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Multichannel wearable fNIRS-EEG system for long-term clinical monitoring.

ABSTRACT: Continuous brain imaging techniques can be beneficial for the monitoring of neurological pathologies (such as epilepsy or stroke) and neuroimaging protocols involving movement. Among existing ones, functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG) have the advantage of being noninvasive, nonobstructive, inexpensive, yield portable solutions, and offer complementary monitoring of electrical and local hemodynamic activities. This article presents a novel system with 128 fNIRS channels and 32 EEG channels with the potential to cover a larger fraction of the adult superficial cortex than earlier works, is integrated with 32 EEG channels, is light and battery-powered to improve portability, and can transmit data wirelessly to an interface for real-time display of electrical and hemodynamic activities. A novel fNIRS-EEG stretchable cap, two analog channels for auxiliary data (e.g., electrocardiogram), eight digital triggers for event-related protocols and an internal accelerometer for movement artifacts removal contribute to improve data acquisition quality. The system can run continuously for 24 h. Following instrumentation validation and reliability on a solid phantom, performance was evaluated on (1) 12 healthy participants during either a visual (checkerboard) task at rest or while pedalling on a stationary bicycle or a cognitive (language) task and (2) 4 patients admitted either to the epilepsy (n?=?3) or stroke (n?=?1) units. Data analysis confirmed expected hemodynamic variations during validation recordings and useful clinical information during in-hospital testing. To the best of our knowledge, this is the first demonstration of a wearable wireless multichannel fNIRS-EEG monitoring system in patients with neurological conditions. Hum Brain Mapp 39:7-23, 2018. © 2017 Wiley Periodicals, Inc.

SUBMITTER: Kassab A

PROVIDER: S-EPMC6866376 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Multichannel wearable fNIRS-EEG system for long-term clinical monitoring.

Kassab Ali A Le Lan Jérôme J Tremblay Julie J Vannasing Phetsamone P Dehbozorgi Mahya M Pouliot Philippe P Gallagher Anne A Lesage Frédéric F Sawan Mohamad M Nguyen Dang Khoa DK

Human brain mapping 20171023 1

Continuous brain imaging techniques can be beneficial for the monitoring of neurological pathologies (such as epilepsy or stroke) and neuroimaging protocols involving movement. Among existing ones, functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG) have the advantage of being noninvasive, nonobstructive, inexpensive, yield portable solutions, and offer complementary monitoring of electrical and local hemodynamic activities. This article presents a novel system with 12 ...[more]

PMID: 29058341

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Project description:We studied the capability of a Hybrid functional neuroimaging technique to quantify human mental workload (MWL). We have used electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) as imaging modalities with 17 healthy subjects performing the letter n-back task, a standard experimental paradigm related to working memory (WM). The level of MWL was parametrically changed by variation of n from 0 to 3. Nineteen EEG channels were covering the whole-head and 19 fNIRS channels were located on the forehead to cover the most dominant brain region involved in WM. Grand block averaging of recorded signals revealed specific behaviors of oxygenated-hemoglobin level during changes in the level of MWL. A machine learning approach has been utilized for detection of the level of MWL. We extracted different features from EEG, fNIRS, and EEG+fNIRS signals as the biomarkers of MWL and fed them to a linear support vector machine (SVM) as train and test sets. These features were selected based on their sensitivity to the changes in the level of MWL according to the literature. We introduced a new category of features within fNIRS and EEG+fNIRS systems. In addition, the performance level of each feature category was systematically assessed. We also assessed the effect of number of features and window size in classification performance. SVM classifier used in order to discriminate between different combinations of cognitive states from binary- and multi-class states. In addition to the cross-validated performance level of the classifier other metrics such as sensitivity, specificity, and predictive values were calculated for a comprehensive assessment of the classification system. The Hybrid (EEG+fNIRS) system had an accuracy that was significantly higher than that of either EEG or fNIRS. Our results suggest that EEG+fNIRS features combined with a classifier are capable of robustly discriminating among various levels of MWL. Results suggest that EEG+fNIRS should be preferred to only EEG or fNIRS, in developing passive BCIs and other applications which need to monitor users' MWL.

Project description:ObjectiveFor people with drug-resistant epilepsy, the use of epilepsy surgery is low despite favorable odds of seizure freedom. To better understand surgery utilization, we explored factors associated with inpatient long-term EEG monitoring (LTM), the first step of the presurgical pathway.MethodsUsing 2001-2018 Medicare files, we identified patients with incident drug-resistant epilepsy using validated criteria of ≥2 distinct antiseizure medication (ASM) prescriptions and ≥1 drug-resistant epilepsy encounter among patients with ≥2 years pre- and ≥1 year post-diagnosis Medicare enrollment. We used multilevel logistic regression to evaluate associations between LTM and patient, provider, and geographic factors. We then analyzed neurologist-diagnosed patients to further evaluate provider/environmental characteristics.ResultsOf 12 044 patients with incident drug-resistant epilepsy diagnosis identified, 2% underwent surgery. Most (68%) were diagnosed by a neurologist. In total, 19% underwent LTM near/after drug-resistant epilepsy diagnosis; another 4% only underwent LTM much prior to diagnosis. Patient factors most strongly predicting LTM were age <65 (adjusted odds ratio 1.5 [95% confidence interval 1.3-1.8]), focal epilepsy (1.6 [1.4-1.9]), psychogenic non-epileptic spells diagnosis (1.6 [1.1-2.5]) prior hospitalization (1.7, [1.5-2]), and epilepsy center proximity (1.6 [1.3-1.9]). Additional predictors included female gender, Medicare/Medicaid non-dual eligibility, certain comorbidities, physician specialties, regional neurologist density, and prior LTM. Among neurologist-diagnosed patients, neurologist <10 years from graduation, near an epilepsy center, or epilepsy-specialized increased LTM likelihood (1.5 [1.3-1.9], 2.1 [1.8-2.5], 2.6 [2.1-3.1], respectively). In this model, 37% of variation in LTM completion near/after diagnosis was explained by individual neurologist practice and/or environment rather than measurable patient factors (intraclass correlation coefficient 0.37).SignificanceA small proportion of Medicare beneficiaries with drug-resistant epilepsy completed LTM, a proxy for epilepsy surgery referral. While some patient factors and access measures predicted LTM, non-patient factors explained a sizable proportion of variance in LTM completion. To increase surgery utilization, these data suggest initiatives targeting better support of neurologist referral.

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Multichannel wearable fNIRS-EEG system for long-term clinical monitoring.

Publications

Multichannel wearable fNIRS-EEG system for long-term clinical monitoring.

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