Dataset Information

Multiscale Entropy of Electroencephalogram as a Potential Predictor for the Prognosis of Neonatal Seizures.

ABSTRACT:

Objective

Increasing animal studies supported the harmful effects of prolonged or frequent neonatal seizures in developing brain, including increased risk of later epilepsy. Various nonlinear analytic measures had been applied to investigate the change of brain complexity with age. This study focuses on clarifying the relationship between later epilepsy and the changes of electroencephalogram (EEG) complexity in neonatal seizures.

Methods

EEG signals from 19 channels of the whole brain from 32 neonates below 2 months old were acquired. The neonates were classified into 3 groups: 9 were normal controls, 9 were neonatal seizures without later epilepsy, and 14 were neonatal seizures with later epilepsy. Sample entropy (SamEn), multiscale entropy (MSE) and complexity index (CI) were analyzed.

Results

Although there was no significant change in SamEn, the CI values showed significantly decreased over Channels C3, C4, and Cz in patients with neonatal seizures and later epilepsy compared with control group. More multifocal epileptiform discharges in EEG, more abnormal neuroimaging findings, and higher incidence of future developmental delay were noted in the group with later epilepsy.

Conclusions

Decreased MSE and CI values in patients with neonatal seizures and later epilepsy may reflect the mixed effects of acute insults, underlying brain immaturity, and prolonged seizures-related injuries. The analysis of MSE and CI can therefore provide a quantifiable and accurate way to decrypt the mystery of neonatal seizures, and could be a promising predictor.

SUBMITTER: Lu WY

PROVIDER: S-EPMC4676749 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Publications

Multiscale Entropy of Electroencephalogram as a Potential Predictor for the Prognosis of Neonatal Seizures.

Lu Wen-Yu WY Chen Jyun-Yu JY Chang Chi-Feng CF Weng Wen-Chin WC Lee Wang-Tso WT Shieh Jiann-Shing JS

PloS one 20151211 12

<h4>Objective</h4>Increasing animal studies supported the harmful effects of prolonged or frequent neonatal seizures in developing brain, including increased risk of later epilepsy. Various nonlinear analytic measures had been applied to investigate the change of brain complexity with age. This study focuses on clarifying the relationship between later epilepsy and the changes of electroencephalogram (EEG) complexity in neonatal seizures.<h4>Methods</h4>EEG signals from 19 channels of the whole ...[more]

PMID: 26658680

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Project description:Epilepsy is a common neurological disease that affects a wide range of the world population and is not limited by age. Moreover, seizures can occur anytime and anywhere because of the sudden abnormal discharge of brain neurons, leading to malfunction. The seizures of approximately 30% of epilepsy patients cannot be treated with medicines or surgery; hence these patients would benefit from a seizure prediction system to live normal lives. Thus, a system that can predict a seizure before its onset could improve not only these patients' social lives but also their safety. Numerous seizure prediction methods have already been proposed, but the performance measures of these methods are still inadequate for a complete prediction system. Here, a seizure prediction system is proposed by exploring the advantages of multivariate entropy, which can reflect the complexity of multivariate time series over multiple scales (frequencies), called multivariate multiscale modified-distribution entropy (MM-mDistEn), with an artificial neural network (ANN). The phase-space reconstruction and estimation of the probability density between vectors provide hidden complex information. The multivariate time series property of MM-mDistEn provides more understandable information within the multichannel data and makes it possible to predict of epilepsy. Moreover, the proposed method was tested with two different analyses: simulation data analysis proves that the proposed method has strong consistency over the different parameter selections, and the results from experimental data analysis showed that the proposed entropy combined with an ANN obtains performance measures of 98.66% accuracy, 91.82% sensitivity, 99.11% specificity, and 0.84 area under the curve (AUC) value. In addition, the seizure alarm system was applied as a postprocessing step for prediction purposes, and a false alarm rate of 0.014 per hour and an average prediction time of 26.73 min before seizure onset were achieved by the proposed method. Thus, the proposed entropy as a feature extraction method combined with an ANN can predict the ictal state of epilepsy, and the results show great potential for all epilepsy patients.

Project description:PURPOSE:Many neonates undergo electroencephalogram (EEG) monitoring to identify and manage acute symptomatic seizures. Information about brain function contained in the EEG background data may also help predict neurobehavioral outcomes. For EEG background features to be useful as prognostic indicators, the interpretation of these features must be standardized across electroencephalographers. We aimed at determining the interrater and intrarater agreement among electroencephalographers interpreting neonatal EEG background patterns. METHODS:Five neonatal electroencephalographers reviewed 5-to-7.5-minute epochs of EEG from full-term neonates who underwent continuous conventional EEG monitoring. The EEG assessment tool used to classify background patterns was based on the American Clinical Neurophysiology Society's guideline for neonatal EEG terminology. Interrater and intrarater agreement were measured using Kappa coefficients. RESULTS:Interrater agreement was consistently highest for voltage (binary: substantial, kappa = 0.783; categorical: moderate, kappa = 0.562), seizure presence (fair-substantial; kappa = 0.375-0.697), continuity (moderate; kappa = 0.481), burst voltage (moderate; kappa = 0.574), suppressed background presence (moderate-substantial; kappa = 0.493-0.643), delta activity presence (fair-moderate; kappa = 0.369-0.432), theta activity presence (fair-moderate; kappa = 0.347-0.600), presence of graphoelements (fair; kappa = 0.381), and overall impression (binary: moderate, kappa = 0.495; categorical: fair-moderate, kappa = 0.347, 0.465). Agreement was poor or inconsistent for all other patterns. Intrarater agreement was variable, with highest average agreement for voltage (binary: substantial, kappa = 0.75; categorical: substantial, kappa = 0.714) and highest consistent agreement for continuity (moderate-substantial; kappa = 0.43-0.67) and overall impression (moderate-substantial; kappa = 0.42-0.68). CONCLUSIONS:This study demonstrates substantial variability in neonatal EEG background interpretation across electroencephalographers, indicating a need for educational and technological strategies aimed at improving performance.

Dataset Information

Multiscale Entropy of Electroencephalogram as a Potential Predictor for the Prognosis of Neonatal Seizures.

Objective

Methods

Results

Conclusions

Publications

Multiscale Entropy of Electroencephalogram as a Potential Predictor for the Prognosis of Neonatal Seizures.

Similar Datasets

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