Automatic interpretation and writing report of the adult waking electroencephalogram

Electroencephalography can Ubiquitously Delineate the Brain Dysfunction of Neurodegenerative Dementia by Both Visual and Automatic Analysis Methods: A Preliminary Study

Introduction: The aim was to examine the differences in electroencephalography (EEG) findings by visual and automated quantitative analyses between Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD). Methods: EEG data of 20 patients with AD and 24 with DLB/PDD (12 DLB and 12 PDD) were retrospectively analyzed. Based on the awake EEG, the posterior dominant rhythm frequency and proportion of patients who showed intermittent focal and diffuse slow waves (IDS) were visually and automatically compared between the AD and DLB/PDD groups. Results: On visual analysis, patients with DLB/PDD showed a lower PDR frequency than patients with AD. In patients with PDR <8 Hz and occipital slow waves or patients with PDR <8 Hz and IDS, DLB/PDD was highly suspected (PPV 100%) and AD was unlikely (PPV 0%). On automatic analysis, the findings of the PDR were similar to those on visual analysis. Comparisons between visual and automatic analysis showed an overlap in the focal slow wave commonly detected by both methods in 10 of 44 patients, and concordant presence or absence of IDS in 29 of 43 patients. With respect to PDR <8 Hz and the combination of PDR <8 Hz and IDS, PPV and NPV in DLB/PDD and AD were not different between visual and automatic analysis. Conclusions: As the noninvasive, widely available clinical tool of low expense, visual analysis of EEG findings provided highly sufficient information to delineate different brain dysfunction in AD and DLB/PDD, and automatic EEG analysis could support visual analysis especially about PD.

Automatic Detection of the EEG Spike-Wave Patterns in Epilepsy: Evaluation of the Effects of Transcranial Current Stimulation Therapy

This study aims to develop a detection method based on morphological features of spike-wave (SW) patterns in the EEG of epilepsy patients and evaluate the effect of cathodal transcranial direct current stimulation (ctDCS) treatment. The proposed method is based on several simple features describing the shape of SW patterns and their synchronous occurrence on at least two EEG channels. High sensitivity, specificity and selectivity values were achieved for each patient and condition. ctDCS resulted in a significant reduction in the number of detected patterns, a decrease in spike duration and amplitude, and an increased spike mobility. The proposed method allows efficient identification of SW patterns regardless of brain condition, although the recruitment of patterns may be modified by ctDCS. This method can be useful in the clinical evaluation of ctDCS effects.

Visual EEG reviewing times with SCORE EEG

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There is concern that the SCORE reporting standard for EEG takes too long.

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This study shows that a normal EEG can typically be reported in SCORE EEG in 8 min.

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Reviewing time is higher for abnormal recordings, and declined by 25% in this study.

Objective

Visual EEG analysis is the gold standard for clinical EEG interpretation and analysis, but there is no published data on how long it takes to review and report an EEG in clinical routine. Estimates of reporting times may inform workforce planning and automation initiatives for EEG. The SCORE standard has recently been adopted to standardize clinical EEG reporting, but concern has been expressed about the time spent reporting.

Methods

Elapsed times were extracted from 5889 standard and sleep-deprived EEGs reported between 2015 and 2017 reported using the SCORE EEG software.

Results

The median review time for standard EEG was 12.5 min, and for sleep deprived EEG 20.9 min. A normal standard EEG had a median review time of 8.3 min. Abnormal EEGs took longer than normal EEGs to review, and had more variable review times. 99% of EEGs were reported within 24 h of end of recording. Review times declined by 25% during the study period.

Conclusion

Standard and sleep-deprived EEG review and reporting times with SCORE EEG are reasonable, increasing with increasing EEG complexity and decreasing with experience. EEG reports can be provided within 24 h.

Significance

Clinical standard and sleep-deprived EEG reporting with SCORE EEG has acceptable reporting times.

Consensus statement on continuous EEG in critically ill adults and children, part II: personnel, technical specifications, and clinical practice

INTRODUCTION

Critical Care Continuous EEG (CCEEG) is a common procedure to monitor brain function in patients with altered mental status in intensive care units. There is significant variability in patient populations undergoing CCEEG and in technical specifications for CCEEG performance.

METHODS

The Critical Care Continuous EEG Task Force of the American Clinical Neurophysiology Society developed expert consensus recommendations on the use of CCEEG in critically ill adults and children.

RECOMMENDATIONS

The consensus panel describes the qualifications and responsibilities of CCEEG personnel including neurodiagnostic technologists and interpreting physicians. The panel outlines required equipment for CCEEG, including electrodes, EEG machine and amplifier specifications, equipment for polygraphic data acquisition, EEG and video review machines, central monitoring equipment, and network, remote access, and data storage equipment. The consensus panel also describes how CCEEG should be acquired, reviewed and interpreted. The panel suggests methods for patient selection and triage; initiation of CCEEG; daily maintenance of CCEEG; electrode removal and infection control; quantitative EEG techniques; EEG and behavioral monitoring by non-physician personnel; review, interpretation, and reports; and data storage protocols.

CONCLUSION

Recommended qualifications for CCEEG personnel and CCEEG technical specifications will facilitate standardization of this emerging technology.

Issues and considerations for using the scalp surface Laplacian in EEG/ERP research: A tutorial review

Despite the recognition that the surface Laplacian may counteract adverse effects of volume conduction and recording reference for surface potential data, electrophysiology as a discipline has been reluctant to embrace this approach for data analysis. The reasons for such hesitation are manifold but often involve unfamiliarity with the nature of the underlying transformation, as well as intimidation by a perceived mathematical complexity, and concerns of signal loss, dense electrode array requirements, or susceptibility to noise. We revisit the pitfalls arising from volume conduction and the mandated arbitrary choice of EEG reference, describe the basic principle of the surface Laplacian transform in an intuitive fashion, and exemplify the differences between common reference schemes (nose, linked mastoids, average) and the surface Laplacian for frequently-measured EEG spectra (theta, alpha) and standard event-related potential (ERP) components, such as N1 or P3. We specifically review common reservations against the universal use of the surface Laplacian, which can be effectively addressed by employing spherical spline interpolations with an appropriate selection of the spline flexibility parameter and regularization constant. We argue from a pragmatic perspective that not only are these reservations unfounded but that the continued predominant use of surface potentials poses a considerable impediment on the progress of EEG and ERP research.