Narrow Results

Changes in heart rate, most often increases, are associated with the onset of epileptic seizures and may be used in lieu of cortical activity for automated seizure detection. The feasibility of this aim was tested on 241 clinical seizures from 81 subjects admitted to several Epilepsy Centers for invasive monitoring for evaluation for epilepsy surgery. The performance of the EKG-based seizure detection algorithm was compared to that of a validated algorithm applied to electrocorticogram (ECoG). With the most sensitive detection settings [threshold T: 1.15; duration D: 0 s], 5/241 seizures (2%) were undetected (false negatives) and with the highest [T: 1.3; D: 5 s] settings, the number of false negative detections rose to 34 (14%). The rate of potential false positive (PFP) detections was 9.5/h with the lowest and 1.1/h with the highest T, D settings. Visual review of 336 ECoG segments associated with PFPs revealed that 120 (36%) were associated with seizures, 127 (38%) with bursts of epileptiform discharges and only 87 (26%) were true false positives. Electrocardiographic (EKG)-based seizure onset detection preceded clinical onset by 0.8 s with the lowest and followed it by 13.8 s with the highest T, D settings. Automated EKG-based seizure detection is feasible and has potential clinical utility given its ease of acquisition, processing, high signal/noise and ergonomic advantages viz-a-viz EEG (electroencephalogram) or ECoG. Its use as an "electronic" seizure diary will remedy in part, the inaccuracies of those generated by patients/care-givers in a cost-effective manner.

Hypoxic-ischemic (HI) studies in preterms lack reliable prognostic biomarkers for diagnostic tests of HI encephalopathy (HIE). Our group’s observations from in utero fetal sheep models suggest that potential biomarkers of HIE in the form of developing HI micro-scale epileptiform transients emerge along suppressed EEG/ECoG background during a latent phase of 6–7h post-insult. However, having to observe for the whole of the latent phase disqualifies any chance of clinical intervention. A precise automatic identification of these transients can help for a well-timed diagnosis of the HIE and to stop the spread of the injury before it becomes irreversible. This paper reports fusion of Reverse-Biorthogonal Wavelets with Type-1 Fuzzy classifiers, for the accurate real-time automatic identification and quantification of high-frequency HI spike transients in the latent phase, tested over seven in utero preterm sheep. Considerable high performance of 99.78 ± 0.10% was obtained from the Rbio-Wavelet Type-1 Fuzzy classifier for automatic identification of HI spikes tested over 42h of high-resolution recordings (sampling-freq:1024Hz). Data from post-insult automatic time-localization of high-frequency HI spikes reveals a promising trend in the average rate of the HI spikes, even in the animals with shorter occlusion periods, which highlights considerable higher number of transients within the first 2h post-insult.

The selection of parameters for phase space reconstruction of empirically observed data has been a source of criticism when estimating the correlation dimension (D₂) from observed data rather than from the solution of differential equations, when analyzing noisy and potentially non-stationary signals, such as the electroencephalogram (EEG). The largely arbitrary selection of the time-delay reconstruction (T) of temporal dynamics, and for the embedding (M) of these series, has been widely criticized. This study adopted an analytic and statistical framework within which the scaling behavior of D₂ with respect to T and M, could be examined over five data lengths (N = 4096, 8192, 12288, 16384, and 20480) over an 8 × 8 grid of cat EEG. It was found that D₂ was invariant over all data lengths only within a very narrow T range (T = 10–16) for M = 4. A statistically significant T by M interaction was found using multiple analysis of variance, with D₂ being highly correlated over T as a function of M. Finally, an examination of phase-randomized surrogates indicated that statistically significant differences existed between EEG and phase-randomized surrogates over all data lengths, with time delays (T = 10–16), indicating that the D₂ for EEG is phase-dependent when it is invariant with respect to data length. The implications of these findings are discussed with respect to current models of ECoG generation, and their implication with respect to the integration in the brain.