaluated from 4 months of age, implementing treatment through instructions to parents on how they should teach their children to speak. This method has also been developed in the Unit and is in its validation process. In the MRI, we pay special attention to subtle and diffuse patterns, due to the high frequency with which they appear in contemporary cohorts at a national and international level. More than 80% of these infants showed abnormal MRI findings that should be taken into consideration. The outcome of children at 8 years old showed that 78%, 76% and 78% of extremely preterm, very preterm and late preterm, respectively, had a normal neurodevelopment. In term infants, only 69% had a normal neurodevelopment; in this group, the majority of infants had very severe brain lesions. Conclusions: It is necessary to evaluate, at an early age, all newborns with prenatal and perinatal risk factors for brain damage. Special attention should be payed to all premature newborns and those newborns who have been discharged from the intensive care unit.

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Learning disorders (LDs) are diagnosed in children whose academic skills of reading, writing or mathematics are impaired and lagging according to their age, schooling and intelligence. Children with LDs experience substantial working memory (WM) deficits, even more pronounced if more than one of the academic skills is affected. We compared the task-related electroencephalogram (EEG) power spectral density of children with LDs (n = 23) with a control group of children with good academic achievement (n = 22), during the performance of a WM task. sLoreta was used to estimate the current distribution at the sources, and 18 brain regions of interest (ROIs) were chosen with an extended version of the eigenvector centrality mapping technique. In this way, we lessened some drawbacks of the traditional EEG at the sensor space by an analysis at the brain-sources level over data-driven selected ROIs. Results: The LD group showed fewer correct responses in the WM task, an overall slower EEG with more delta and theta activity, and less high-frequency gamma activity in posterior areas. We explain these EEG patterns in LD children as indices of an inefficient neural resource management related with a delay in neural maturation.

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Resumen Objetivo: Comparar dos sistemas de puntuación para un test de fluidez verbal con el Modelo de Escalas de Calificación. Método: Se analizaron datos de 289 participantes, de los cuales 92 habían sido diagnosticados con Parkinson. Las puntuaciones se calcularon con dos sistemas de categorización: un procedimiento convencional y otro basado en percentiles. Resultados: Las puntuaciones Rasch procedentes de percentiles dan lugar a categorías adecuadas y medidas fiables; la correlación con las puntuaciones del test Minimental es evidencia de validez concurrente. Tras controlar estadísticamente el efecto de la edad, las medidas Rasch procedentes de percentiles discriminan entre ambos grupos, lo que evidencia validez predictiva. Conclusiones: El análisis de los dos procedimientos permite recomendar el uso de las categorías basadas en percentiles.

Abstract Objective: Two scoring systems for a verbal fluency test were compared using the Rasch Rating Scale Model. Method: The analysis was carried out on 289 participants, 92 of whom had had a Parkinson's disease diagnosis. Scores were calculated with two different category systems: a conventional procedure and a percentile-based one. Results: The percentile-based Rasch scores produce adequate categories and reliable measures, while the correlation with the Mini Mental State Examination evinces concurrent validity. After statistically controlling for age, percentile-based Rasch measures discriminated between both groups, demonstrating predictive validity. Conclusions: The analysis of the two procedures allows for the recommendation of the use of percentile-based categories.

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Perinatal care advances emerging over the past twenty years have helped to diminish the mortality and severe neurological morbidity of extremely and very preterm neonates (e.g., cystic Periventricular Leukomalacia [c-PVL] and Germinal Matrix Hemorrhage - Intraventricular Hemorrhage [GMH-IVH grade 3-4/4]; 22 to < 32 weeks of gestational age, GA). However, motor and/or cognitive disabilities associated with mild-to-moderate white and gray matter injury are frequently present in this population (e.g., non-cystic Periventricular Leukomalacia [non-cystic PVL], neuronal-axonal injury and GMH-IVH grade 1-2/4). Brain research studies using magnetic resonance imaging (MRI) report that 50% to 80% of extremely and very preterm neonates have diffuse white matter abnormalities (WMA) which correspond to only the minimum grade of severity. Nevertheless, mild-to-moderate diffuse WMA has also been associated with significant affectations of motor and cognitive activities. Due to increased neonatal survival and the intrinsic characteristics of diffuse WMA, there is a growing need to study the brain of the premature infant using non-invasive neuroimaging techniques sensitive to microscopic and/or diffuse lesions. This emerging need has led the scientific community to try to bridge the gap between concepts or ideas from different methodologies and approaches; for instance, neuropathology, neuroimaging and clinical findings. This is evident from the combination of intense pre-clinical and clinicopathologic research along with neonatal neurology and quantitative neuroimaging research. In the following review, we explore literature relating the most frequently observed neuropathological patterns with the recent neuroimaging findings in preterm newborns and infants with perinatal brain injury. Specifically, we focus our discussions on the use of neuroimaging to aid diagnosis, measure morphometric brain damage, and track long-term neurodevelopmental outcomes.

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The sensorimotor rhythm (SMR) is an electroencephalographic rhythm associated with motor and cognitive development observed in the central brain regions during wakefulness in the absence of movement, and it reacts contralaterally to generalized and hemibody movements. The purpose of this work was to characterize the SMR of 4-month-old infants, born either healthy at term or prematurely with periventricular leukomalacia (PVL). Two groups of infants were formed: healthy and premature with PVL. Their electroencephalograms (EEGs) were recorded in four conditions: rest, free movement, right-hand grasping and left-hand grasping, in order to explore general reactivity to free movement and contralateral reactivity in hand-grasping conditions. Associations between SMR, and cognitive and motor performance were analyzed. The healthy infants showed a SMR between 5.47 and 7.03 Hz, with clear contralateral reactivity to free movement and right-hand grasping. However, the premature infants with PVL did not show enough electroencephalographic characteristics to evidence the presence of SMR. Poor performance, characteristic of children with PVL, was related to low-frequency SMR, while good performance was associated with a higher frequency rhythm in the left hemisphere. The presence of SMR in the group of healthy infants could be considered a sign of health at this age. Thus, poor SMR evidence in the EEG of infants with PVL is probably a sign of brain immaturity or brain dysfunction. Our results provide data on infant SMR development that is needed to design neurofeedback protocols for infants with PVL.

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In this paper, we present a novel methodology to solve the classification problem, based on sparse (data-driven) regressions, combined with techniques for ensuring stability, especially useful for high-dimensional datasets and small samples number. The sensitivity and specificity of the classifiers are assessed by a stable ROC procedure, which uses a non-parametric algorithm for estimating the area under the ROC curve. This method allows assessing the performance of the classification by the ROC technique, when more than two groups are involved in the classification problem, i.e., when the gold standard is not binary. We apply this methodology to the EEG spectral signatures to find biomarkers that allow discriminating between (and predicting pertinence to) different subgroups of children diagnosed as Not Otherwise Specified Learning Disabilities (LD-NOS) disorder. Children with LD-NOS have notable learning difficulties, which affect education but are not able to be put into some specific category as reading (Dyslexia), Mathematics (Dyscalculia), or Writing (Dysgraphia). By using the EEG spectra, we aim to identify EEG patterns that may be related to specific learning disabilities in an individual case. This could be useful to develop subject-based methods of therapy, based on information provided by the EEG. Here we study 85 LD-NOS children, divided in three subgroups previously selected by a clustering technique over the scores of cognitive tests. The classification equation produced stable marginal areas under the ROC of 0.71 for discrimination between Group 1 vs. Group 2; 0.91 for Group 1 vs. Group 3; and 0.75 for Group 2 vs. Group1. A discussion of the EEG characteristics of each group related to the cognitive scores is also presented.

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En el presente trabajo se compararon dos grupos de niños mexicanos en edades comprendidas entre los 8 a 10 años, el primer grupo con trastorno específico en el aprendizaje (TEA), tanto en la precisión de la lectura como en el cálculo, y el otro con buen desempeño académico (BDA), por medio de Escala Wechsler de Inteligencia para Niños, en su cuarta versión (WISC-IV) y la batería de Evaluación Neuropsicológica Infantil (ENI), (subpruebas de Habilidades Académicas, Memoria, Atención y Habilidades Metalingüísticas), ambos instrumentos normados en población mexicana. Se encontraron diferencias significativas (p≤ 0.05) entre los niños BDA y TEA, mediante la U de Mann Whitney, en todas las subpruebas evaluadas a excepción del Índice Velocidad de Procesamiento (WISC), Conteo, Codificación/Evocación y Atención Auditiva, además de Atención visual (ENI). Mediante el Análisis de Componentes Principales se identificaron 5 subgrupos: 2 en los niños con BDA y 3 en los TEA. Las diferencias significativas (p≤ 0.05)entre las variables cognitivas y académicas fueron determinadas mediante la prueba de Kruskal-Wallis. Fue posible observar que los subgrupos TEA obtuvieron puntajes más bajos que los subgrupos BDA tanto en habilidades académicas como en otras variables cognitivas,siendo el Índice de Memoria de Trabajo en la escala Wechsler y las Habilidades Metalingüísticas de la ENI las que mejor diferenciaron a los subgrupos TEA de los BDA.Conclusión: La aplicación de instrumentos normados en la población bajo estudio resulta de gran utilidad para identificar subtipos neuropsicológicos tantoen niños con BDA como con TEA.

In this work two groups of Mexican children aged between 8 to 10 years old were compared, the first group with specific learningdisorder (SLD),in both reading accuracy as in the calculation, and the other compared to good performance academic (GPA) by Wechsler Intelligence Scale for Children, in its fourth version (WISC-IV) and battery Child Neuropsychological Assessment (ENI), (subtests Academic Skills, Memory, Attention and Metalinguistic Skills), both instruments normed in Mexican population. Significant differences (p ≤ 0.05) were found among SLD and GPA children, by Mann Whitney U Test, they were found in all subtests evaluated except Processing Speed Rate (WISC), Counting, Coding / Evocation and Auditory Attention, also Visual Attention (ENI). By the Principal Component Analysis were identified five subgroups: 2 children with GPA and 3 in the SLD. Significant differences (p ≤ 0.05) between cognitive and academic variables were determined by the Kruskal-Wallis Test. It was possible to observe that the TEA subgroups scored lower than the BDA subgroups in academic abilities as well as in other cognitive variables, with the Working Memory Index on the Wechsler scale as the subtests that evaluate the ENI Metalinguistic Skills the variables that give the best discrimination between the TEA and the BDA subgroups.Conclusion: The application of normed instruments in the population under study is useful to identify neuropsychological subtypes in children with GPA as SLD.

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Children with learning disabilities (LD) frequently have an EEG characterized by an excess of theta and a deficit of alpha activities. NFB using an auditory stimulus as reinforcer has proven to be a useful tool to treat LD children by positively reinforcing decreases of the theta/alpha ratio. The aim of the present study was to optimize the NFB procedure by comparing the efficacy of visual (with eyes open) versus auditory (with eyes closed) reinforcers. Twenty LD children with an abnormally high theta/alpha ratio were randomly assigned to the Auditory or the Visual group, where a 500 Hz tone or a visual stimulus (a white square), respectively, was used as a positive reinforcer when the value of the theta/alpha ratio was reduced. Both groups had signs consistent with EEG maturation, but only the Auditory Group showed behavioral/cognitive improvements. In conclusion, the auditory reinforcer was more efficacious in reducing the theta/alpha ratio, and it improved the cognitive abilities more than the visual reinforcer.

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