Real-Time Management of Multimodal Streaming Data for Monitoring of Epileptic Patients

This is the Accepted Manuscript version of the following article: I. Mporas, D. Triantafyllopoulos, V. Megalooikonomou, “Real-Time Management of Multimodal Streaming Data for Monitoring of Epileptic Patients”, Journal of Medical Systems, Vol. 40(45), December 2015. The final published versions is available at: https://link.springer.com/article/10.1007%2Fs10916-015-0403-3 © Springer Science+Business Media New York 2015.New generation of healthcare is represented by wearable health monitoring systems, which provide real-time monitoring of patient’s physiological parameters. It is expected that continuous ambulatory monitoring of vital signals will improve treatment of patients and enable proactive personal health management. In this paper, we present the implementation of a multimodal real-time system for epilepsy management. The proposed methodology is based on a data streaming architecture and efficient management of a big flow of physiological parameters. The performance of this architecture is examined for varying spatial resolution of the recorded data.Peer reviewedFinal Accepted Versio

Forehead EEG in Support of Future Feasible Personal Healthcare Solutions: Sleep Management, Headache Prevention, and Depression Treatment

© 2013 IEEE. There are current limitations in the recording technologies for measuring EEG activity in clinical and experimental applications. Acquisition systems involving wet electrodes are time-consuming and uncomfortable for the user. Furthermore, dehydration of the gel affects the quality of the acquired data and reliability of long-term monitoring. As a result, dry electrodes may be used to facilitate the transition from neuroscience research or clinical practice to real-life applications. EEG signals can be easily obtained using dry electrodes on the forehead, which provides extensive information concerning various cognitive dysfunctions and disorders. This paper presents the usefulness of the forehead EEG with advanced sensing technology and signal processing algorithms to support people with healthcare needs, such as monitoring sleep, predicting headaches, and treating depression. The proposed system for evaluating sleep quality is capable of identifying five sleep stages to track nightly sleep patterns. Additionally, people with episodic migraines can be notified of an imminent migraine headache hours in advance through monitoring forehead EEG dynamics. The depression treatment screening system can predict the efficacy of rapid antidepressant agents. It is evident that frontal EEG activity is critically involved in sleep management, headache prevention, and depression treatment. The use of dry electrodes on the forehead allows for easy and rapid monitoring on an everyday basis. The advances in EEG recording and analysis ensure a promising future in support of personal healthcare solutions

An Integrated Multi-modal Registration Technique for Medical Imaging

Registration of medical imaging is essential for aligning in time and space different modalities and hence consolidating their strengths for enhanced diagnosis and for the effective planning of treatment or therapeutic interventions. The primary objective of this study is to develop an integrated registration method that is effective for registering both brain and whole-body images. We seek in the proposed method to combine in one setting the excellent registration results that FMRIB Software Library (FSL) produces with brain images and the excellent results of Statistical Parametric Mapping (SPM) when registering whole-body images. To assess attainment of these objectives, the following registration tasks were performed: (1) FDG_CT with FLT_CT images, (2) pre-operation MRI with intra-operation CT images, (3) brain only MRI with corresponding PET images, and (4) MRI T1 with T2, T1 with FLAIR, and T1 with GE images. Then, the results of the proposed method will be compared to those obtained using existing state-of-the-art registration methods such as SPM and FSL. Initially, three slices were chosen from the reference image, and the normalized mutual information (NMI) was calculated between each of them for every slice in the moving image. The three pairs with the highest NMI values were chosen. The wavelet decomposition method is applied to minimize the computational requirements. An initial search applying a genetic algorithm is conducted on the three pairs to obtain three sets of registration parameters. The Powell method is applied to reference and moving images to validate the three sets of registration parameters. A linear interpolation method is then used to obtain the registration parameters for all remaining slices. Finally, the aligned registered image with the reference image were displayed to show the different performances of the 3 methods, namely the proposed method, SPM and FSL by gauging the average NMI values obtained in the registration results. Visual observations are also provided in support of these NMI values. For comparative purposes, tests using different multi-modal imaging platforms are performed

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

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

Self-Organized Criticality as a Neurodynamical Correlate of Consciousness: A neurophysiological approach to measure states of consciousness based on EEG-complexity features

Background and Objectives This thesis was based on the hypothesis that the physics-derived theoretical framework of self-organized criticality can be applied to the neuronal dynamics of the human brain. From a consciousness science perspective, this is especially appealing as critical brain dynamics imply a vicinity a phase transition, which is associated with optimized information processing functions as well as the largest repertoire of configurations that a system explores throughout its temporal evolution. Hence, self-organised criticality could serve as a neurodynamical correlate for consciousness, which provides the possibility of deriving empirically testable neurophysiological indices suitable to characterise and quantify states of consciousness. The purpose of this work was to experimentally examine the feasibility of the self-organized criticality theory as a correlate for states of consciousness. Therefore, it was aimed at answering the following research questions based on the analysis of three 64 channel EEG datasets: (i) Can signatures of self-organized criticality be found on the level of the EEG in terms of scale-free distribution of neuronal avalanches and the presence of long-range temporal correlations (LRTC) in neuronal oscillations? (ii) Are criticality features suitable to differentiate state of consciousness in the spectrum of wakefulness? (iii) Can the neuronal dynamics be shifted towards the critical point of a phase transition associated with optimized information processing function by mind-body interventions? (iv) Can an explicit relationship to other nonlinear complexity features and power spectral density parameter be identified? (v) Do EEG-based criticality features reflect individual temperament traits? Material and Methods (1): Re-analysis: Thirty participants highly proficient in meditation (mean age 47 years, 11 females/19 males, meditation experience of at least 5 years practice or more than 1000 h of total meditation time) were measured with 64-channel EEG during one session consisting of a task-free baseline resting, a reading condition and three meditation conditions, namely thoughtless emptiness, presence monitoring and focused attention. (2): 64-channel EEG was recorded from 34 participants (mean age 36.0 ±13.4 years, 24 females/ 10 males) before, during and after a professional singing bowl massage. Further, psychometric data was assessed including absorption capacity defined as the individual’s capacity for engaging attentional resources in sensory and imaginative experiences measured by the Tellegen-Absorption Scale (TAS-D), subjective changes in in body sensation, emotional state, and mental state (CSP-14) as well as the phenomenology of consciousness (PCI-K). (3): Electrophysiological data (64 channels of EEG, EOG, ECG, skin conductance, and respiration) was recorded from 116 participants (mean age 40.0 ±13.4 years, 83 females/ 33 males) – in collaboration with the Institute of Psychology, Bundeswehr University Munich - during a task-free baseline resting state. The individual level of sensory processing sensitivity was assessed using the High Sensitive Person Scale (HSPS-G). The datasets were analysed applying analytical tools from self-organized criticality theory (detrended fluctuation analysis, neuronal avalanche analysis), nonlinear complexity algorithms (multiscale entropy, Higuchi’s fractal dimension) and power spectral density. In study 1 and 2, task conditions were contrasted, and effect sizes were compared using a paired two-tailed t-test calculated across participants, and features. T-values were corrected for multiple testing using false discovery rate. To calculate correlations between the EEG features, Spearman’s rank correlation was applied after determining that the distribution was not appropriate for parametric testing by the Shapiro-Wilk test. In addition, in study 1, a discrimination analysis was carried out to determine the classification performance of the EEG features. Here, partial least squares regression and receiver operating characteristics analysis was applied. To determine whether the EEG features reflect individual temperament traits, the individual level of absorption capacity (study 2) and sensory processing sensitivity (study 3) was correlated with the EEG features using Spearman’s rank correlation. Results Signatures of self-organized criticality in the form of scale-free distribution of neuronal avalanches and long-range temporal correlations (LRTCs) in the amplitude of neural oscillations were observed in three distinct EEG-datasets. EEG criticality as well as complexity features were suitable to characterise distinct states of consciousness. In study 1, compared to the task-free resting condition, all three meditative states revealed significantly reduced long-range temporal correlation with moderate effect sizes (presence monitoring: d= -0.49, p<.001; thoughtless emptiness: d= -0.37, p<.001; and focused attention: d= -0.28, p=.003). The critical exponent was suitable to differentiate between focused attention and presence monitoring (d= -0.32, p=.02). Further, in study 2, the criticality features significantly changed during the course of the experiment, whereby values indicated a shift towards the critical regime during the sound condition. Both analyses of the first and second dataset revealed that the critical exponent was significantly negatively correlated with the sample entropy, the scaling exponent resulting from the DFA denoting the amount of long-range temporal correlations as well as Higuchi’s fractal dimension in each condition, respectively. In addition, the critical scaling exponent was found to be significantly negatively correlated with the trait absorption (Spearman's ρ= -0.39, p= .007), whereas an association between critical dynamics and the level of sensory processing sensitivity could not be verified (study 3). Conclusion The findings of this thesis suggest that neuronal dynamics are governed by the phenomena of self-organized criticality. EEG-based criticality features were shown to be sensitive to detect experimentally induced alterations in the state of consciousness. Further, an explicit relationship with nonlinear measures determining the degree of neuronal complexity was identified. Thus, self-organized criticality seems feasible as a neurodynamical correlate for consciousness with the potential to quantify and characterize states of consciousness. Its agreement with the current most influencing theories in the field of consciousness research is discussed