ELEKTROENCEPHALOGRAM

&
PROSES KESADARAN

Departemen Fisiologi FK USU

 Sub pokok bahasan & SLO
• Dasar fisiologi EEG
• Asal gelombang otak
• Jenis-jenis gelombang otak
• Perbedaan EEG pada keadaan sadar dan tidur
• Fungsi pencatatan EEG

• Fungsi formatio retikularis dalam proses kesadaran

• Kesadaran dan mekanisme terbentuknya kesadaran
• Peran RAS dalam mengaktivasi korteks
• Pengaturan tidur dan bangun
• Pola tidur
• Electroencephalogram or EEG is a graphic record of extracellular
current flow, arising from electrical activity (brain waves) within
the cerebral cortex, by placing recording electrodes on the scalp.
• Brain waves are not due to action potentials, but represent the
momentary collective postsynaptic potential activity (that is,
EPSPs and IPSPs) in the cell bodies and dendrites located in the
cortical layers under the recording electrode.

• Thus….the EEG recorded from the scalp is a measure of the

summation of dendritic postsynaptic potentials rather than action
potentials.
Brain waves:

The intensities of brain waves range from 0 to 200

microvolts, and frequencies range from once every few
seconds to 50 or more per second.

The waves change markedly between the states of

wakefulness and sleep and coma.
 Types of brain waves:
• Alpha waves are rhythmical waves that occur at frequencies
between 8 and 13 cycles per second, voltage is about 50 µV.
• Occur most intensely in the occipital region, also in the parietal
and frontal regions of the scalp.
• Found in the EEGs of almost all normal adult people during
awake and in a quiet, resting state of cerebration.
• During deep sleep, the alpha waves disappear.
• When the awake person’s attention is directed to some specific
type of mental activity, the alpha waves are replaced by
asynchronous, higher-frequency but lower-voltage beta waves.
• Beta waves occur at frequencies greater than 14 cycles per
second and as high as 80 cycles per second.
• Recorded mainly from the parietal and frontal regions during
specific activation of these parts of the brain.

• Delta waves include all the waves of the EEG with frequencies
less than 3.5 cycles per second, and they often have voltages
two to four times greater than most other types of brain waves.
• They occur in very deep sleep, in infancy, and in serious organic
brain disease.
• Theta waves have frequencies between 4 and 7 cycles
per second.
• Occur normally in the parietal and temporal regions in
children, but they also occur during emotional stress in
some adults, particularly during disappointment and
frustration.
• Theta waves also occur in many brain disorders, often in
degenerative brain states.
• Electrical activity can always be recorded from the living
brain, even during sleep and unconscious states, but the
waveforms vary, depending on the degree of activity of the
cerebral cortex.

Progressive changes in
the the characteristics
of the brain waves
during different stages
of wakefulness and
sleep.
The EEG has three major uses:

1. To distinguish various stages of sleep

2. As a clinical tool in the diagnosis of cerebral
dysfunction.
Diseased or damaged cortical tissue often gives rise to
altered EEG patterns (e.g. epilepsy)
3. Use in the legal determination of brain death.
Indication of brain death is electrocerebral silence—an
essentially flat EEG
 Reticular activating system
• A widespread network of interconnected neurons called the
reticular formation runs throughout the entire brain stem
and into the thalamus.
• This network receives and integrates all incoming sensory
synaptic input.
• Ascending fibers (in blue) originating in the reticular formation carry
signals upward to arouse and activate the cerebral cortex.
• These fibers compose the reticular activating system (RAS), which
controls the overall degree of cortical alertness and is important in
the ability to direct attention.
• In turn, fibers descending from the cortex, especially its motor
areas, can activate the RAS.
States of consciousness, based on the extent of interaction
between peripheral stimuli and the brain:
• maximum alertness
• wakefulness
• sleep (several different types)
• coma

• Maximum alertness depends on attention-getting sensory input

that “energizes” the RAS and the activity level of the CNS.
• At the other extreme, coma is the total unresponsiveness of a
living person to external stimuli, caused either by brain stem
damage that interferes with the RAS or by widespread
depression of the cerebral cortex, such as accompanies O2
deprivation.
 Sleep
• Two Types of Sleep:

(1) slow-wave sleep, because in this type of sleep the brain waves are
very strong and very low frequency,
(2) rapid eye movement sleep (REM sleep), because in this type of
sleep the eyes undergo rapid movements despite the fact that the
person is still asleep.

• Most sleep during each night is of the slow-wave variety; this is the
deep, restful sleep that the person experiences during the first hour
of sleep.
• REM sleep, on the other hand, occurs in episodes that occupy about
25 per cent of the sleep time; each episode normally recurs about
every 90 minutes. This type of sleep is not so restful, and it is usually
associated with vivid dreaming.
 Slow-Wave Sleep or non-REM (NREM)

• This sleep is associated with decrease in peripheral vascular

tone (10 to 30 per cent decreases in blood pressure) and
many other vegetative functions of the body (respiratory
rate and basal metabolic rate).
• Although slow-wave sleep is frequently called “dreamless
sleep,” dreams and sometimes even nightmares do occur
during slow-wave sleep.
• However, the dreams of slow-wave sleep usually are not
remembered, consolidation of the dreams in memory does
not occur.
 REM Sleep (Paradoxical Sleep, Desynchronized Sleep)
• In a normal night of sleep, the bout of REM sleep usually appear
every 90 minutes and lasting 5 to 30 minutes.
• When the person is extremely sleepy, each bout of REM sleep is
shorter, and it may even be absent.
• Conversely, as the person becomes more rested through the
night, the durations of the REM bouts increase.

• There are several important characteristics of REM sleep:

1. Usually associated with active dreaming and active bodily

muscle movements.
2. The person is more difficult to arouse by sensory stimuli than
during deep slow-wave sleep, but people usually awaken
spontaneously in the morning during an episode of REM sleep.
3. Heart rate and respiratory rate usually become irregular,
which is characteristic of the dream state.
4. Muscle tone throughout the body is exceedingly depressed,
indicating strong inhibition of the spinal muscle control areas.
5. Despite the extreme inhibition of the peripheral muscles,
irregular muscle movements do occur. These are in addition to
the rapid movements of the eyes.
6. The brain is highly active in REM sleep, and overall brain
metabolism may be increased as much as 20 per cent.

The EEG shows a pattern of brain waves similar to those that

occur during wakefulness. This type of sleep is also called
paradoxical sleep because it is a paradox that a person can still
be asleep despite marked activity in the brain.
 Basic Theories of Sleep
• The passive theory of sleep: the excitatory areas of the upper
brain stem (the reticular activating system) getting fatigued
during the waking day and became inactive.

• The active inhibitory process: there seems to be some center

located below the mid-pontile level of the brain stem that is
required to cause sleep by inhibiting other parts of the brain.
It was discovered that transecting the brain stem at the level of
the midpons creates a brain whose cortex never goes to sleep.

• A Possible Specific Role for Serotonin: when a drug that blocks

the formation of serotonin is administered to an animal, the
animal often cannot sleep for several days.
 Basic Theories of Sleep
• The theory regarding the transitions from sleep to
wakefulness involves alternating reciprocal activity
of different groups of RAS neurons.
• When the activity of norepinephrine- and
serotonin-containing neurons is dominant, there is
a reduced level of activity in acetylcholine-
containing neurons in the pontine reticular
formation contributes to the appearance of the
awake state.
• The reverse of this pattern leads to REM sleep.
• When there is more activity of the aminergic and
cholinergic neurons, NREM sleep occurs.

• In addition, an increased release of GABA and

reduced release of histamine increase the
likelihood of NREM sleep via deactivation of the
thalamus and cortex.
• Wakefulness occurs when GABA release is reduced
and histamine release is increased.
• In addition to previous
theories, there is a theory
involving melatonin.

• Melatonin release from

pineal gland.

• The synthesis and secretion

are increased during the dark
period of the day, and whilst
maintained at a low level
during daylight hours.
• This diurnal variation in secretion is brought about by
norepinephrine secreted by the postganglionic sympathetic
nerves that innervate the pineal gland.
• Norepinephrine acts via β-adrenergic receptors to increase
intracellular cAMP, and the cAMP in turn produces a marked
increase in N-acetyltransferase activity (the enzymes responsible
for melatonin synthesis from serotonin) results in increased
melatonin synthesis and secretion
Sources of texts and pictures:

1. Textbook of Medical Physiology, Guyton & Hall

2. Ganong’s Review of Medical Physiology
3. Fundamental of Physiology, Sherwood L.