Leslie Prichep

• NYU Langone Medical Center

Quantitative electroencephalogram (QEEG) is a technology which has grown exponentially since the foundational publication by in Science in 1997, introducing the use of age-regressed metrics to quantify characteristics of the EEG signal, enhancing the clinical utility of EEG in neuropsychiatry. Essential to the validity and reliability of QEEG metri...

Importance The identification of brain activity–based concussion subtypes at time of injury has the potential to advance the understanding of concussion pathophysiology and to optimize treatment planning and outcomes. Objective To investigate the presence of intrinsic brain activity–based concussion subtypes, defined as distinct resting state quan...

This paper extends the frequency domain quantitative electroencephalography (qEEG) methods pursuing higher sensitivity to detect Brain Developmental Disorders. Prior qEEG work lacked integration of cross-spectral information omitting important functional connectivity descriptors. Lack of geographical diversity precluded accounting for site-specific...

Protein Energy Malnutrition (PEM) has lifelong consequences on brain development and cognitive function. We studied the lifelong developmental trajectories of resting-state EEG source activity in 66 individuals with histories of Protein Energy Malnutrition (PEM) limited to the first year of life and in 83 matched classmate controls (CON) who are al...

This paper extends our frequency domain quantitative electroencephalography (qEEG) methods pursuing higher sensitivity to detect Brain Developmental Disorders. Prior qEEG work lacked integration of cross-spectral information omitting important functional connectivity descriptors. Lack of geographical diversity precluded accounting for site-specific...

Background: Prompt, accurate, objective assessment of concussion is crucial, particularly for children/adolescents and young adults. While there is currently no gold standard for the diagnosis of concussion, the importance of multidimensional/multimodal assessments has recently been emphasized. Methods: Concussed subjects (N = 177), matched cont...

The goal of this study is to identify the quantitative electroencephalographic (qEEG) signature of early childhood malnutrition [protein-energy malnutrition (PEM)]. To this end, archival digital EEG recordings of 108 participants in the Barbados Nutrition Study (BNS) were recovered and cleaned of artifacts (46 children who suffered an episode of PE...

The original (G1 first generation) cohort evaluated in 1978 consisted of 258 children, and 137 of these EEG recordings were recovered in 2016.

Introduction Early childhood Protein Energy Malnutrition (PEM) is an increasing worldwide phenomenon with lifelong neurodevelopmental consequences. There is thus a need for inexpensive imaging technologies to objectively identify and follow up the neural impact of malnutrition—Electroencephalography being an obvious choice. But EEG studies of PEM a...

Chronic pain affects more than 35% of the US adult population representing a major public health imperative. Currently, there are no objective means for identifying the presence of pain, nor for quantifying pain severity. Through a better understanding of the pathophysiology of pain, objective indicators of pain might be forthcoming. Brain mechanis...

The potential clinical utility of a novel quantitative EEG-based Brain Function Index (BFI) as a measure of the presence and severity of functional brain injury was studied as part of an independent prospective validation trial. The BFI was derived using EEG features associated with functional brain impairment reflecting current consensus on the ph...

Objective: To evaluate the effectiveness of the electroencephalographic (EEG) Brain Function Index (BFI) for characterizing sports-related concussive injury and recovery. Participants: Three hundred fifty-four (354) male contact sport high school and college athletes were prospectively recruited from multiple locations over 6 academic years of p...

Objectives: A brain electrical activity biomarker for identifying traumatic brain injury (TBI) in Emergency Department (ED) patients presenting with high GCS after sustaining a head injury has shown promise for objective, rapid, triage. The main objective of this study was to prospectively evaluate the efficacy of an automated classification algor...

Background: Extremely high accuracy for predicting CT+ traumatic brain injury (TBI) using a quantitative EEG (QEEG) based multivariate classification algorithm was demonstrated in an independent validation trial, in Emergency Department (ED) patients, using an easy to use handheld device. This study compares the predictive power using that algorit...

A method comprises the steps of obtaining a baseline measurement corresponding to a representation of brain activity from a living body and storing the baseline measurements on a storage device configured to be wearable on the living body in combination with obtaining, at a time subsequent to the baseline measurement, a second measurement represent...

Objectives: Acute stroke is a leading cause of brain injury and death and requires rapid and accurate diagnosis. Noncontrast head computed tomography (CT) is the first line for diagnosis in the emergency department (ED). Complicating rapid triage are presenting conditions that clinically mimic stroke. There is an extensive literature reporting cli...

An overwhelming majority of patients presenting with mild traumatic brain injury (>1million cases/year) routinely undergo a Head CT in the Emergency Departments (ED) and 70% of those scanned are found to have a negative head CT. This occurs primarily because of zero tolerance for missed acute traumatic intracranial lesion and because the current cl...

Background There is an urgent need for objective criteria adjunctive to standard clinical assessment of acute Traumatic Brain Injury (TBI). Details of the development of a quantitative index to identify structural brain injury based on brain electrical activity will be described. Methods Acute closed head injured and normal patients (n=1470) were...

Abstract Rapid identification of traumatic intracranial hematomas following closed head injury represents a significant health care need due to the potentially life-threatening risk they present This study demonstrates the clinical utility of an index of brain electrical activity used to identify intracranial hematomas in traumatic brain injury (TB...

Study Objective We compared the performance of a hand-held Quantitative Electroencephalogram (QEEG) acquisition device to New Orleans Criteria (NOC), Canadian CT Head Rule (CCHR) and National Emergency X-Radiography Utilization Study II (NEXUS II) Rule in predicting intracranial lesions on Head CT in acute mild traumatic brain injury (TBI) in the E...

Abstract This study investigates the potential clinical utility in the emergency department (ED) of an index of brain electrical activity to identify intracranial hematomas. The relationship between this index and depth, size, and type of hematoma was explored. Ten minutes of brain electrical activity was recorded from a limited montage in 38 adult...

A device and method for assessment of traumatic brain injury (TBI) is described. The device is configured to acquire brain electrical signals from a patient's forehead using one or more neurological electrodes. The acquired brain electrical activity data is subjected to artifact rejection and feature extraction, and a subset of features are then co...

The incidence of emergency department (ED) visits for Traumatic Brain Injury (TBI) in the United States exceeds 1,000,000 cases/year with the vast majority classified as mild (mTBI). Using existing computed tomography (CT) decision rules for selecting patients to be referred for CT, such as the New Orleans Criteria (NOC), approximately 70% of those...

The International Pharmaco-EEG Society (IPEG) presents updated guidelines summarising the requirements for the recording and computerised evaluation of pharmaco-EEG data in man. Since the publication of the first pharmaco-EEG guidelines in 1982, technical and data processing methods have advanced steadily, thus enhancing data quality and expanding...

Assessment of medical disorders is often aided by objective diagnostic tests which can lead to early intervention and appropriate treatment. In the case of brain dysfunction caused by head injury, there is an urgent need for quantitative evaluation methods to aid in acute triage of those subjects who have sustained Traumatic Brain Injury (TBI). Cur...

Background and purpose: Recent neuroimaging studies suggest that abnormalities in brain function after concussion exist beyond the point of observed clinical recovery. This study investigated the relationship between an index of brain dysfunction (traumatic brain injury [TBI] Index), concussion severity, and outcome. Methods: EEG was collected f...

To follow recovery from concussion in a sample of athletes using an electroencephalographic (EEG) index of quantitative brain activity developed previously on an independent Emergency Department (ED) sample of head-injured subjects with traumatic brain injury. EEG recordings from five frontal electrode sites were obtained on 59 injured athletes and...

Scalp electric potentials (electroencephalogram; EEG) are contingent to the impressed current density unleashed by cortical pyramidal neurons undergoing post-synaptic processes. EEG neuroimaging consists of estimating the cortical current density from scalp recordings. We report a solution to this inverse problem that attains exact localization: ex...

An extensive neuroimaging literature on chronic pain demonstrates increased cerebral blood flow and metabolism consistent with increased neuronal activity in the structures comprising the "pain matrix"; furthermore, some of these regions have been shown to encode pain intensity. It is the objective of this study to demonstrate the feasibility of us...

Assessment of awareness in patients with severe brain injury remains subjective, although patients with even limited awareness (e.g. minimal conscious state, MCS) have different prognoses and treatment than those in vegetative state (VS). Recently, task appropriate differential regional activation in VS has been reported using fMRI during mental im...

EEG (Electroencephalography) resting state was studied by means of group blind source separation (gBSS), employing a test-retest strategy in two large-sample normative databases (N=57 and N=84). Using a BSS method in the complex Fourier domain and a model-driven distributed inverse solution we closely replicate both the spatial distribution and spe...

To investigate the clinical utility and sensitivity of a portable, automatic, frontal quantitative electroencephalographic (QEEG) acquisition device currently in development in detecting abnormal brain electrical activity after sport-related concussion. This was a prospective, non-randomized study of 396 high school and college football players, in...

The aim of this work is to study the coherence profile (dependence) of robust eyes-closed resting EEG sources isolated by group blind source separation (gBSS). We employ a test-retest strategy using two large sample normative databases (N = 57 and 84). Using a BSS method in the complex Fourier domain, we show that we can rigourously study the out-o...

Subjective, physiological and electroencephalographic (EEG) profiles were studied in cocaine dependent study participants in response to cocaine cue exposure or a dose of smoked cocaine. Both stimuli increased subjective ratings of cocaine high and craving, enhanced negative affect, and boosted plasma ACTH and skin conductance levels. However, coca...

This preliminary study sought to localize epileptogenic regions in patients with partial epilepsy by analysis of interictal EEG activity utilizing variable resolution electromagnetic tomography (VARETA), a three-dimensional quantitative electroencephalographic (QEEG) frequency-domain distributed source modeling technique. The very narrow band (VNB)...

Subjective cognitive impairment (SCI) has been a common, but poorly understood condition, frequently occurring in older persons. The past and the emerging literature on SCI and synonymously named conditions is reviewed. Findings include: (1) There is support from at least one longitudinal study for a long-standing concept of SCI as a pre-mild cogni...

This research sought neurobiological features common to psychotic states displayed by patients with different clinical diagnoses. Cluster analysis with quantitative electroencephalographic (QEEG) variables was used to subtype drug-naïve, non-medicated, and medicated schizophrenic, depressed and alcoholic patients with psychotic symptoms, from the U...

The early detection of subjects with probable Alzheimer's disease (AD) is crucial for effective appliance of treatment strategies. Here we explored the ability of a multitude of linear and non-linear classification algorithms to discriminate between the electroencephalograms (EEGs) of patients with varying degree of AD and their age-matched control...

To demonstrate the utility of three-dimensional source localization of the scalp-recorded electroencephalogram (EEG) for the identification of the most probable underlying brain dysfunction in patients with obsessive-compulsive disorder (OCD). Eyes-closed resting EEG data was recorded from the scalp locations of the International 10/20 System. Vari...

Electroencephalographic (EEG) changes with normal aging have long been reported. Departures from age-expected changes have been observed in mild cognitive impairment and dementia, the magnitude of which correlates with the degree of cognitive impairment. Such abnormalities include increased delta and theta activity, decreased mean frequency, and ch...

We describe methods for the classification of brain state using quantitative analysis of the EEG (QEEG). Neurometric analysis of EEG collected from the 19 standard locations of the International 10-20 System already provides such a tool. In this work we demonstrate the effectiveness of this approach when the available inputs are reduced to a set of...

It has become apparent that the electrical signals recorded from the scalp of healthy individuals under standardized conditions are predictable, and that patients with a wide variety of brain disorders display activity with unusual features. It also early became apparent that centrally active medications produced striking changes in this activity....

Positron emission tomography (PET) and quantitative electroencephalography (qEEG) were obtained in 15 normal male subjects with eyes closed at rest. Correlations between qEEG variables and regional metabolism were examined as an approach to investigating the metabolic and neuroanatomical basis of the generation of the EEG. Analogous to the neuromet...

Quantitative electroencephalographic (qEEG) profiles were studied in cocaine-dependent patients in response to an acute, single-blind, self-administered dose of smoked cocaine base (50 mg) vs placebo. qEEG data were averaged using neurometric analytical methods and the spectral power of each primary bandwidth was computed and topographically imaged...

We used quantitative analysis of the electroencephalogram (EEG) in 42 patients to assess the effect of tracheal intubation after induction of anesthesia with etomidate and sufentanil using standard clinical practice. The EEG was recorded from eight bipolar electrode derivations and Z-transformed relative to age expected normative data for relative...

An extensive literature reports changes in quantitative electroencephalogram (QEEG) with aging and a relationship between magnitude of changes and degree of clinical deterioration in progressive dementia. Longitudinal studies have demonstrated QEEG differences between mild cognitively impaired (MCI) elderly who go on to decline and those who do not...

Brainstem auditory evoked responses (BAER) are transient signals embedded in the EEG recorded from scalp electrodes, when a subject is presented with a series of acoustic clicks. These signals typically have a signal-to-noise ratio (SNR) well below -10 dB. The extraction of BAER signals from the EEG for the purpose of automatically computing featur...

A system for monitoring a brain wave response of a fetus in utero, comprises removably connecting an auditory transducer, including at least one biosensor electrode, producing pulsed auditory sounds to a mother's abdomen to detect brain wave activity in a fetus. The transducer is pulsed with one of rectangular waves and tone pips of a selected freq...

We used quantitative analysis of the electroencephalogram (EEG) during routine clinical practice to assess the effect of tracheal intubation following induction of anesthesia with propofol and fentanyl. The topographic EEG was recorded from eight bipolar electrode derivations in 25 patients. Z-scores relative to age expected normative data were com...

Recent reviews of the neurobiology of Attention-Deficit/Hyperactivity Disorder (AD/HD) have concluded that there is no single pathophysiological profile underlying this disorder. Certainly, dysfunctions in the frontal/subcortical pathways that control attention and motor behavior are implicated. However, no diagnostic criteria or behavioral/neuroim...

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The clinical utility of the EEG, especially in psychiatric, learning and cognitive disorders, has been greatly enhanced by the use of quantitative analysis (QEEG) and comparisons to a normative database. Of primary importance in the use of such a reference database are the following considerations and cautions: adequate sampling across a broad age...

The hypothesis of a functional disconnection of neuro-cognitive networks in patients with mild cognitive impairment (MCI) and Alzheimer Dementia was investigated using baseline resting EEG data. EEG databases from New York (264 subjects) and Stockholm (155 subjects), including healthy controls and patients with varying degrees of cognitive decline...

This article presents a critical review of quantitative electroencephalographic (qEEG) research and issues relevant to its clinical application. Included is a summary of methodologic issues necessary for a reliable implementation of qEEG within clinical settings and a brief discussion of controversial issues surrounding this implementation. The mai...

This retrospective study describes the performance of the Patient State Index (PSI), under standard clinical practice conditions. The PSI is comprised of quantitative features of the EEG (QEEG) that display clear differences between hypnotic states, but consistency across anaesthetic agents within the state. The PSI was constructed from a systemati...

There are regional differences in the effects of anaesthetics agents and perioperative stimuli on the EEG. We studied the topography of the EEG during induction of anaesthesia and intubation in patients receiving thiopental and fentanyl to document regional electrical brain activity. EEG was recorded in 25 patients in the awake state, after pre-med...

Quantitative electroencephalographic (qEEG) profiles were studied in cocaine dependent patients in response to cocaine cue exposure. Using neurometric analytical methods, the spectral power of each primary bandwidth was computed and topographically mapped. Additional measures of cue-reactivity included cocaine craving, anxiety and related subjectiv...

The effectiveness of drugs that have a specific effect on the activity of the serotonergic neurotransmitter system has changed the outlook for patients suffering from obsessive-compulsive disorder (OCD). With a response rate of about 70% to such compounds and the great amount of brain imaging studies conducted over the past decades, an understandin...

A fetal Brain Monitor (FBM) (14) utilizes a transducer (10) which is placed on the abdomen (11) of a mother and which is pulsed to generate auditory sounds, i.e., clicks, to provide auditory brainstem evoked responses (BAER) of a fetus within the mother's uterus. The fetus' brain waves are detected by a biosensor (15), amplified (17), converted to...

Psychiatric diagnosis suffers from being based on phenomenology and not on pathophysiology. Data are presented showing that psychiatric patients reveal consistent quantitative electroencephalographic abnormalities, such that they can be separated from normals and from each other. Clustering these pathophysiological groupings reveals an underlying v...

Let G = (V; E) be a graph with time-dependent edges where the cost of a path p through the graph is determined by a vector functions F (p) = [f 1 (p); f 2 (p); : : : ; f n (p)] , where f 1 ; f 2 ; : : : ; f n are independent objective functions. Where n > 1 there is no clear idea of what a "best" solution is, instead we turn to the idea of Pareto-o...

Background: The Patient State Index (PSI) uses derived quantitative electroencephalogram features in a multivariate algorithm that varies as a function of hypnotic state. Data are recorded from two anterior, one midline central, and one midline posterior scalp locations. PSI has been demonstrated to have a significant relation to level of hypnosis...

Most studies of continuous EEG data have used frequency transformation, which allows the quantification of brain states that vary over seconds. For the analysis of shorter, transient EEG events, it is possible to identify and quantify brain electric microstates as subsecond time epochs with stable field topography. These microstates may correspond...

We previously described the existence of two quantitative EEG (QEEG) subtypes of cocaine dependent males, identified at baseline, displaying differential proneness to relapse. The current study expands the population to include females and enhances the measure set to include both QEEG and somatosensory EP (SEP) features. Fifty-seven cocaine depende...

The electroencephalogram (EEG) is an emergent phenomenon of neural activity, which suggests that the EEG might reflect the apparently abnormal neurobiology observed in cocaine dependence. The EEG is noninvasive, inexpensive, and quantitative analysis of the EEG (QEEG) is based on information processing technology that is constantly growing with res...

Significant changes in topographic quantitative EEG (QEEG) features were documented during induction and emergence from anaesthesia induced by the systematic administration of sevoflurane and propofol in combination with remifentanil. The goal was to identify those changes that were sensitive to alterations in the state of consciousness but indepen...

Continuous recordings of brain electrical activity were obtained from a group of 176 patients throughout surgical procedures using general anesthesia. Artifact-free data from the 19 electrodes of the International 10/20 System were subjected to quantitative analysis of the electroencephalogram (QEEG). Induction was variously accomplished with etomi...

Methods have recently been proposed for localization of multiple brain sources of particular EEG frequencies recorded from the scalp, to identify their most probable neuroanatomical generators. This paper reports the accurate localization of a deep white matter lymphoma, using Variable Resolution Electromagnetic Tomography (VARETA). The accuracy of...

Quantitative EEG (QEEG) can play an important role in the evaluation and treatment of children and adolescents with attention deficit and learning disorders. Children with learning disorders are a heterogeneous population with QEEG abnormality in 25% to 45% of reported cases. EEG slowing is the most common abnormal finding, and the nature of the QE...

This study investigates the existence of outcome related neurophysiological subtypes within a population of abstinent cocaine dependent adults. We have previously reported and replicated the existence of a distinctive quantitative EEG (QEEG) profile in such a population, and demonstrated the persistence of this pattern at one and six month follow-u...

We present the case of a young man with a diagnosis of a childhood-onset pervasive developmental disorder who developed a progressive neurologic deterioration with persistent catatonia and right hemiparesis. On his initial evaluation approximately three years after the onset of mutism, he manifested right hemiparesis and catalepsy. Two years later,...

The major objective of this study was to examine the persistence of abnormal quantitative EEG (qEEG) measures over a six month time interval in subjects in strictly supervised drug free residential treatment for crack cocaine dependence. Seventeen subjects were assessed with qEEG at five to 10 days, one month and six months following their last use...