Chaos-modified detrended moving average methodology for monitoring the depth of anaesthesia

This paper proposes a new method to monitor the depth of anaesthesia (DoA) based on the EEG signal. This approach firstly uses discrete wavelet transform (DWT) to to remove the spikes and the low frequency noise from raw EEG signals. After de-noising the EEG signals, the modified Hurst parameter is proposed with two new indices (CDoA and CsDoA), to estimate the anaesthesia states of the patients. To reduce the fluctuation of the new DoA index, a combination of Modified Chaos and Modifying Detrended Moving Average is used (MC-DMA). Analyses of variance (ANOVA) for C-MDMA and BIS distributions are presented The results indicate that the C-MDMA distributions at each anaesthesia state level are significantly different and the C-MDMA can distinguish five depths of anaesthesia. Compared with BIS trends, MC-DMA trend is close to BIS trend covering the whole scale from 100 to 0 with a full recording time

Prediction of Nociceptive Responses during Sedation by Linear and Non-Linear Measures of EEG Signals in High Frequencies

The level of sedation in patients undergoing medical procedures evolves continuously, affected by the interaction between the effect of the anesthetic and analgesic agents and the pain stimuli. The monitors of depth of anesthesia, based on the analysis of the electroencephalogram (EEG), have been progressively introduced into the daily practice to provide additional information about the state of the patient. However, the quantification of analgesia still remains an open problem. The purpose of this work is to improve the prediction of nociceptive responses with linear and non-linear measures calculated from EEG signal filtered in frequency bands higher than the traditional bands. Power spectral density and auto-mutual information function was applied in order to predict the presence or absence of the nociceptive responses to different stimuli during sedation in endoscopy procedure. The proposed measures exhibit better performances than the bispectral index (BIS). Values of prediction probability of Pk above 0.75 and percentages of sensitivity and specificity above 70% were achieved combining EEG measures from the traditional frequency bands and higher frequency bands

Permutation entropy and its main biomedical and econophysics applications: a review

Entropy is a powerful tool for the analysis of time series, as it allows describing the probability distributions of the possible state of a system, and therefore the information encoded in it. Nevertheless, important information may be codified also in the temporal dynamics, an aspect which is not usually taken into account. The idea of calculating entropy based on permutation patterns (that is, permutations defined by the order relations among values of a time series) has received a lot of attention in the last years, especially for the understanding of complex and chaotic systems. Permutation entropy directly accounts for the temporal information contained in the time series; furthermore, it has the quality of simplicity, robustness and very low computational cost. To celebrate the tenth anniversary of the original work, here we analyze the theoretical foundations of the permutation entropy, as well as the main recent applications to the analysis of economical markets and to the understanding of biomedical systems.Facultad de Ingenierí

Study and prediction of time of recovery of consciousness after general anaesthesia

Treballs Finals de Grau d'Enginyeria Biomèdica. Facultat de Medicina i Ciències de la Salut. Universitat de Barcelona. Curs: 2022-2023. Tutor/Director: Gambús Cerrillo, Pedro LuisSeveral studies address the process of loss of consciousness during the induction of general anaesthesia, but few of them discuss or study the process of recovery of consciousness once the of general anaesthesia has been administered successfully. The main objective of this project is to study and develop a predictive model of the duration of this process of consciousness recovery based on Machine Learning (ML) and the analysis of electroencephalographic (EEG) signals. A dataset comprising 143 patients from the 4th operating room of the Hospital Clínic of Barcelona was analysed. The project involved data pre-processing, including the segmentation of EEG signals during the recovery process, feature extraction, and correlation analysis. Five ML regression algorithms, namely Linear, Lasso, and Ridge Regression, Support Vector Regression (SVR), and Random Forest (RF), were evaluated using a Cross-Validation pipeline. Model performance, feature selection, and hyperparameter optimization were assessed using the R-squared score criterion. The best performing algorithm was the regularized linear regression model, Lasso, achieving an R-squared score of 0.74 ± 0.032 (mean and standard deviation). Through the correlation analysis and the feature selection performed by the algorithm, high predictive capabilities of consciousness recovery time were obtained for alpha and beta relative averaged band power in the first minute before stopping general anaesthesia administration. The findings demonstrate that EEG signals contain valuable information regarding the process of consciousness recovery, enabling the construction of ML predictive models. However, further studies are required to enhance our understanding of the consciousness recovery process and to validate the predictive model in a clinical setting. Future investigations should focus on increasing data variability, addressing biases in validation techniques, exploring additional EEG channels to capture global brain activity, and considering regulatory considerations for Artificial Intelligence algorithms

Machine learning reveals interhemispheric somatosensory coherence as indicator of anesthetic depth

The goal of this study was to identify features in mouse electrocorticogram recordings that indicate the depth of anesthesia as approximated by the administered anesthetic dosage. Anesthetic depth in laboratory animals must be precisely monitored and controlled. However, for the most common lab species (mice) few indicators useful for monitoring anesthetic depth have been established. We used electrocorticogram recordings in mice, coupled with peripheral stimulation, in order to identify features of brain activity modulated by isoflurane anesthesia and explored their usefulness in monitoring anesthetic depth through machine learning techniques. Using a gradient boosting regressor framework we identified interhemispheric somatosensory coherence as the most informative and reliable electrocorticogram feature for determining anesthetic depth, yielding good generalization and performance over many subjects. Knowing that interhemispheric somatosensory coherence indicates the effectively administered isoflurane concentration is an important step for establishing better anesthetic monitoring protocols and closed-loop systems for animal surgeries

Predicting optimal anesthesia level from propofol and remifentanil concentration: analysis of covariate factors for individualization

Treballs Finals de Grau d'Enginyeria Biomèdica. Facultat de Medicina i Ciències de la Salut. Universitat de Barcelona. Curs: 2020-2021. Tutor: Pedro Gambús Cerrillo. Tutor Extern: Sebastián Jaramillo SelmanGeneral anesthesia involves some targeting effects which aim to prevent the patient from suffering against the therapeutic aggression. These effects are hypnosis, analgesia, amnesia and immobility and to achieve them a combination of drugs is delivered into the patient, from which propofol and remifentanil are highlighted. In the operating room, monitoring systems are used to assess the depth of anesthesia in real time. This monitoring includes basic systems such as arterial blood pressure, oxygenation or electrocardiogram and electroencephalogram derived measures, which are more complex; from this last group, BIS index is a good indicator. Being able to predict the anesthetic depth from a set of input variables could be valuable during the surgery, as it would help the anesthesiologists to prevent adverse effects, and it would help the post-operative recovery. Knowing this, the aim of this project is to predict the probability to be in the optimal level of anesthesia, which is related to the BIS index. This probability is obtained from the input concentration of propofol and remifentanil, a hypnotic and an analgesic drug respectively, and from the demographic variables such as age, height or gender. To do so, a Logistic Regression model will be built with data from patients undergoing general anesthesia in Cirurgia Major Ambulatòria (CMA) in Hospital Clínic

Coupling between gamma-band power and cerebral blood volume during recurrent acute neocortical seizures

Characterization of neural and hemodynamic biomarkers of epileptic activity that can be measured using non-invasive techniques is fundamental to the accurate identification of the epileptogenic zone (EZ) in the clinical setting. Recently, oscillations at gamma-band frequencies and above (>30 Hz) have been suggested to provide valuable localizing information of the EZ and track cortical activation associated with epileptogenic processes. Although a tight coupling between gamma-band activity and hemodynamic-based signals has been consistently demonstrated in non-pathological conditions, very little is known about whether such a relationship is maintained in epilepsy and the laminar etiology of these signals. Confirmation of this relationship may elucidate the underpinnings of perfusion-based signals in epilepsy and the potential value of localizing the EZ using hemodynamic correlates of pathological rhythms. Here, we use concurrent multi-depth electrophysiology and 2-dimensional optical imaging spectroscopy to examine the coupling between multi-band neural activity and cerebral blood volume (CBV) during recurrent acute focal neocortical seizures in the urethane-anesthetized rat. We show a powerful correlation between gamma-band power (25-90 Hz) and CBV across cortical laminae, in particular layer 5, and a close association between gamma measures and multi-unit activity (MUA). Our findings provide insights into the laminar electrophysiological basis of perfusion-based imaging signals in the epileptic state and may have implications for further research using non-invasive multi-modal techniques to localize epileptogenic tissue

C-Trend parameters and possibilities of federated learning

Abstract. In this observational study, federated learning, a cutting-edge approach to machine learning, was applied to one of the parameters provided by C-Trend Technology developed by Cerenion Oy. The aim was to compare the performance of federated learning to that of conventional machine learning. Additionally, the potential of federated learning for resolving the privacy concerns that prevent machine learning from realizing its full potential in the medical field was explored. Federated learning was applied to burst-suppression ratio’s machine learning and it was compared to the conventional machine learning of burst-suppression ratio calculated on the same dataset. A suitable aggregation method was developed and used in the updating of the global model. The performance metrics were compared and a descriptive analysis including box plots and histograms was conducted. As anticipated, towards the end of the training, federated learning’s performance was able to approach that of conventional machine learning. The strategy can be regarded to be valid because the performance metric values remained below the set test criterion levels. With this strategy, we will potentially be able to make use of data that would normally be kept confidential and, as we gain access to more data, eventually develop machine learning models that perform better. Federated learning has some great advantages and utilizing it in the context of qEEGs’ machine learning could potentially lead to models, which reach better performance by receiving data from multiple institutions without the difficulties of privacy restrictions. Some possible future directions include an implementation on heterogeneous data and on larger data volume.C-Trend-teknologian parametrit ja federoidun oppimisen mahdollisuudet. Tiivistelmä. Tässä havainnointitutkimuksessa federoitua oppimista, koneoppimisen huippuluokan lähestymistapaa, sovellettiin yhteen Cerenion Oy:n kehittämään C-Trend-teknologian tarjoamaan parametriin. Tavoitteena oli verrata federoidun oppimisen suorituskykyä perinteisen koneoppimisen suorituskykyyn. Lisäksi tutkittiin federoidun oppimisen mahdollisuuksia ratkaista yksityisyyden suojaan liittyviä rajoitteita, jotka estävät koneoppimista hyödyntämästä täyttä potentiaaliaan lääketieteen alalla. Federoitua oppimista sovellettiin purskevaimentumasuhteen koneoppimiseen ja sitä verrattiin purskevaimentumasuhteen laskemiseen, johon käytettiin perinteistä koneoppimista. Kummankin laskentaan käytettiin samaa dataa. Sopiva aggregointimenetelmä kehitettiin, jota käytettiin globaalin mallin päivittämisessä. Suorituskykymittareiden tuloksia verrattiin keskenään ja tehtiin kuvaileva analyysi, johon sisältyi laatikkokuvioita ja histogrammeja. Odotetusti opetuksen loppupuolella federoidun oppimisen suorituskyky pystyi lähestymään perinteisen koneoppimisen suorituskykyä. Menetelmää voidaan pitää pätevänä, koska suorituskykymittarin arvot pysyivät alle asetettujen testikriteerien tasojen. Tämän menetelmän avulla voimme ehkä hyödyntää dataa, joka normaalisti pidettäisiin salassa, ja kun saamme lisää dataa käyttöömme, voimme lopulta kehittää koneoppimismalleja, jotka saavuttavat paremman suorituskyvyn. Federoidulla oppimisella on joitakin suuria etuja, ja sen hyödyntäminen qEEG:n koneoppimisen yhteydessä voisi mahdollisesti johtaa malleihin, jotka saavuttavat paremman suorituskyvyn saamalla tietoja useista eri lähteistä ilman yksityisyyden suojaan liittyviä rajoituksia. Joitakin mahdollisia tulevia suuntauksia ovat muun muassa heterogeenisen datan ja suurempien tietomäärien käyttö