Sample entropy analysis of EEG signals via artificial neural networks to model patients' consciousness level based on anesthesiologists experience.

Electroencephalogram (EEG) signals, as it can express the human brain's activities and reflect awareness, have been widely used in many research and medical equipment to build a noninvasive monitoring index to the depth of anesthesia (DOA). Bispectral (BIS) index monitor is one of the famous and important indicators for anesthesiologists primarily using EEG signals when assessing the DOA. In this study, an attempt is made to build a new indicator using EEG signals to provide a more valuable reference to the DOA for clinical researchers. The EEG signals are collected from patients under anesthetic surgery which are filtered using multivariate empirical mode decomposition (MEMD) method and analyzed using sample entropy (SampEn) analysis. The calculated signals from SampEn are utilized to train an artificial neural network (ANN) model through using expert assessment of consciousness level (EACL) which is assessed by experienced anesthesiologists as the target to train, validate, and test the ANN. The results that are achieved using the proposed system are compared to BIS index. The proposed system results show that it is not only having similar characteristic to BIS index but also more close to experienced anesthesiologists which illustrates the consciousness level and reflects the DOA successfully.This research is supported by the Center forDynamical Biomarkers and Translational Medicine, National Central University, Taiwan, which is sponsored by Ministry of Science and Technology (Grant no. MOST103-2911-I-008-001). Also, it is supported by National Chung-Shan Institute of Science & Technology in Taiwan (Grant nos. CSIST-095-V301 and CSIST-095-V302)

EEG artifacts reduction by multivariate empirical mode decomposition and multiscale entropy for monitoring depth of anaesthesia during surgery

Electroencephalography (EEG) has been widely utilized to measure the depth of anaesthesia (DOA) during operation. However, the EEG signals are usually contaminated by artifacts which have a consequence on the measured DOA accuracy. In this study, an effective and useful filtering algorithm based on multivariate empirical mode decomposition and multiscale entropy (MSE) is proposed to measure DOA. Mean entropy of MSE is used as an index to find artifacts-free intrinsic mode functions. The effect of different levels of artifacts on the performances of the proposed filtering is analysed using simulated data. Furthermore, 21 patients' EEG signals are collected and analysed using sample entropy to calculate the complexity for monitoring DOA. The correlation coefficients of entropy and bispectral index (BIS) results show 0.14 ± 0.30 and 0.63 ± 0.09 before and after filtering, respectively. Artificial neural network (ANN) model is used for range mapping in order to correlate the measurements with BIS. The ANN method results show strong correlation coefficient (0.75 ± 0.08). The results in this paper verify that entropy values and BIS have a strong correlation for the purpose of DOA monitoring and the proposed filtering method can effectively filter artifacts from EEG signals. The proposed method performs better than the commonly used wavelet denoising method. This study provides a fully adaptive and automated filter for EEG to measure DOA more accuracy and thus reduce risk related to maintenance of anaesthetic agents.This research was financially supported by the Center for Dynamical Biomarkers and Translational Medicine, National Central University, Taiwan, which is sponsored by Ministry of Science and Technology (Grant Number: NSC102-2911-I-008-001). Also, it was supported by Chung-Shan Institute of Science and Technology in Taiwan (Grant Numbers: CSIST-095-V301 and CSIST-095-V302) and National Natural Science Foundation of China (Grant Number: 51475342)

Artifact Removal Methods in EEG Recordings: A Review

To obtain the correct analysis of electroencephalogram (EEG) signals, non-physiological and physiological artifacts should be removed from EEG signals. This study aims to give an overview on the existing methodology for removing physiological artifacts, e.g., ocular, cardiac, and muscle artifacts. The datasets, simulation platforms, and performance measures of artifact removal methods in previous related research are summarized. The advantages and disadvantages of each technique are discussed, including regression method, filtering method, blind source separation (BSS), wavelet transform (WT), empirical mode decomposition (EMD), singular spectrum analysis (SSA), and independent vector analysis (IVA). Also, the applications of hybrid approaches are presented, including discrete wavelet transform - adaptive filtering method (DWT-AFM), DWT-BSS, EMD-BSS, singular spectrum analysis - adaptive noise canceler (SSA-ANC), SSA-BSS, and EMD-IVA. Finally, a comparative analysis for these existing methods is provided based on their performance and merits. The result shows that hybrid methods can remove the artifacts more effectively than individual methods

Sample entropy analysis for the estimating depth of anaesthesia through human EEG signal at different levels of unconsciousness during surgeries

Estimating the depth of anaesthesia (DoA) in operations has always been a challenging issue due to the underlying complexity of the brain mechanisms. Electroencephalogram (EEG) signals are undoubtedly the most widely used signals for measuring DoA. In this paper, a novel EEG-based index is proposed to evaluate DoA for 24 patients receiving general anaesthesia with different levels of unconsciousness. Sample Entropy (SampEn) algorithm was utilised in order to acquire the chaotic features of the signals. After calculating the SampEn from the EEG signals, Random Forest was utilised for developing learning regression models with Bispectral index (BIS) as the target. Correlation coefficient, mean absolute error, and area under the curve (AUC) were used to verify the perioperative performance of the p roposed method. Validation comparisons with typical nonstationary signal analysis methods (i.e., recurrence analysis and permutation entropy) and regression methods (i.e., neural network and support vector machine) were conducted. To further verify the accuracy and validity of the proposed methodology, the data is divided into four unconsciousness-level groups on the basis of BIS levels. Subsequently, analysis of variance (ANOVA) was applied to the corresponding index (i.e., regression output). Results indicate that the correlation coefficient improved to 0.72 ± 0.09 after filtering and to 0.90 ± 0.05 after regression from the initial values of 0.51 ± 0.17. Similarly, the final mean absolute error dramatically declined to 5.22 ± 2.12. In addition, the ultimate AUC increased to 0.98 ± 0.02, and the ANOVA analysis indicates that each of the four groups of different anaesthetic levels demonstrated significant difference from the nearest levels. Furthermore, the Random Forest output was extensively linear in relation to BIS, thus with better DoA prediction accuracy. In conclusion, the proposed method provides a concrete basis for monitoring patients' anaesthetic level during surgeries.variou

Quasi-Periodicities Detection Using Phase-Rectified Signal Averaging in EEG Signals as a Depth of Anesthesia Monitor

Phase-rectified signal averaging (PRSA) has been known to be a useful method to detect periodicities in non-stationary biological signals. Determination of quasi-periodicities in electroencephalogram (EEG) is a candidate for quantifying the changes of depth of anesthesia (DOA). In this paper, DOA monitoring capacity of periodicities detected using PRSA were quantified by assessing EEG signals collected from 56 patients during surgery. The method is compared to sample entropy (SampEn), detrended fluctuation analysis (DFA) and permutation entropy (PE). The performance of quasi-periodicities defined by acceleration capacity (AC) and deceleration capacity (DC) was tested using the area under the receiver operating characteristic curve (AUC) and Pearson correlation coefficient. During the surgery, a significant difference (p < 0.05) in the quasi-periodicities was observed among three different stages under general anesthesia. There is a larger mean AUC and correlation coefficient of quasi-periodicities compared to SampEn, DFA and PE using expert assessment of conscious level (EACL) and bispectral index (BIS) as the gold standard, respectively. Quasi-periodicities detected using PRSA in EEG signals are powerful monitor of DOA and perform more accurate and robust results compared to SampEn, DFA and PE. The results do provide a valuable reference to researchers in the filed of clinical applications.10.13039/501100003711-Center for Dynamical Biomarkers and Translational Medicine, National Central University, Taiwan, which is sponsored by the Ministry of Science and Technology; 10.13039/501100001809-National Natural Science Foundation of China

Depth of anaesthesia assessment based on time and frequency features of simplified electroencephalogram (EEG)

Anaesthesiology is a medical subject focusing on the use of drugs and other methods to deprive patients’ sensation for discomfort in painful medical diagnosis or treatment. It is important to assess the depth of anaesthesia (DoA) accurately since a precise as- sessment is helpful for avoiding various adverse reactions such as intraoperative awareness with recall (underdosage), prolonged recovery and an increased risk of post- operative complications for a patient (overdosage). Evidence shows that the depth of anaesthesia monitoring using electroencephalograph (EEG) improves patient treat- ment outcomes by reducing the incidences of intra-operative awareness, minimizing anaesthetic drug consumption and resulting in faster wake-up and recovery. For an accurate DoA assessment, intensive research has been conducted in finding 'an ulti- mate index', and various monitors and DoA algorithms were developed. Generally, the limitations of the existing DoA monitors or latest DoA algorithms include unsatis- factory data filtering techniques, time delay and inflexible. The focus of this dissertation is to develop reliable DoA algorithms for accurate DoA assessment. Some novel time-frequency domain signal processing techniques, which are better suited for non-stationary EEG signals than currently established methods, have been proposed and applied to monitor the DoA based on simplified EEG signals based on plenty of programming work (including C and other programming language). The fast Fourier transform (FFT) and the discrete wavelet transforms are applied to pre-process EEG data in the frequency domain. The nonlocal mean, mobility, permu- tation entropy, Lempel-Ziv complexity, second order difference plot and interval feature extraction methods are modified and applied to investigate the scaling behaviour of the EEG in the time domain. We proposed and developed three new indexes for identifying, classifying and monitoring the DoA. The new indexes are evaluated by comparing with the most popular BIS index. Simulation results demonstrate that our new methods monitor the DoA in all anaesthesia states accurately. The results also demonstrate the advantages of proposed indexes in the cases of poor signal quality and the consistency with the anaesthetists’ records. These new indexes show a 3.1-59.7 seconds earlier time response than BIS during the change from awake to light anaesthesia and a 33-264 seconds earlier time response than BIS during the change from deep anaesthesia to moderate anaesthesia

Real time depth of anaesthesia monitoring through electroencephalogram (EEG) signal analysis based on Bayesian method and analytical technique

The electroencephalogram (EEG) signal from the brain is used for analysing brain abnormality, diseases, and monitoring patient conditions during surgery. One of the applications of the EEG signals analysis is real-time anaesthesia monitoring, as the anaesthetic drugs normally targeted the central nervous system. Depth of anaesthesia has been clinically assessed through breathing pattern, heart rate, arterial blood pressure, pupil dilation, sweating and the presence of movement. Those assessments are useful but are an indirect-measurement of anaesthetic drug effects. A direct method of assessment is through EEG signals because most anaesthetic drugs affect neuronal activity and cause a changed pattern in EEG signals. The aim of this research is to improve real-time anaesthesia assessment through EEG signal analysis which includes the filtering process, EEG features extraction and signal analysis for depth of anaesthesia assessment. The first phase of the research is EEG signal acquisition. When EEG signal is recorded, noises are also recorded along with the brain waves. Therefore, the filtering is necessary for EEG signal analysis. The filtering method introduced in this dissertation is Bayesian adaptive least mean square (LMS) filter which applies the Bayesian based method to find the best filter weight step for filter adaptation. The results show that the filtering technique is able to remove the unwanted signals from the EEG signals. This dissertation proposed three methods for EEG signal features extraction and analysing. The first is the strong analytical signal analysis which is based on the Hilbert transform for EEG signal features' extraction and analysis. The second is to extract EEG signal features using the Bayesian spike accumulation technique. The third is to apply the robust Bayesian Student-t distribution for real-time anaesthesia assessment. Computational results from the three methods are analysed and compared with the recorded BIS index which is the most popular and widely accepted depth of anaesthesia monitor. The outcomes show that computation times from the three methods are leading the BIS index approximately 18-120 seconds. Furthermore, the responses to anaesthetic drugs are verified with the anaesthetist's documentation and then compared with the BIS index to evaluate the performance. The results indicate that the three methods are able to extract EEG signal features efficiently, improve computation time, and respond faster to anaesthetic drugs compared to the existing BIS index

Development of nonlinear techniques based on time-frequency representation and information theory for the analysis of EEG signals to assess different states of consciousness

Electroencephalogram (EEG) recordings provide insight into the changes in brain activity associated with various states of anesthesia, epilepsy, brain attentiveness, sleep disorders, brain disorders, etc. EEG's are complex signals whose statistical properties depend on both space and time. Their randomness and non-stationary characteristics make them impossible to be described in an accurate way with a simple technique, requiring analysis and characterization involves techniques that take into account their non-stationarity. For that, new advanced techniques in order to improve the efficiency of the EEG based methods used in the clinical practice have to be developed. The main objective of this thesis was to investigate and implement different methods based on nonlinear techniques in order to develop indexes able to characterize the frequency spectrum, the nonlinear dynamics and the complexity of the EEG signals recorded in different state of consciousness. Firstly, a new method for removing peak and spike in biological signal based on the signal envelope was successfully designed and applied to simulated and real EEG signals, obtaining performances significantly better than the traditional adaptive filters. Then, several studies were carried out in order to extract and evaluate EEG measures based on nonlinear techniques in different contexts such as the automatic detection of sleepiness and the characterization and prediction of the nociceptive stimuli and the assessment of the sedation level. Four novel indexes were defined by calculating entropy of the Choi-Williams distribution (CWD) with respect to time or frequency, by using the probability mass function at each time instant taken independently or by using the probability mass function of the entire CWD. The values of these indexes tend to decrease, with different proportion, when the behavior of the signals evolved from chaos or randomness to periodicity and present differences when comparing EEG recorded in eyes-open and eyes-closed states and in ictal and non-ictal states. Measures obtained with time-frequency representation, mutual information function and correntropy, were applied to EEG signals for the automatic sleepiness detection in patients suffering sleep disorders. The group of patients with excessive daytime sleepiness presented more power in ¿ band than the group without sleepiness, which presented higher spectral and cross-spectral entropy in the frontal zone in d band. More complexity in the occipital zone was found in the group of patients without sleepiness in ß band, while a stronger nonlinear coupling between the occipital and frontal regions was detected in patients with excessive daytime sleepiness, in ß band. Time-frequency representation and non-linear measures were also used in order to study how adaptation and fatigue affect the event-related brain potentials to stimuli of different modalities. Differences between the responses to infrequent and frequent stimulation in different recording periods were found in series of averaged EEG epochs recorded after thermal, electrical and auditory stimulation. Nonlinear measures calculated on EEG filtered in the traditional frequency bands and in higher frequency bands improved the assessment of the sedation level. These measures were obtained by applying all the developed techniques on signals recorded from patients sedated, in order to predict the responses to pain stimulation such as nail bad compression and endoscopy tube insertion. The proposed measures exhibit better performances than the bispectral index (BIS), a traditional indexes used for hypnosis assessment. In conclusion, nonlinear measures based on time-frequency representation, mutual information functions and correntropy provided additional information that helped to improve the automatic sleepiness detection, the characterization and prediction of the nociceptive responses and thus the assessment of the sedation level.El registro de la señal Electroencefalografíca (EEG) proporciona información sobre los cambios en la actividad cerebral asociados con varios estados de la anestesia, la epilepsia, la atención cerebral, los trastornos del sueño, los trastornos cerebrales, etc. Los EEG son señales complejas cuyas propiedades estadísticas dependen del espacio y del tiempo. Sus características aleatorias y no estacionarias hacen imposible que el EEG se describa de forma precisa con una técnica sencilla requiriendo un análisis y una caracterización que implica técnicas que tengan en cuenta su no estacionariedad. Todo esto aumenta la necesidad de desarrollar nuevas técnicas avanzadas con el fin de mejorar la eficiencia de los métodos utilizados en la práctica clínica que son basados en el análisis de EEG. En esta tesis se han investigado y aplicado diferentes métodos utilizando técnicas no lineales con el fin de desarrollar índices capaces de caracterizar el espectro de frecuencias, la dinámica no lineal y la complejidad de las señales EEG registradas en diferentes estados de conciencia. En primer lugar, se ha desarrollado un nuevo algoritmo basado en la envolvente de la señal para la eliminación de ruido de picos en las señales biológicas. Este algoritmo ha sido aplicado a señales simuladas y reales obteniendo resultados significativamente mejores comparados con los filtros adaptativos tradicionales. Seguidamente, se han llevado a cabo varios estudios con el fin de extraer y evaluar las medidas de EEG basadas en técnicas no lineales en diferentes contextos. Se han definido nuevos índices mediante el cálculo de la entropía de la distribución de Choi-Williams (DCW) con respecto al tiempo o la frecuencia. Se ha observado que los valores de estos índices tienden a disminuir, en diferentes proporciones, cuando el comportamiento de las señales evoluciona de caótico o aleatorio a periódico. Además, se han encontrado valores diferentes de estos índices aplicados a la señal EEG registrada en diferentes estados. Diferentes medidas basadas en la representación tiempo-frecuencia, la función de información mutua y la correntropia se han aplicado al EEG para la detección automática de la somnolencia en pacientes que sufren trastornos del sueño. Se ha observado en la zona frontal que la potencia en la banda θ es mayor en los pacientes con somnolencia diurna excesiva, mientras que la entropía espectral y la entropía espectral cruzada en la banda δ es mayor en los pacientes sin somnolencia. En el grupo sin somnolencia se ha encontrado más complejidad en la zona occipital, mientras que el acoplamiento no lineal entre las regiones occipital y frontal ha resultado más fuerte en pacientes con somnolencia diurna excesiva, en la banda β. La representación tiempo-frecuencia y las medidas no lineales se han utilizado para estudiar cómo la adaptación y la fatiga afectan a los potenciales cerebrales relacionados con estímulos térmicos, eléctricos y auditivos. Analizando el promedio de varias épocas de EEG grabadas después de la estimulación, se han encontrado diferencias entre las respuestas a la estimulación frecuente e infrecuente en diferentes períodos de registro. Todas las técnicas que se han desarrollado, se han aplicado a señales EEG registradas en pacientes sedados, con el fin de predecir las respuestas a la estimulación del dolor. Un conjunto de medidas calculadas en señales EEG filtradas en diferentes bandas de frecuencia ha permitido mejorar la evaluación del nivel de sedación. Las medidas propuestas han presentado un mejor rendimiento comparado con el índice bispectral, un indicador de hipnosis tradicional. En conclusión, las medidas no lineales basadas en la representación tiempofrecuencia, funciones de información mutua y correntropia han proporcionado informaciones adicionales que contribuyeron a mejorar la detección automática de la somnolencia, la caracterización y predicción de las respuestas nociceptivas y por lo tanto la evaluación del nivel de sedación

An Approach for Brain-Controlled Prostheses Based on a Facial Expression Paradigm

One of the most exciting areas of rehabilitation research is brain-controlled prostheses, which translate electroencephalography (EEG) signals into control commands that operate prostheses. However, the existing brain-control methods have an obstacle between the selection of brain computer interface (BCI) and its performance. In this paper, a novel BCI system based on a facial expression paradigm is proposed to control prostheses that uses the characteristics of theta and alpha rhythms of the prefrontal and motor cortices. A portable brain-controlled prosthesis system was constructed to validate the feasibility of the facial-expression-based BCI (FE-BCI) system. Four types of facial expressions were used in this study. An effective filtering algorithm based on noise-assisted multivariate empirical mode decomposition (NA-MEMD) and sample entropy (SampEn) was used to remove electromyography (EMG) artifacts. A wavelet transform (WT) was applied to calculate the feature set, and a back propagation neural network (BPNN) was employed as a classifier. To prove the effectiveness of the FE-BCI system for prosthesis control, 18 subjects were involved in both offline and online experiments. The grand average accuracy over 18 subjects was 81.31 ± 5.82% during the online experiment. The experimental results indicated that the proposed FE-BCI system achieved good performance and can be efficiently applied for prosthesis control

Connectivity Analysis in EEG Data: A Tutorial Review of the State of the Art and Emerging Trends

Understanding how different areas of the human brain communicate with each other is a crucial issue in neuroscience. The concepts of structural, functional and effective connectivity have been widely exploited to describe the human connectome, consisting of brain networks, their structural connections and functional interactions. Despite high-spatial-resolution imaging techniques such as functional magnetic resonance imaging (fMRI) being widely used to map this complex network of multiple interactions, electroencephalographic (EEG) recordings claim high temporal resolution and are thus perfectly suitable to describe either spatially distributed and temporally dynamic patterns of neural activation and connectivity. In this work, we provide a technical account and a categorization of the most-used data-driven approaches to assess brain-functional connectivity, intended as the study of the statistical dependencies between the recorded EEG signals. Different pairwise and multivariate, as well as directed and non-directed connectivity metrics are discussed with a pros-cons approach, in the time, frequency, and information-theoretic domains. The establishment of conceptual and mathematical relationships between metrics from these three frameworks, and the discussion of novel methodological approaches, will allow the reader to go deep into the problem of inferring functional connectivity in complex networks. Furthermore, emerging trends for the description of extended forms of connectivity (e.g., high-order interactions) are also discussed, along with graph-theory tools exploring the topological properties of the network of connections provided by the proposed metrics. Applications to EEG data are reviewed. In addition, the importance of source localization, and the impacts of signal acquisition and pre-processing techniques (e.g., filtering, source localization, and artifact rejection) on the connectivity estimates are recognized and discussed. By going through this review, the reader could delve deeply into the entire process of EEG pre-processing and analysis for the study of brain functional connectivity and learning, thereby exploiting novel methodologies and approaches to the problem of inferring connectivity within complex networks