EEG signals analysis using multiscale entropy for depth of anesthesia monitoring during surgery through artificial neural networks

In order to build a reliable index to monitor the depth of anesthesia (DOA), many algorithms have been proposed in recent years, one of which is sample entropy (SampEn), a commonly used and important tool to measure the regularity of data series. However, SampEn only estimates the complexity of signals on one time scale. In this study, a new approach is introduced using multiscale entropy (MSE) considering the structure information over different time scales. The entropy values over different time scales calculated through MSE are applied as the input data to train an artificial neural network (ANN) model using bispectral index (BIS) or expert assessment of conscious level (EACL) as the target. To test the performance of the new index's sensitivity to artifacts, we compared the results before and after filtration by multivariate empirical mode decomposition (MEMD). The new approach via ANN is utilized in real EEG signals collected from 26 patients before and after filtering by MEMD, respectively; the results show that is a higher correlation between index from the proposed approach and the gold standard compared with SampEn. Moreover, the proposed approach is more structurally robust to noise and artifacts which indicates that it can be used for monitoring the DOA more accurately.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 no. MOST103-2911-I-008-001). Also, it was supported by National Chung-Shan Institute of Science & Technology in Taiwan (Grant nos. CSIST-095-V301 and CSIST-095-V302) and National Natural Science Foundation of China (Grant no. 51475342)

Do Complexity Measures of Frontal EEG Distinguish Loss of Consciousness in Geriatric Patients Under Anesthesia?

While geriatric patients have a high likelihood of requiring anesthesia, they carry an increased risk for adverse cognitive outcomes from its use. Previous work suggests this could be mitigated by better intraoperative monitoring using indexes defined by several processed electroencephalogram (EEG) measures. Unfortunately, inconsistencies between patients and anesthetic agents in current analysis techniques have limited the adoption of EEG as standard of care. In attempts to identify new analyses that discriminate clinically-relevant anesthesia timepoints, we tested 1/f frequency scaling as well as measures of complexity from nonlinear dynamics. Specifically, we tested whether analyses that characterize time-delayed embeddings, correlation dimension (CD), phase-space geometric analysis, and multiscale entropy (MSE) capture loss-of-consciousness changes in EEG activity. We performed these analyses on EEG activity collected from a traditionally hard-to-monitor patient population: geriatric patients on beta-adrenergic blockade who were anesthetized using a combination of fentanyl and propofol. We compared these analyses to traditional frequency-derived measures to test how well they discriminated EEG states before and after loss of response to verbal stimuli. We found spectral changes similar to those reported previously during loss of response. We also found significant changes in 1/f frequency scaling. Additionally, we found that our phase-space geometric characterization of time-delayed embeddings showed significant differences before and after loss of response, as did measures of MSE. Our results suggest that our new spectral and complexity measures are capable of capturing subtle differences in EEG activity with anesthesia administration-differences which future work may reveal to improve geriatric patient monitoring

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

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

Self-organized criticality as a framework for consciousness: A review study

Objective: No current model of consciousness is univocally accepted on either theoretical or empirical grounds, and the need for a solid unifying framework is evident. Special attention has been given to the premise that self-organized criticality (SOC) is a fundamental property of neural system. SOC provides a competitive model to describe the physical mechanisms underlying spontaneous brain activity, and thus, critical dynamics were proposed as general gauges of information processing representing a strong candidate for a surrogate measure of consciousness. As SOC could be a neurodynamical framework, which may be able to bring together existing theories and experimental evidence, the purpose of this work was to provide a comprehensive overview of progress of research on SOC in association with consciousness. Methods: A comprehensive search of publications on consciousness and SOC published between 1998 and 2021 was conducted. The Web of Science database was searched, and annual number of publications and citations, type of articles, and applied methods were determined. Results: A total of 71 publications were identified. The annual number of citations steadily increased over the years. Original articles comprised 50.7% and reviews/theoretical articles 43.6%. Sixteen studies reported on human data and in seven studies data were recorded in animals. Computational models were utilized in n = 12 studies. EcoG data were assessed in n = 4 articles, fMRI in n = 4 studies, and EEG/MEG in n = 10 studies. Notably, different analytical tools were applied in the EEG/MEG studies to assess a surrogate measure of criticality such as the detrended fluctuation analysis, the pair correlation function, parameters from the neuronal avalanche analysis and the spectral exponent. Conclusion: Recent studies pointed out agreements of critical dynamics with the current most influencing theories in the field of consciousness research, the global workspace theory and the integrated information theory. Thus, the framework of SOC as a neurodynamical parameter for consciousness seems promising. However, identified experimental work was small in numbers, and a heterogeneity of applied analytical tools as a surrogate measure of criticality was observable, which limits the generalizability of findings

Depth Analysis of Anesthesia Using EEG Signals via Time Series Feature Extraction and Machine Learning

Data Availability Statement: Data presented in the paper are available on request from the corresponding author J.-S.S.Copyright © 2023 by the authors. The term “anesthetic depth” refers to the extent to which a general anesthetic agent sedates the central nervous system with specific strength concentration at which it is delivered. The depth level of anesthesia plays a crucial role in determining surgical complications, and it is imperative to keep the depth levels of anesthesia under control to perform a successful surgery. This study used electroencephalography (EEG) signals to predict the depth levels of anesthesia. Traditional preprocessing methods such as signal decomposition and model building using deep learning were used to classify anesthetic depth levels. This paper proposed a novel approach to classify the anesthesia levels based on the concept of time series feature extraction, by finding out the relation between EEG signals and the bi-spectral Index over a period of time. Time series feature extraction on basis of scalable hypothesis tests were performed to extract features by analyzing the relation between the EEG signals and Bi-Spectral Index, and machine learning models such as support vector classifier, XG boost classifier, gradient boost classifier, decision trees and random forest classifier are used to train the features and predict the depth level of anesthesia. The best-trained model was random forest, which gives an accuracy of 83%. This provides a platform to further research and dig into time series-based feature extraction in this area.Ministry of Science and Technology, Taiwan (grant number: MOST 107-2221-E-155-009-MY2)

CEPS: An Open Access MATLAB Graphical User Interface (GUI) for the Analysis of Complexity and Entropy in Physiological Signals

Background: We developed CEPS as an open access MATLAB® GUI (graphical user interface) for the analysis of Complexity and Entropy in Physiological Signals (CEPS), and demonstrate its use with an example data set that shows the effects of paced breathing (PB) on variability of heart, pulse and respiration rates. CEPS is also sufficiently adaptable to be used for other time series physiological data such as EEG (electroencephalography), postural sway or temperature measurements. Methods: Data were collected from a convenience sample of nine healthy adults in a pilot for a larger study investigating the effects on vagal tone of breathing paced at various different rates, part of a development programme for a home training stress reduction system. Results: The current version of CEPS focuses on those complexity and entropy measures that appear most frequently in the literature, together with some recently introduced entropy measures which may have advantages over those that are more established. Ten methods of estimating data complexity are currently included, and some 28 entropy measures. The GUI also includes a section for data pre-processing and standard ancillary methods to enable parameter estimation of embedding dimension m and time delay τ (‘tau’) where required. The software is freely available under version 3 of the GNU Lesser General Public License (LGPLv3) for non-commercial users. CEPS can be downloaded at https://bitbucket.org/deepak_panday/ceps/src/pipeline_v2/. In our illustration on PB, most complexity and entropy measures decreased significantly in response to breathing at 7 breaths per minute, differentiating more clearly than conventional linear, time- and frequency-domain measures between breathing states. In contrast, Higuchi fractal dimension increased during paced breathing. Conclusions: We have developed CEPS software as a physiological data visualiser able to integrate state of the art techniques. The interface is designed for clinical research and has a structure designed for integrating new tools. The aim is to strengthen collaboration between clinicians and the biomedical community, as demonstrated here by using CEPS to analyse various physiological responses to paced breathing

Developing new techniques to analyse and classify EEG signals

A massive amount of biomedical time series data such as Electroencephalograph (EEG), electrocardiography (ECG), Electromyography (EMG) signals are recorded daily to monitor human performance and diagnose different brain diseases. Effectively and accurately analysing these biomedical records is considered a challenge for researchers. Developing new techniques to analyse and classify these signals can help manage, inspect and diagnose these signals. In this thesis novel methods are proposed for EEG signals classification and analysis based on complex networks, a statistical model and spectral graph wavelet transform. Different complex networks attributes were employed and studied in this thesis to investigate the main relationship between behaviours of EEG signals and changes in networks attributes. Three types of EEG signals were investigated and analysed; sleep stages, epileptic and anaesthesia. The obtained results demonstrated the effectiveness of the proposed methods for analysing these three EEG signals types. The methods developed were applied to score sleep stages EEG signals, and to analyse epileptic, as well as anaesthesia EEG signals. The outcomes of the project will help support experts in the relevant medical fields and decrease the cost of diagnosing brain diseases

Automatic sleep stages classification using EEG entropy features and unsupervised pattern analysis techniques

Sleep is a growing area of research interest in medicine and neuroscience. Actually, one major concern is to find a correlation between several physiologic variables and sleep stages. There is a scientific agreement on the characteristics of the five stages of human sleep, based on EEG analysis. Nevertheless, manual stage classification is still the most widely used approach. This work proposes a new automatic sleep classification method based on unsupervised feature classification algorithms recently developed, and on EEG entropy measures. This scheme extracts entropy metrics from EEG records to obtain a feature vector. Then, these features are optimized in terms of relevance using the Q-&#945; algorithm. Finally, the resulting set of features is entered into a clustering procedure to obtain a final segmentation of the sleep stages. 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