Quantitative EEG Is an Objective, Sensitive, and Reliable Indicator of Transient Anesthetic Effects During Wada Tests

Tu, Bin; Assassi, Nadege; Bazil, Carl W.; Hamberger, Marla J.; Hirsch, Lawrence J.

doi:10.1097/wnp.0000000000000154

Cited by 8 publications

(9 citation statements)

References 36 publications

(49 reference statements)

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“…EEG acquisition was similar to previously described. 22 Ag/AgCl electrodes were placed on scalp based on international 10-20 system with collodion USP (Mavidon Medical Products, Riviera Beach, FL, U.S.A.), further secured by wrapping the entire head with gauze when possible. The ground electrode was placed between the left or right central and parietal electrodes.…”

Section: Patients and Eegsmentioning

confidence: 99%

Diagnostic accuracy between readers for identifying electrographic seizures in critically ill adults

Young

Kokoszka

et al. 2017

Epilepsia Open

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SummaryObjectiveElectrographic seizures in critically ill patients are often equivocal. In this study, we sought to determine the diagnostic accuracy of electrographic seizure annotation in adult intensive care units (ICUs) and to identify affecting factors.MethodsTo investigate diagnostic accuracy, interreader agreement (IRA) measures were derived from 5,769 unequivocal and 6,263 equivocal seizure annotations by five experienced electroencephalogram (EEG) readers after reviewing 74 days of EEGs from 50 adult ICU patients. Factors including seizure equivocality (unequivocal vs. equivocal) and laterality (generalized, partial, or bilaterally independent), cyclicity (cyclic vs. noncyclic), persistency (occurrence of status epilepticus), and patient consciousness level (coma vs. noncoma) were further investigated for their influence on IRA measures.ResultsOn average, 70% of seizures marked by a reference reader overlapped, at least in part, with those marked by a test reader (any‐overlap sensitivity, AO‐Sn). Agreed seizure duration between reader pairs (overlap‐integral sensitivity, OI‐Sn) was 62%, while agreed nonseizure duration (overlap‐integral specificity, OI‐Sp) was 99%. A test reader would annotate one additional seizure not overlapping with a reference reader's annotation in every 11.7 h of EEG, that is, the false‐positive rate (FPR) was 0.0854/h. Classifying seizure patterns into unequivocal and equivocal improved specificity and FPR (unequivocal patterns) but compromised sensitivity only for equivocal patterns. Sensitivity of all and unequivocal annotations was higher for patients with status epilepticus. Specificity was higher for partial than for bilaterally independent unequivocal seizure patterns, and lower for cyclic all seizure patterns.SignificanceDiagnosing electrographic seizures in critically ill adults is highly specific and moderately sensitive. Improved criteria for diagnosing electrographic seizures in the ICU are needed.

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Section: Patients and Eegsmentioning

confidence: 99%

Diagnostic accuracy between readers for identifying electrographic seizures in critically ill adults

Young

Kokoszka

et al. 2017

Epilepsia Open

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“…Sum the energy in the second filter (corresponding to 0.7-2.3Hz) 5. Log scale the summed energy Subsequently, relative FBE (rFBE) was calculated expressing actual FBE relative to its median FBE value of the 5 minutes before injection (87). Also for the midline electrodes (Fz, Cz and Fz), rFBE was calculated to obtain a complete overview of all electrodes without excluding potential useful information beforehand.…”

Section: Calculation Of a Temporal Delta Power Qeeg Measurementioning

confidence: 99%

“…In this paper, we used a data-driven approach to improve EEG asymmetry detection during the Wada test. Our optimization was based on two previously defined qEEG measures: the Brain Symmetry Index (BSI) (7) and the relative Filter bank Bank Energy (rFBE) (87). Furthermore, we evaluated which electrodes resulted in optimal asymmetry detection performance when used to calculate BSI and rFBE .…”

Section: Asymmetry Detection Performancementioning

confidence: 99%

“…Various quantitative EEG analysis techniques (qEEG) have recently been introduced in order to eliminate the subjectivity inherent to visual EEG assessment during the Wada test (7,87). The Brain Symmetry Index (BSI) quantifies inter-hemispheric differences (7,88).…”

Section: Introductionmentioning

confidence: 99%

“…It is defined as the absolute value of the relative difference between the spectral density of the right and left hemisphere. Tu et al showed that the period of hemiplegia corresponded best with changes in delta power, and amplitude-integrated EEG had the highest signal/noise ratio (87). However, BSI is a conceptual measure for global hemispheric asymmetry, and hemiplegia caused by amobarbital perfusion in motor areas may not reflect functioning of deeper mesial structures, which are associated with memory function.…”

Section: Introductionmentioning

confidence: 99%

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Quantitative EEG and machine learning methods for the detection of epileptic seizures and cerebral asymmetry

Bogaarts¹

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People interested in the research are advised to contact the author for the final version of the publication, or visit the DOI to the publisher's website. • The final author version and the galley proof are versions of the publication after peer review. • The final published version features the final layout of the paper including the volume, issue and page numbers. Link to publication General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal. The 10-20 system The electrical cortical activity is usually recorded at equally distributed standardized locations (international 10-20 system) on the scalp (9). The electrode locations are defined by dividing the head into 10% and 20% angular intervals using the inion and nasion as landmarks (figure 1). The first letter of the electrode refers to the brain region it is placed on, and numbers refer to the left (odd) and right (even) hemisphere. Montages Measuring an EEG signal always involves a differential signal between two electrodes. In practice EEG signals are recorded using differential Background EEG The background activity describes the general patterns that are observed in the EEG. These patterns are generally described as rhythms from a certain frequency range. In increasing order of frequency the following frequency bands are used: delta (<4 Hz), theta (4-8 Hz), alpha (8-12 Hz), beta (12-30 Hz) and gamma (>30 Hz) (4). Each frequency band is associated with well-known properties and deviations or abnormalities are mostly related to pathologies or brain damage. Normal background properties are also related to age and circadian rhythm. For example slow activity in the delta and theta range is normal Visual inspection of the EEG Reviewing EEG recordings is a complex and time consuming task which can only be performed by experienced clinicians (4). The EEG is reviewed as multiple time series tiled horizontally, as illustrated in figure 2 and 3. Using a variety of montages, a clinical neurophysiologist looks for abnormalities in background patterns and transient phenomena. Traditionally the EEG is reviewed visually in the time domain. Conventionally, the frequency content is band-pass filtered between 0.5 and 50 Hz although physiological and pathological EEG Figure 6 Example of an SVM classifier separating two classes, red and blue, in a 2dimensional space. The solid line indicates the decision boundary, defined by the Support Vectors. Each Support Vector, indicated with circles, lie on, or within the margin which is indicat...

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Quantitative EEG: special applications and multimodal monitoring

2022

Hirsch and Brenner's Atlas of EEG in Critical Care

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Quantitative EEG Is an Objective, Sensitive, and Reliable Indicator of Transient Anesthetic Effects During Wada Tests

Cited by 8 publications

References 36 publications

Diagnostic accuracy between readers for identifying electrographic seizures in critically ill adults

Diagnostic accuracy between readers for identifying electrographic seizures in critically ill adults

Quantitative EEG and machine learning methods for the detection of epileptic seizures and cerebral asymmetry

Quantitative EEG: special applications and multimodal monitoring

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