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© 1993-2012 IEEE. Inherent fuzzy entropy is an objective measurement of electroencephalography (EEG) complexity reflecting the robustness of brain systems. In this study, we present a novel application of multiscale relative inherent fuzzy entropy using repetitive steady-state visual evoked potentials (SSVEPs) to investigate EEG complexity change between two migraine phases, i.e., interictal (baseline) and preictal (before migraine attacks) phases. We used a wearable headband EEG device with O1, Oz, O2, and Fpz electrodes to collect EEG signals from 80 participants [40 migraine patients and 40 healthy controls (HCs)] under the following two conditions: During resting state and SSVEPs with five 15-Hz photic stimuli. We found a significant enhancement in occipital EEG entropy with increasing stimulus times in both HCs and patients in the interictal phase, but a reverse trend in patients in the preictal phase. In the 1st SSVEP, occipital EEG entropy of the HCs was significantly lower than that of patents in the preictal phase (FDR-adjusted p < 0.05). Regarding the transitional variance of EEG entropy between the 1st and 5th SSVEPs, patients in the preictal phase exhibited significantly lower values than patients in the interictal phase (FDR-adjusted p < 0.05). Furthermore, in the classification model, the AdaBoost ensemble learning showed an accuracy of 81 pm 6%and area under the curve of 0.87 for classifying interictal and preictal phases. In contrast, there were no differences in EEG entropy among groups or sessions by using other competing entropy models, including approximate entropy, sample entropy, and fuzzy entropy on the same dataset. In conclusion, inherent fuzzy entropy offers novel applications in visual stimulus environments and may have the potential to provide a preictal alert to migraine patients.

Yen-Ni Hung,1 Zbigniew Kadziola,2 Alan JM Brnabic,3 Ju-Fen Yeh,4 Jong-Ling Fuh,5,6 Jen-Ping Hwang,7,8 William Montgomery,9 1School of Gerontology Health Management and Master Program in Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan, Republic of China; 2Real World Analytics, Eli Lilly GmbH, Vienna, Austria; 3Real World Analytics, Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia; 4Department of Medicine, Eli Lilly and Company, Taiwan, Republic of China; 5Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, 6Faculty of Medicine, School of Medicine, National Yang Ming University, 7Department of Psychiatry, Taipei Veterans General Hospital, 8Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China; 9Eli Lilly Australia Pty Ltd, West Ryde, NSW, Australia Purpose: The objectives of this study were to estimate the incidence, cumulative incidence, and economic burden of Alzheimer’s disease (AD) in Taiwan, using data from the National Health Insurance Research Database (NHIRD).Materials and methods: This was a retrospective, longitudinal, observational study using data from the Longitudinal Health Insurance Database of the NHIRD. Patients were included in this study if they were 50years of age or older and their records included a primary or secondary diagnosis of AD. New patients who met inclusion criteria were followed up longitudinally from 2005 to 2010. Costs were calculated for the first year following the diagnosis of AD.Results: Overall, a higher percentage of women than men were diagnosed with AD (54% vs 46%, respectively). The first AD diagnosis occurred most frequently in the age of 75–84years. The person-year incidence rate increased from 5.63/1,000 persons (95% CI, 5.32–5.94) in 2005 to 8.17/1,000 persons (95% CI, 7.78–8.57) in 2010. The cumulative incidence rate was 33.54/1,000 persons (95% CI, 32.76–34.33) in 2005–2010. The total mean inflated annual costs per patient in new Taiwan dollars (NT$) in the first year of diagnosis ranged from NT$205,413 (2009) to NT$227,110 (2005), with hospitalization representing the largest component.Conclusion: AD represents a substantial burden in Taiwan, and based on the observed increase in incidence rate over time, it is likely that this burden will continue to increase. The findings reported here are consistent with previous research. The NHIRD contains extensive real-world information that can be used to conduct research, allowing us to expand our understanding of the incidence, prevalence, and burden of disease in Taiwan. Keywords: Alzheimer’s disease, incidence, medical costs, resource utilization

Chih-Wen Yang,1,2 Jong-Ling Fuh2,3 1Department of Neurology, National Yang-Ming University Hospital, Ilan, 2National Yang-Ming University School of Medicine, 3Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China Abstract: Exposure to anesthesia and surgery has been hypothesized to increase the risk of developing Alzheimer's disease (AD). While the exact pathogenesis of AD remains unknown, it potentially involves specific proteins (eg, amyloid beta and tau) and neuroinflammation. A growing body of preclinical evidence also suggests that anesthetic agents interact with the components that mediate AD neuropathology at multiple levels. However, it remains unclear whether anesthesia and surgery are associated with an increased risk of AD in humans. To date, there have not been randomized controlled trials to provide evidence for such a causal relationship. Besides, observational studies showed inconsistent results. A meta-analysis of 15 case–control studies revealed no statistically significant association between general anesthesia and the development of AD (pooled odds ratio [OR] =1.05; P=0.43). However, a few retrospective cohort studies have demonstrated that exposure to anesthesia and surgery is associated with an increased risk of AD. Thus, well-designed studies with longer follow-up periods are still needed to define the role of anesthesia in relation to the development of AD. Keywords: anesthesia, surgery, dementia, Alzheimer's disease&nbsp