Validation of Electroencephalographic Recordings Obtained with a Consumer-Grade, Single Dry Electrode, Low-Cost Device: A Comparative Study

The functional validity of the signal obtained with low-cost electroencephalography (EEG) devices is still under debate. Here, we have conducted an in-depth comparison of the EEG-recordings obtained with a medical-grade golden-cup electrodes ambulatory device, the SOMNOwatch + EEG-6, vs those obtained with a consumer-grade, single dry electrode low-cost device, the NeuroSky MindWave, one of the most a ordable devices currently available. We recorded EEG signals at Fp1 using the two di erent devices simultaneously on 21 participants who underwent two experimental phases: a 12-minute resting state task (alternating two cycles of closed/open eyes periods), followed by 60-minute virtual-driving task. We evaluated the EEG recording quality by comparing the similarity between the temporal data series, their spectra, their signal-to-noise ratio, the reliability of EEG measurements (comparing the closed eyes periods), as well as their blink detection rate. We found substantial agreement between signals: whereas, qualitatively, the NeuroSky MindWave presented higher levels of noise and a biphasic shape of blinks, the similarity metric indicated that signals from both recording devices were significantly correlated. While the NeuroSky MindWave was less reliable, both devices had a similar blink detection rate. Overall, the NeuroSky MindWave is noise-limited, but provides stable recordings even through long periods of time. Furthermore, its data would be of adequate quality compared to that of conventional wet electrode EEG devices, except for a potential calibration error and spectral differences at low frequencies.Spanish Department of Transportation, Madrid, Spain (Grant No. SPIP2014-1426 to L.L.D.S.)A.C. is funded by a Spanish Ministry of Economy and Competitiveness grant (PSI2016-80558-R to A.C.)S.R. is funded by an Andalusian Government Excellence Research grant (P11-TIC-7983)L.J.F. is funded by a Spanish Ministry of Economy and Competitiveness grant (PSI2014-53427-P) and a Fundación Séneca grant (19267/PI/14)L.L.D.S. is currently supported by the Ramón y Cajal fellowship program (RYC-2015-17483)C.D.-P. is currently supported by the CEIMAR program (CEIMAR2018-2)C.D.-P. and L.L.D.S. are supported by a Santander Bank—CEMIX UGR-MADOC grant (Project PINS 2018-15

Development and applications of a smartphone-based mobile electroencephalography (EEG) system

Electroencephalography (EEG) is a clinical and research technique used to non-invasively acquire brain activity. EEG is performed using static systems in specialist laboratories where participant mobility is constrained. It is desirable to have EEG systems which enable acquisition of brain activity outside such settings. Mobile systems seek to reduce the constraining factors of EEG device and participant mobility to enable recordings in various environments but have had limited success due to various factors including low system specification. The main aim of this thesis was to design, build, test and validate a novel smartphone-based mobile EEG system.A literature review found that the term ‘mobile EEG’ has an ambiguous meaning as researchers have used it to describe many differing degrees of participant and device mobility. A novel categorisation of mobile EEG (CoME) scheme was derived from thirty published EEG studies which defined scores for participant and device mobilities, and system specifications. The CoME scheme was subsequently applied to generate a specification for the proposed mobile EEG system which had 24 channels, sampled at 24 bit at a rate of 250 Hz. Unique aspects of the EEG system were the introduction of a smartphone into the specification, along with the use of Wi-Fi for communications. The smartphone’s processing power was used to remotely control the EEG device so as to enable EEG data capture and storage as well as electrode impedance checking via the app. This was achieved by using the Unity game engine to code an app which provided the flexibility for future development possibilities with its multi-platform support.The prototype smartphone-based waist-mounted mobile EEG system (termed ‘io:bio’) was validated against a commercial FDA clinically approved mobile system (Micromed). The power spectral frequency, amplitude and area of alpha frequency waves were determined in participants with their eyes closed in various postures: lying, sitting, standing and standing with arms raised. Since a correlation analysis to compare two systems has interpretability problems, Bland and Altman plots were utilised with a priori justified limits of agreement to statistically assess the agreement between the two EEG systems. Overall, the results found similar agreements between the io:bio and Micromed systems indicating that the systems could be used interchangeably. Utilising the io:bio and Micromed systems in a walking configuration, led to contamination of EEG channels with artifacts thought to arise from movement and muscle-related sources, and electrode displacement.To enable an event related potential (ERP) capability of the EEG system, additional coding of the smartphone app was undertaken to provide stimulus delivery and associated data marking. Using the waist-mounted io:bio system, an auditory oddball paradigm was also coded into the app, and delivery of auditory tones (standard and deviant) to the participant (sitting posture) achieved via headphones connected to the smartphone. N100, N200 and P300 ERP components were recorded in participants sitting, and larger amplitudes were found for the deviant tones compared to the standard ones. In addition, when the paradigm was tested in individual participants during walking, movement-related artifacts impacted negatively upon the quality of the ERP components, although components were discernible in the grand mean ERP.The io:bio system was redesigned into a head-mounted configuration in an attempt to reduce EEG artifacts during participant walking. The initial approach taken to redesign the system involved using electronic components populated onto a flexible PCB proved to be non-robust. Instead, the rigid PCB form of the circuitry was taken from the io:bio waist-mounted system and placed onto the rear head section of the electrode cap via a bespoke cradle. Using this head-mounted system, in a preliminary auditory oddball paradigm study, ERP responses were obtained in participants whilst walking. Initial results indicate that artifacts are reduced in this head-mounted configuration, and N100, N200 and P300 components are clearly identifiable in some channels

Development and evaluation of a smartphone-based electroencephalography (EEG) system

The aim of the study was to design, develop and evaluate a general-purpose EEG platform which integrates with a smartphone. The target specification was a system with 19 EEG channels and data stored onto the smartphone via a Wi-Fi connection. The hardware was developed using three ADS1299 integrated circuits, and the game engine, Unity, was used to develop the smartphone app. An evaluation of the system was conducted using recordings of alpha waves during periods of eye closure in participants (Bland-Altman statistical comparison with a clinical grade EEG system). The smartphone was also used to deliver time-locked auditory stimuli using an oddball paradigm to evaluate the ability of the developed system to acquire event related potentials (ERP) during sitting and walking. No significant differences were found for the alpha wave peak amplitude, frequency and area under the curve for the intra-system (two consecutive periods of alpha waves) or inter-system (developed smartphone-based EEG system versus FDA-approved system) comparisons. ERP results showed the peak amplitude of the auditory P300 component to deviant tones was significantly higher when compared to standard tones for sitting and walking activities. It is envisaged that our general-purpose EEG system will encourage other researchers to design and build their own specific versions rather than being limited by the fixed features of commercial products

The use of wearable/portable digital sensors in Huntington’s disease: a systematic review

In chronic neurological conditions, wearable/portable devices have potential as innovative tools to detect subtle early disease manifestations and disease fluctuations for the purpose of clinical diagnosis, care and therapeutic development. Huntington’s disease (HD) has a unique combination of motor and non-motor features which, combined with recent and anticipated therapeutic progress, gives great potential for such devices to prove useful. The present work aims to provide a comprehensive account of the use of wearable/portable devices in HD and of what they have contributed so far. We conducted a systematic review searching MEDLINE, Embase, and IEEE Xplore. Thirty references were identified. Our results revealed large variability in the types of sensors used, study design, and the measured outcomes. Digital technologies show considerable promise for therapeutic research and clinical management of HD. However, more studies with standardized devices and harmonized protocols are needed to optimize the potential applicability of wearable/portable devices in HD

Effects of Systematic Sleep Fragmentation on Tolerance and Threshold in a Pressure Pain Task: Associations with Sustained Attention

Purpose: Pain is amplified following partial sleep deprivation. Pain has not been evaluated after sleep interruption, when total sleep time is preserved. Sleep interruption, also called sleep fragmentation, is ecologically relevant because it is caused by common sleep disorders such as Obstructive Sleep Apnea [OSA], Upper Airway Resistance Syndrome [UARS] and Periodic Limb Movements Disorder [PLMD]. The Sleep Continuity Hypothesis posits that the restorative effects of sleep are related to sleep quality in addition to quantity. With this study, my goal was to evaluate whether sleep fragmentation affected pain threshold and/or tolerance by systematically fragmenting the sleep of otherwise healthy adults.;Methods: Twelve adult female participants without chronic pain or evidence of a sleep disorder underwent a 14-day protocol. Sleep was monitored using actigraphy throughout the study. Participants completed daily morning and evening reaction time tasks to evaluate changes in attention. To measure changes in pain threshold (when a stimulus becomes painful) and tolerance (when a stimulus is no longer tolerable), a pressure-pain task was administered in-lab by a researcher. This test occurred a total of eight times, morning and evening. Participants spent the eighth, ninth and 13th nights in-lab. Night eight was for acclimatization to the research facility [BASE]. To compare pain after experimental sleep fragmentation (every five minutes; [FRAG]) with pain after sham [SHAM], these conditions were assigned pseudo-randomly to nights nine and 13. Three nights of recovery sleep outside the lab occurred between SHAM and FRAG nights.;Results: Sleep interruptions were induced at a rate of 5.2 times per hour, on average, without changing participants\u27 total sleep time. Stage two sleep proportion was higher on fragmentation night. Lapses in vigilance were lower after BASE than other nights. The slowest 10% of reaction times were slower after SHAM than BASE. Overall, reaction time did not reliably differ as a result of fragmentation. Neither pain threshold nor pain tolerance differed as a function of experimental condition.;Conclusions: Systematic sleep fragmentation, particularly of stage two sleep, did not affect reaction time (a measure of sustained attention) or pressure pain (threshold or tolerance). Reaction time was not related to individual-level changes in fragmentation or pain. Future work should aim to establish the minimal fragmentation that engenders a clinical effect (without concomitant hypoxemia) to inform clinical definitions of fragmentation severity

Non-Contact Sleep Monitoring

"The road ahead for preventive medicine seems clear. It is the delivery of high quality, personalised (as opposed to depersonalised) comprehensive medical care to all." Burney, Steiger, and Georges (1964) This world's population is ageing, and this is set to intensify over the next forty years. This demographic shift will result in signicant economic and societal burdens (partic- ularly on healthcare systems). The instantiation of a proactive, preventative approach to delivering healthcare is long recognised, yet is still proving challenging. Recent work has focussed on enabling older adults to age in place in their own homes. This may be realised through the recent technological advancements of aordable healthcare sen- sors and systems which continuously support independent living, particularly through longitudinally monitoring deviations in behavioural and health metrics. Overall health status is contingent on multiple factors including, but not limited to, physical health, mental health, and social and emotional wellbeing; sleep is implicitly linked to each of these factors. This thesis focusses on the investigation and development of an unobtrusive sleep mon- itoring system, particularly suited towards long-term placement in the homes of older adults. The Under Mattress Bed Sensor (UMBS) is an unobstrusive, pressure sensing grid designed to infer bed times and bed exits, and also for the detection of development of bedsores. This work extends the capacity of this sensor. Specically, the novel contri- butions contained within this thesis focus on an in-depth review of the state-of-the-art advances in sleep monitoring, and the development and validation of algorithms which extract and quantify UMBS-derived sleep metrics. Preliminary experimental and community deployments investigated the suitability of the sensor for long-term monitoring. Rigorous experimental development rened algorithms which extract respiration rate as well as motion metrics which outperform traditional forms of ambulatory sleep monitoring. Spatial, temporal, statistical and spatiotemporal features were derived from UMBS data as a means of describing movement during sleep. These features were compared across experimental, domestic and clinical data sets, and across multiple sleeping episodes. Lastly, the optimal classier (built using a combina- tion of the UMBS-derived features) was shown to infer sleep/wake state accurately and reliably across both younger and older cohorts. Through long-term deployment, it is envisaged that the UMBS-derived features (in- cluding spatial, temporal, statistical and spatiotemporal features, respiration rate, and sleep/wake state) may be used to provide unobtrusive, continuous insights into over- all health status, the progression of the symptoms of chronic conditions, and allow the objective measurement of daily (sleep/wake) patterns and routines

Bioresorbable silicon electronics for transient spatiotemporal mapping of electrical activity from the cerebral cortex.

Bioresorbable silicon electronics technology offers unprecedented opportunities to deploy advanced implantable monitoring systems that eliminate risks, cost and discomfort associated with surgical extraction. Applications include postoperative monitoring and transient physiologic recording after percutaneous or minimally invasive placement of vascular, cardiac, orthopaedic, neural or other devices. We present an embodiment of these materials in both passive and actively addressed arrays of bioresorbable silicon electrodes with multiplexing capabilities, which record in vivo electrophysiological signals from the cortical surface and the subgaleal space. The devices detect normal physiologic and epileptiform activity, both in acute and chronic recordings. Comparative studies show sensor performance comparable to standard clinical systems and reduced tissue reactivity relative to conventional clinical electrocorticography (ECoG) electrodes. This technology offers general applicability in neural interfaces, with additional potential utility in treatment of disorders where transient monitoring and modulation of physiologic function, implant integrity and tissue recovery or regeneration are required

Wearable devices for remote vital signs monitoring in the outpatient setting: an overview of the field

Early detection of physiological deterioration has been shown to improve patient outcomes. Due to recent improvements in technology, comprehensive outpatient vital signs monitoring is now possible. This is the first review to collate information on all wearable devices on the market for outpatient physiological monitoring. A scoping review was undertaken. The monitors reviewed were limited to those that can function in the outpatient setting with minimal restrictions on the patient’s normal lifestyle, while measuring any or all of the vital signs: heart rate, ECG, oxygen saturation, respiration rate, blood pressure and temperature. A total of 270 papers were included in the review. Thirty wearable monitors were examined: 6 patches, 3 clothing-based monitors, 4 chest straps, 2 upper arm bands and 15 wristbands. The monitoring of vital signs in the outpatient setting is a developing field with differing levels of evidence for each monitor. The most common clinical application was heart rate monitoring. Blood pressure and oxygen saturation measurements were the least common applications. There is a need for clinical validation studies in the outpatient setting to prove the potential of many of the monitors identified. Research in this area is in its infancy. Future research should look at aggregating the results of validity and reliability and patient outcome studies for each monitor and between different devices. This would provide a more holistic overview of the potential for the clinical use of each device