An EEG Severity Index of Traumatic Brain Injury

Abstract

EEG spectral analyses were conducted from 19 scalp locations for patients with mild (n=40), moderate (n=25), and severe (n=43) traumatic brain injury (TBI), 15 days to 4 years after injury. Severity of TBI was judged by emergency hospital admission records (Glasgow Coma Score and duration of coma and amnesia). Highest-loading EEG variables on each factor that differed significantly between severe and mild TBI by univariate t-test were entered into a multivariate discriminant analysis, yielding 16 variables. Discriminant analysis between mild and severe TBI groups showed classification accuracy of 96.39%, sensitivity 95.45%, and specificity 97.44%. The EEG discriminant score also measured intermediate severity in moderate TBI patients. Results were cross-validated in 503 VA patients. Significant correlations between EEG discriminant scores, emergency admission measures, and post-trauma neuropsychological test scores validated the discriminant function as an index of severity of injury and a classifier of the extremes of severity.

Classification algorithms for the identification of structural injury in TBI using brain electrical activity

“…Quantitative features of brain electrical activity (QEEG) used in the BrainScope technology have also been shown to be sensitive to these changes in brain activity [12][13][14] without the limitations of other neuroimaging tools (e.g., availability at point of care, radiation exposure, cost-effectiveness). For example, the hypometabolism reported in PET imaging in TBI is consistent with slowing of the EEG spectra seen in this population.…”

“…The emergency medicine, neurosurgical and neuroscience literature indicates that the prevalence of structural brain injury visible on CT ("CT positive", CTþ) in adult patients with mTBI and Glasgow Coma Scale score (GCS) [4] of [13][14][15], evaluated in the ED ranges from 7.5% to 12.1% [5][6][7]. Several factors related to the status of the patients at the time of evaluation are important Contents lists available at ScienceDirect journal homepage: www.elsevier.com/locate/cbm determinants in the prevalence numbers reported.…”

“…The use of such measures for the classification and identification of head injured patients has also been studied using 19 lead electroencephalogram (EEG) data, and reported to be sensitive to both structural and functional brain injury [12][13][14]. This paper will describe the development of a hand-held tool using a classification algorithm based on quantitative features of brain electrical activity for rapid, objective, and reliable assessment of the likelihood of the presence of structural brain injury for the triage of patients who present with mild TBI to the ED.…”

Clinical electrophysiologic assessments and mild traumatic brain injury: State-of-the-science and implications for clinical practice

“…Although specific qEEG findings vary between studies of persons with mTBI, among the most consistent findings are reduction in mean alpha frequency (Chen et al, 2006;Coutin-Churchman et al, 2003;Gosselin et al, 2009;Korn et al, 2005;Tebano et al, 1988;von Bierbrauer et al, 1992), increased theta activity (Fenton et al, 1993;Fenton, 1996;McClelland et al, 1994;Montgomery et al, 1991) or increased theta-alpha ratios (Chen et al, 2006;von Bierbrauer et al, 1992;Watson et al, 1995), reduced differences in alpha and beta power between anterior and posterior cortical regions, reduced alpha power posteriorly, and increased coherence and decreased phase between frontal and temporal areas (Thatcher et al, , 2001b(Thatcher et al, , 1989. Since abnormalities of these types are not etiology-specific (Coburn et al, 2006;Nuwer et al, 2005), efforts have been directed both at identifying combinations of qEEG panels that function usefully as neurodiagnostics for mTBI and also at exploring the relationship between qEEG abnormalities and the neurobiology of mTBI.…”

Treating Thought Disorders

“…186,187 The importance of proper location and frequency band selection was also shown by Moore in a review of two OCD studies he conducted, where he found that pure alpha training did not produce any results. He concluded that this was because there were two OCD subgroups, neither of which would have been expected to benefit from alpha training.…”