Spatial variation in automated burst suppression detection in pharmacologically induced coma

Burst suppression is actively studied as a control signal to guide anesthetic dosing in patients undergoing medically induced coma. The ability to automatically identify periods of EEG suppression and compactly summarize the depth of coma using the burst suppression probability (BSP) is crucial to effective and safe monitoring and control of medical coma. Current literature however does not explicitly account for the potential variation in burst suppression parameters across different scalp locations. In this study we analyzed standard 19-channel EEG recordings from 8 patients with refractory status epilepticus who underwent pharmacologically induced burst suppression as medical treatment for refractory seizures. We found that although burst suppression is generally considered a global phenomenon, BSP obtained using a previously validated algorithm varies systematically across different channels. A global representation of information from individual channels is proposed that takes into account the burst suppression characteristics recorded at multiple electrodes. BSP computed from this representative burst suppression pattern may be more resilient to noise and a better representation of the brain state of patients. Multichannel data integration may enhance the reliability of estimates of the depth of medical coma.National Institutes of Health (U.S.) (Grant K23 NS090900)National Institute of Neurological Diseases and Stroke (U.S.) (Grant K23 NS090900)National Institutes of Health (U.S.) (Grant DP2-OD006454)National Institutes of Health (U.S.) (Grant TROI-GMI04948

Automatic EEG processing for the early diagnosis of traumatic brain injury

Traumatic Brain Injury (TBI) is recognized as an important cause of death and disabilities after an accident. The availability a tool for the early diagnosis of brain dysfunctions could greatly improve the quality of life of people affected by TBI and even prevent deaths. The contribution of the paper is a process including several methods for the automatic processing of electroencephalography (EEG) data, in order to provide a fast and reliable diagnosis of TBI. Integrated in a portable decision support system called EmerEEG, the TBI diagnosis is obtained using discriminant analysis based on quantitative EEG (qEEG) features extracted from data recordings after the automatic removal of artifacts. The proposed algorithm computes the TBI diagnosis on the basis of a model extracted from clinically-labelled EEG records. The system evaluations have confirmed the speed and reliability of the processing algorithms as well as the system's ability to deliver accurate diagnosis. The developed algorithms have achieved 79.1% accuracy in removing artifacts, and 87.85% accuracy in TBI diagnosis. Therefore, the developed system enables a short response time in emergency situations and provides a tool the emergency services could base their decision upon, thus preventing possibly miss-diagnosed injuries

Analytical methods and experimental approaches for electrophysiological studies of brain oscillations

Brain oscillations are increasingly the subject of electrophysiological studies probing their role in the functioning and dysfunction of the human brain. In recent years this research area has seen rapid and significant changes in the experimental approaches and analysis methods. This article reviews these developments and provides a structured overview of experimental approaches, spectral analysis techniques and methods to establish relationships between brain oscillations and behaviour

VME-DWT : an efficient algorithm for detection and elimination of eye blink from short segments of single EEG channel

Objective: Recent advances in development of low-cost single-channel electroencephalography (EEG) headbands have opened new possibilities for applications in health monitoring and brain-computer interface (BCI) systems. These recorded EEG signals, however, are often contaminated by eye blink artifacts that can yield the fallacious interpretation of the brain activity. This paper proposes an efficient algorithm, VME-DWT, to remove eye blinks in a short segment of the single EEG channel. Method: The proposed algorithm: (a) locates eye blink intervals using Variational Mode Extraction (VME) and (b) filters only contaminated EEG interval using an automatic Discrete Wavelet Transform (DWT) algorithm. The performance of VME-DWT is compared with an automatic Variational Mode Decomposition (AVMD) and a DWT-based algorithms, proposed for suppressing eye blinks in a short segment of the single EEG channel. Results: The VME-DWT detects and filters 95% of the eye blinks from the contaminated EEG signals with SNR ranging from −8 to +3 dB. The VME-DWT shows superiority to the AVMD and DWT with the higher mean value of correlation coefficient (0.92 vs. 0.83, 0.58) and lower mean value of RRMSE (0.42 vs. 0.59, 0.87). Significance: The VME-DWT can be a suitable algorithm for removal of eye blinks in low-cost single-channel EEG systems as it is: (a) computationally-efficient, the contaminated EEG signal is filtered in millisecond time resolution, (b) automatic, no human intervention is required, (c) low-invasive, EEG intervals without contamination remained unaltered, and (d) low-complexity, without need to the artifact reference

Bispectral Index and Other Processed Parameters of Electroencephalogram: an Update

SummaryBackground and objectivesThe processed analysis of electroencephalogram became extremely important to monitor nervous system, being used to obtain a better anesthetic adequacy. The objective was to conduct a review about each processed parameter, defining its real importance.ContentA review was conducted showing mathematical, physical and clinical aspects as well as their correlations and updates, presenting new integrated parameters.ConclusionsAn adequate analysis of processed parameters of electroencephalogram may provide more intraoperative safety as well as result in a better outcome for the patient

Detecció automàtica i robusta de Bursts en EEG de nounats amb HIE. Enfocament tensorial

[ANGLÈS] Hypoxic-Ischemic Encephalopathy (HIE) is an important cause of brain injury in the newborn, and can result in long-term devastating consequences. Burst-suppression pattern is one of several indicators of severe pathology in the EEG signal that may occur after brain damage caused by e.g. asphyxia around the time of birth. The goal of this thesis is to design a robust method to detect burst patterns automatically regardless of the physiologic and extra-physiologic artifacts that may occur at any time. At first, a pre-detector has been designed to obtain potential burst candidates from different patients. Then, a post-classification has been implemented, applying high dimensional feature extraction methods, to get the real burst patterns from these patients with a high sensitivity.[CASTELLÀ] La Hipoxia-Isquemia Encefálica (HIE) es una causa importante de lesión cerebral en los recién nacidos, pudiendo acarrear devastadoras consecuencias a largo plazo. El patrón Burst-Suppression es uno de los indicadores dados en patologías severas en señales EEG los cuales ocurren después de una lesión cerebral causada, por ejemplo, por una asfixia poco después del nacimiento. El objetivo de esta tésis es diseñar un método robusto que detecte automáticamente patrones Burst, prescindiendo de los artefactos fisiológicos y extra-fisiológicos que puedan aparecer en cualquier momento. Primeramente, se ha diseñado un pre-detector para obtener los candidatos potenciales a Burst provenientes de diferentes pacientes. Seguidamente, se ha implementado una post-clasificación, aplicando métodos de extracción de características para altas dimensiones, para obtener patrones reales de Burst con una alta sensitividad.[CATALÀ] La Hipòxia-Isquèmia Encefàlica (HIE) és una causa important de lesió cerebral en nounats, que poden comportar devastadores conseqüències a llarg termini. El patró Burst-Suppression és un dels indicadors donats en patologies severes en els senyals EEG els quals ocorren després d'una lesió cerebral causada, per exemple, per una asfixia poc després del naixement. L'objectiu d'aquesta tesis és dissenyar un mètode robust que detecti automàticament patrons Burst, prescindint dels artefactes fisiològics i extra-fisiològics que poden aparèixer en qualsevol moment. Primerament, s'ha dissenyat un pre-detector per obtenir els candidats potencials a Burst provinents de diferents pacients. Seguidament, s'ha implementat una post-classificació, aplicant mètodes d'extracció de característiques per a altes dimensions, per tal d'obtenir patrons reals de Burst amb una alta sensitivitat

Design of a Simulator for Neonatal Multichannel EEG: Application to Time-Frequency Approaches for Automatic Artifact Removal and Seizure Detection

The electroencephalogram (EEG) is used to noninvasively monitor brain activities; it is the most utilized tool to detect abnormalities such as seizures. In recent studies, detection of neonatal EEG seizures has been automated to assist neurophysiologists in diagnosing EEG as manual detection is time consuming and subjective; however it still lacks the necessary robustness that is required for clinical implementation. Moreover, as EEG is intended to record the cerebral activities, extra-cerebral activities external to the brain are also recorded; these are called “artifacts” and can seriously degrade the accuracy of seizure detection. Seizures are one of the most common neurologic problems managed by hospitals occurring in 0.1%-0.5% livebirths. Neonates with seizures are at higher risk for mortality and are reported to be 55-70 times more likely to have severe cerebral-palsy. Therefore, early and accurate detection of neonatal seizures is important to prevent long-term neurological damage. Several attempts in modelling the neonatal EEG and artifacts have been done, but most did not consider the multichannel case. Furthermore, these models were used to test artifact or seizure detection separately, but not together. This study aims to design synthetic models that generate clean or corrupted multichannel EEG to test the accuracy of available artifact and seizure detection algorithms in a controlled environment. In this thesis, synthetic neonatal EEG model is constructed by using; single-channel EEG simulators, head model, 21-electrodes, and propagation equations, to produce clean multichannel EEG. Furthermore, neonatal EEG artifact model is designed using synthetic signals to corrupt EEG waveforms. After that, an automated EEG artifact detection and removal system is designed in both time and time-frequency domains. Artifact detection is optimised and removal performance is evaluated. Finally, an automated seizure detection technique is developed, utilising fused and extended multichannel features along a cross-validated SVM classifier. Results show that the synthetic EEG model mimics real neonatal EEG with 0.62 average correlation, and corrupted-EEG can degrade seizure detection average accuracy from 100% to 70.9%. They also show that using artifact detection and removal enhances the average accuracy to 89.6%, and utilising the extended features enhances it to 97.4% and strengthened its robustness.لمراقبة ورصد أنشطة واشارات المخ، دون الحاجة لأي عملیات (EEG) یستخدم الرسم أو التخطیط الكھربائي للدماغ للدماغجراحیة، وھي تعد الأداة الأكثر استخداما في الكشف عن أي شذوذأو نوبات غیر طبیعیة مثل نوبات الصرع. وقد أظھرت دراسات حدیثة، أن الكشف الآلي لنوبات حدیثي الولادة، ساعد علماء الفسیولوجیا العصبیة في تشخیص الاشارات الدماغیة بشكل أكبر من الكشف الیدوي، حیث أن الكشف الیدوي یحتاج إلى وقت وجھد أكبر وھوذو فعالیة أقل بكثیر، إلا أنھ لا یزال یفتقر إلى المتانة الضروریة والمطلوبة للتطبیق السریري.علاوة على ذلك؛ فكما یقوم الرسم الكھربائي بتسجیل الأنشطة والإشارات الدماغیة الداخلیة، فھو یسجل أیضا أي نشاط أو اشارات خارجیة، مما یؤدي إلى -(artifacts) :حدوث خلل في مدى دقة وفعالیة الكشف عن النوبات الدماغیة الداخلیة، ویطلق على تلك الاشارات مسمى (نتاج صنعي) . 0.5٪ولادة حدیثة في -٪تعد نوبات الصرع من أكثر المشكلات العصبیة انتشارا،ً وھي تصیب ما یقارب 0.1المستشفیات. حیث أن حدیثي الولادة المصابین بنوبات الصرع ھم أكثر عرضة للوفاة، وكما تشیر التقاریر الى أنھم 70مرة أكثر. لذا یعد الكشف المبكر والدقیق للنوبات الدماغیة -معرضین للإصابة بالشلل الدماغي الشدید بما یقارب 55لحدیثي الولادة مھم جدا لمنع الضرر العصبي على المدى الطویل. لقد تم القیام بالعدید من المحاولات التي كانتتھدف الى تصمیم نموذج التخطیط الكھربائي والنتاج الصنعي لدماغ حدیثي الولادة, إلا أن معظمھا لم یعر أي اھتمام الى قضیة تعدد القنوات. إضافة الى ذلك, استخدمت ھذه النماذج , كل على حدة, أو نوبات الصرع. تھدف ھذه الدراسة الى تصمیم نماذج مصطنعة من شأنھا (artifact) لإختبار كاشفات النتاج الصنعيأن تولد اشارات دماغیة متعددة القنوات سلیمة أو معطلة وذلك لفحص مدى دقة فعالیة خوارزمیات الكشف عن نوبات ضمن بیئة یمكن السیطرة علیھا. (artifact) الصرع و النتاج الصنعي في ھذه الأطروحة, یتكون نموذج الرسم الكھربائي المصطنع لحدیثي الولادة من : قناة محاكاة واحده للرسم الكھربائي, نموذج رأس, 21قطب كھربائي و معادلات إنتشار. حیث تھدف جمیعھا لإنتاج إشاراة سلیمة متعدده القنوات للتخطیط عن طریق استخدام اشارات مصطنعة (artifact) الكھربائي للدماغ.علاوة على ذلك, لقد تم تصمیم نموذجالنتاج الصنعيفي نطاقالوقت و (artifact) لإتلاف الرسم الكھربائي للدماغ. بعد ذلك تم انشاء برنامج لكشف و إزالةالنتاج الصناعينطاقالوقت و التردد المشترك. تم تحسین برنامج الكشف النتاج الصناعيالى ابعد ما یمكن بینما تمت عملیة تقییم أداء الإزالة. وفي الختام تم التمكن من تطویر تقنیة الكشف الآلي عن نوبات الصرع, وذلك بتوظیف صفات مدمجة و صفات الذي تم التأكد من صحتھ. (SVM) جدیدة للقنوات المتعددة لإستخدامھا للمصنفلقد أظھرت النتائج أن نموذج الرسم الكھربائي المصطنع لحدیثي الولادة یحاكي الرسمالكھربائي الحقیقي لحدیثي الولادة بمتوسط ترابط 0.62, و أنالرسم الكھربائي المتضرر للدماغ قد یؤدي الى حدوث ھبوطفي مدى دقة متوسط الكشف عن نوبات الصرع من 100%الى 70.9%. وقد أشارت أیضا الى أن استخدام الكشف والإزالة عن النتاج الصنعي (artifact) یؤدي الى تحسن مستوى الدقة الى نسبة 89.6 %, وأن توظیف الصفات الجدیدة للقنوات المتعددة یزید من تحسنھا لتصل الى نسبة 94.4 % مما یعمل على دعم متانتھا