Electroencephalography (EEG) and electrocardiography (ECG) are powerful and widely used techniques for assessing in vivo brain and cardiac function, respectively. EEG is the recording of electrical brain activity by attaching electrodes to the scalp1. The signal recorded with non-invasive EEG represents voltage fluctuations arising from summated excitatory and inhibitory postsynaptic potentials generated mainly by cortical pyramidal neurons1,2. EEG is the most common neurodiagnostic test for evaluating and managing patients with epilepsy3,4. It is especially useful when epileptic seizures occur without obvious convulsive behavioral manifestations, such as absence seizures or non-convulsive status epilepticus5,6. Conversely, non-epilepsy related conditions that lead to convulsive episodes or loss of consciousness may be misdiagnosed as epileptic seizures without video-EEG monitoring7. In addition to its usefulness in the field of epilepsy, EEG is also widely used to detect abnormal brain activity associated with sleep disorders, encephalopathies, and memory disorders, as well as to supplement general anesthesia during surgeries2,8,9.
In contrast to EEG, ECG (or EKG as it is sometimes abbreviated) is the recording of the electrical activity of the heart10. ECGs are usually performed by attaching electrodes to the limb extremities and chest wall, which allows detection of the voltage changes generated by the myocardium during each cardiac cycle of contraction and relaxation10,11. The primary ECG waveform components of a normal cardiac cycle include the P wave, the QRS complex, and the T wave, which correspond to atrial depolarization, ventricular depolarization, and ventricular repolarization, respectively10,11. ECG monitoring is routinely used to identify cardiac arrhythmias and defects of the cardiac conduction system12. Among epilepsy patients, the importance of using ECG to identify potentially life-threatening arrhythmias is amplified since they are at significantly increased risk of sudden cardiac arrest, as well as sudden unexpected death in epilepsy13,14,15.
In addition to their clinical applications, EEG and ECG recordings have become an indispensable tool for identifying brain and heart dysfunction in mouse models of disease. Although traditionally these recordings have been performed separately, here we describe a technique to record video, EEG, and ECG simultaneously in mice. The simultaneous video-EEG-ECG method detailed here utilizes a tethered recording configuration in which the implanted electrode on the head of the mouse is hard-wired to the recording equipment. Historically, this tethered, or wired, configuration has been the standard and most extensively used method for EEG recordings in mice; however, wireless EEG telemetry systems have also been developed recently and are gaining in popularity16.
Compared to wireless EEG systems, the tethered arrangement possesses several technical advantages that may make it preferable depending on the desired application. These advantages include a greater number of channels for recording EEG or other biopotentials; lower electrode costs; electrode disposability; less susceptibility to signal loss; and greater frequency bandwidth (i.e., sampling rate) of recordings17. Done properly, the tethered recording method described here is capable of providing high quality, artifact-free EEG, and ECG data simultaneously, along with the corresponding video for behavioral monitoring. This EEG and ECG data can then be mined to identify neural, cardiac, or neurocardiac abnormalities such as seizures, changes in EEG power spectrum, cardiac conduction blocks (i.e., skipped heart beats), and changes in heart rate variability. To demonstrate the application of these EEG-ECG quantitative methods, we present an example experiment using a Kcna1 knockout (-/-) mouse. Kcna1-/- mice lack voltage-gated Kv1.1 α-subunits and as a consequence exhibit spontaneous seizures, cardiac dysfunction, and premature death, making them an ideal model for simultaneous EEG-ECG evaluation of deleterious epilepsy-associated neurocardiac dysfunction.