Analyzing autonomic activity in neonatal seizures

Thesis (M. Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2011.Cataloged from PDF version of thesis.Includes bibliographical references (p. 54-55).Recent studies suggest that seizures in the newborn occur more often than previously appreciated. The effect of neonatal seizures remain unclear, however. Do seizures in the newborn cause brain injury, are they a consequence of brain injury, or are they benign? Seizures in the newborn tend to occur without overt clinical correlates, such as convulsions, so their diagnosis requires electroencephalography (EEG). In this thesis, we investigate whether seizure activity is associated with changes in the discharge pattern of the autonomic nervous system, which could be picked up in heart rate (HR) or heart-rate variability (HRV) analysis. More fundamentally, we seek to investigate whether seizures in the neonate are confined to the cerebral cortex or whether they might originate from or propagate to deeper brain structures. Prior studies have provided some evidence that neonatal seizures can result in HR and HRV changes. From these past studies, there seems to be a heart-brain connection, however, this connection is currently poorly understood. Our long term goal is to understand the connection between electro-cortical activity, electro-cardiac activity, and brain injury in newborns with seizures. In this study, we analyzed the EEG and the electrocardiogram (ECG) signals in fourteen newborns with neonatal stroke and three newborns with hypoxemic-ischemic encephalopathy. Furthermore, we used information from magnetic resonance imaging and magnetic resonance spectroscopy reports to identify injury location in these full-term newborns. Our results indicate that some babies show strong changes in HR and HRV during seizure episodes while others tend to respond very weakly. Due to the small sample size of our patient population, no consistent picture emerged whether the location of injury might be responsible for this response pattern. We also explored a spectrogram-based method to determine the occurrence of seizure (on a lead-by-lead basis) and to determine seizure propagation from one region of the cortex to another.by Priya Ramaswamy.M.Eng

Stress response index for adverse childhood experience based on fusion of hypothalamus pituitary adrenocorticol and autonomic nervous system biomakers

Early life exposure to stress such as adverse childhood experiences has been suggested to cause changes in physiological processes and alteration in stress response magnitude which might have significant impact on health later in life. For this reason, detection of this altered stress response can be used as an indicator for future health. To date, there is no study that utilized this information to indicate future health. In order to detect the altered stress response, biomarkers that represent both Autonomic Nervous System (ANS) and Hypothalamic-Pituitary-Adrenocorticol (HPA) is proposed. Among the available biomarkers, Heart Rate Variability (HRV) has been proven as a powerful biomarker that represents ANS. Meanwhile, salivary cortisol has been suggested as a biomarker that reflects the HPA. Even though many studies used multiple biomarkers to measure the stress response, the results for each biomarker were analysed separately. Therefore, this study fuses the biomarker that represents both ANS and HPA as a single measure, proposes a new method to classify the stress response based on adverse childhood experience in the form of stress response index as a future health indicator. Electrocardiograph, blood pressure, pulse rate and Salivary Cortisol (SCort) were collected from 23 participants, 12 participants who had adverse childhood experience while the remaining 11 act as the control group. The recording session was done during a Paced Auditory Serial Addition Test (PASAT). HRV features were then extracted from the electrocardiograph (ECG) using time, frequency, time-frequency analysis, and wavelet transform. Following this, genetic algorithm was implemented to select a subset of 12 HRV features from 83 features. Next, the selected HRV features were combined with other biomarkers using parallel and serial fusion for performance comparison. Using Support Vector Machine (SVM), results showed that fused feature of the parallel fusion, so-called Euclidean distance (ed), demonstrated the highest performance with 80.0% accuracy, 83.3% sensitivity and 78.3% specificity. Finally, the fused feature of the Euclidean distance was fed into SVM in order to model the stress response index as an indicator for future health. This index was validated using all samples and achieved 91.3% accuracy. From this study, a new method based on HRV-SCort biomarker using Euclidean distance and SVM named as ed-SVM was proven to be an effective method to classify the stress response and could further be used to model a stress response index. This index can then be benefited as an indicator for future health to improve the health care management in adulthood

Stress response index for adverse childhood experience based on fusion of hypothalamus pituitary adrenocorticol and autonomic nervous system biomarkers

Early life exposure to stress such as adverse childhood experiences has been suggested to cause changes in physiological processes and alteration in stress response magnitude which might have significant impact on health later in life. For this reason, detection of this altered stress response can be used as an indicator for future health. To date, there is no study that utilized this information to indicate future health. In order to detect the altered stress response, biomarkers that represent both Autonomic Nervous System (ANS) and Hypothalamic-Pituitary-Adrenocorticol (HPA) is proposed. Among the available biomarkers, Heart Rate Variability (HRV) has been proven as a powerful biomarker that represents ANS. Meanwhile, salivary cortisol has been suggested as a biomarker that reflects the HPA. Even though many studies used multiple biomarkers to measure the stress response, the results for each biomarker were analysed separately. Therefore, this study fuses the biomarker that represents both ANS and HPA as a single measure, proposes a new method to classify the stress response based on adverse childhood experience in the form of stress response index as a future health indicator. Electrocardiograph, blood pressure, pulse rate and Salivary Cortisol (SCort) were collected from 23 participants, 12 participants who had adverse childhood experience while the remaining 11 act as the control group. The recording session was done during a Paced Auditory Serial Addition Test (PASAT). HRV features were then extracted from the electrocardiograph (ECG) using time, frequency, time-frequency analysis, and wavelet transform. Following this, genetic algorithm was implemented to select a subset of 12 HRV features from 83 features. Next, the selected HRV features were combined with other biomarkers using parallel and serial fusion for performance comparison. Using Support Vector Machine (SVM), results showed that fused feature of the parallel fusion, so-called Euclidean distance (ed), demonstrated the highest performance with 80.0% accuracy, 83.3% sensitivity and 78.3% specificity. Finally, the fused feature of the Euclidean distance was fed into SVM in order to model the stress response index as an indicator for future health. This index was validated using all samples and achieved 91.3% accuracy. From this study, a new method based on HRV-SCort biomarker using Euclidean distance and SVM named as ed-SVM was proven to be an effective method to classify the stress response and could further be used to model a stress response index. This index can then be benefited as an indicator for future health to improve the health care management in adulthood