Holistic approach for automated background EEG assessment in asphyxiated full-term infants

OBJECTIVE To develop an automated algorithm to quantify background EEG abnormalities in full-term neonates with hypoxic ischemic encephalopathy. APPROACH The algorithm classifies 1 h of continuous neonatal EEG (cEEG) into a mild, moderate or severe background abnormality grade. These classes are well established in the literature and a clinical neurophysiologist labeled 272 1 h cEEG epochs selected from 34 neonates. The algorithm is based on adaptive EEG segmentation and mapping of the segments into the so-called segments' feature space. Three features are suggested and further processing is obtained using a discretized three-dimensional distribution of the segments' features represented as a 3-way data tensor. Further classification has been achieved using recently developed tensor decomposition/classification methods that reduce the size of the model and extract a significant and discriminative set of features. MAIN RESULTS Effective parameterization of cEEG data has been achieved resulting in high classification accuracy (89%) to grade background EEG abnormalities. SIGNIFICANCE For the first time, the algorithm for the background EEG assessment has been validated on an extensive dataset which contained major artifacts and epileptic seizures. The demonstrated high robustness, while processing real-case EEGs, suggests that the algorithm can be used as an assistive tool to monitor the severity of hypoxic insults in newborns.

[1]  A. Flisberg,et al.  Automatic classification of background EEG activity in healthy and sick neonates , 2010, Journal of neural engineering.

[2]  I. Lemahieu,et al.  Automatic detection of sleep stages using the EEG , 2001, 2001 Conference Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[3]  K. Hara,et al.  Behavioral state cycles, background EEGs and prognosis of newborns with perinatal hypoxia. , 1980, Electroencephalography and clinical neurophysiology.

[4]  M. De Vos,et al.  Automated artifact removal as preprocessing refines neonatal seizure detection , 2011, Clinical Neurophysiology.

[5]  Lenka Lhotská,et al.  Multivariate Analysis of Full-Term Neonatal Polysomnographic Data , 2009, IEEE Transactions on Information Technology in Biomedicine.

[6]  N. J. Stevenson,et al.  Quantitative EEG analysis in neonatal hypoxic ischaemic encephalopathy , 2011, Clinical Neurophysiology.

[7]  S. Huffel,et al.  Automated neonatal seizure detection mimicking a human observer reading EEG , 2008, Clinical Neurophysiology.

[8]  Svojmil Petránek,et al.  Quantitative topographic differentiation of the neonatal EEG , 2006, Clinical Neurophysiology.

[9]  B Hagberg,et al.  The changing panorama of cerebral palsy in Sweden. IX. Prevalence and origin in the birth‐year period 1995–1998 , 1996, Acta paediatrica.

[10]  N Monod,et al.  Neonatal Electroencephalography During the First Twenty-Four Hours of Life in Full-Term Newborn Infants , 1986, Neuropediatrics.

[11]  K Lindecrantz,et al.  Prognostic capacity of automated quantification of suppression time in the EEG of post‐asphyctic full‐term neonates , 2011, Acta paediatrica.

[12]  J. S. Barlow,et al.  Computer characterization of tracé alternant and REM sleep patterns in the neonatal EEG by adaptive segmentation--an exploratory study. , 1985, Electroencephalography and clinical neurophysiology.

[13]  S. Huffel,et al.  Relationship of EEG sources of neonatal seizures to acute perinatal brain lesions seen on MRI: A pilot study , 2013, Human brain mapping.

[14]  A Värri,et al.  Automatic identification of significant graphoelements in multichannel EEG recordings by adaptive segmentation and fuzzy clustering. , 1991, International journal of bio-medical computing.

[15]  J. S. Barlow,et al.  Computerized EEG pattern classification by adaptive segmentation and probability density function classification. Clinical evaluation. , 1985, Electroencephalography and clinical neurophysiology.

[16]  Thomas Nowotny,et al.  Machine Learning for Automatic Prediction of the Quality of Electrophysiological Recordings , 2013, PloS one.

[17]  N Löfgren,et al.  Classification of burst and suppression in the neonatal electroencephalogram , 2008, Journal of neural engineering.

[18]  A. Cichocki,et al.  Tensor decompositions for feature extraction and classification of high dimensional datasets , 2010 .

[19]  M. Scher,et al.  Automated EEG-sleep analyses and neonatal neurointensive care. , 2004, Sleep medicine.

[20]  G. Larry Bretthorst,et al.  Automating the analysis of EEG recordings from prematurely-born infants: A Bayesian approach , 2013, Clinical Neurophysiology.

[21]  Sabine Van Huffel,et al.  Removal of Muscle Artifacts from EEG Recordings of Spoken Language Production , 2010, Neuroinformatics.

[22]  J. Gotman,et al.  Automatic seizure detection in the newborn: methods and initial evaluation. , 1997, Electroencephalography and clinical neurophysiology.

[23]  L. D. de Vries,et al.  Role of cerebral function monitoring in the newborn , 2005, Archives of Disease in Childhood - Fetal and Neonatal Edition.

[24]  G Bodenstein,et al.  Computerized EEG pattern classification by adaptive segmentation and probability-density-function classification. Description of the method. , 1985, Computers in biology and medicine.

[25]  Kinoti Sn Asphyxia of the newborn in east, central and southern Africa. , 1993 .

[26]  G. Lightbody,et al.  An Automated System for Grading EEG Abnormality in Term Neonates with Hypoxic-Ischaemic Encephalopathy , 2012, Annals of Biomedical Engineering.

[27]  Carola van Pul,et al.  Automatic burst detection for the EEG of the preterm infant. , 2011, Physiological measurement.

[28]  C. Robertson,et al.  EEG and long-term outcome of term infants with neonatal hypoxic-ischemic encephalopathy , 1999, Clinical Neurophysiology.

[29]  Sean Connolly,et al.  Early EEG Findings in Hypoxic-Ischemic Encephalopathy Predict Outcomes at 2 Years , 2009, Pediatrics.

[30]  J. S. Barlow,et al.  Automatic adaptive segmentation of clinical EEGs. , 1981, Electroencephalography and clinical neurophysiology.

[31]  Sampsa Vanhatalo,et al.  Detection of ‘EEG bursts’ in the early preterm EEG: Visual vs. automated detection , 2010, Clinical Neurophysiology.

[32]  G Cioni,et al.  Constantly discontinuous EEG patterns in full-term neonates with hypoxic-ischaemic encephalopathy , 1999, Clinical Neurophysiology.

[33]  G. Lightbody,et al.  EEG-based neonatal seizure detection with Support Vector Machines , 2011, Clinical Neurophysiology.

[34]  Johan Wagemans,et al.  Single trial ERP reading based on parallel factor analysis. , 2013, Psychophysiology.

[35]  Johan A. K. Suykens,et al.  Least Squares Support Vector Machine Classifiers , 1999, Neural Processing Letters.

[36]  Andrzej Cichocki,et al.  Tensor Decompositions: A New Concept in Brain Data Analysis? , 2013, ArXiv.

[37]  J. Mackenbach,et al.  Differences in perinatal mortality and suboptimal care between 10 European regions: results of an international audit , 2003 .

[38]  Joseph E. Sullivan,et al.  American Clinical Neurophysiology Society Standardized EEG Terminology and Categorization for the Description of Continuous EEG Monitoring in Neonates: Report of the American Clinical Neurophysiology Society Critical Care Monitoring Committee , 2013, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society.

[39]  Justin A. Blanco,et al.  Modeling electroencephalography waveforms with semi-supervised deep belief nets: fast classification and anomaly measurement , 2011, Journal of neural engineering.

[40]  C. Joyce,et al.  Automatic removal of eye movement and blink artifacts from EEG data using blind component separation. , 2004, Psychophysiology.

[41]  Patrick Dupont,et al.  Canonical decomposition of ictal scalp EEG reliably detects the seizure onset zone , 2007, NeuroImage.

[42]  Svojmil Petránek,et al.  Comparison of quantitative EEG characteristics of quiet and active sleep in newborns. , 2003, Sleep medicine.

[43]  G. B. Boylan,et al.  The use of conventional EEG for the assessment of hypoxic ischaemic encephalopathy in the newborn: A review , 2011, Clinical Neurophysiology.

[44]  M. De Vos,et al.  Validation of a new automated neonatal seizure detection system: A clinician’s perspective , 2011, Clinical Neurophysiology.

[45]  Jens Haueisen,et al.  Independent component analysis: comparison of algorithms for the investigation of surface electrical brain activity , 2009, Medical & Biological Engineering & Computing.

[46]  Sabine Van Huffel,et al.  Line length as a robust method to detect high-activity events: Automated burst detection in premature EEG recordings , 2014, Clinical Neurophysiology.

[47]  Okko Johannes Räsänen,et al.  Development of a novel robust measure for interhemispheric synchrony in the neonatal EEG: Activation Synchrony Index (ASI) , 2013, NeuroImage.

[48]  Sabine Van Huffel,et al.  Automated EEG inter-burst interval detection in neonates with mild to moderate postasphyxial encephalopathy , 2012, 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[49]  Joos Vandewalle,et al.  A Multilinear Singular Value Decomposition , 2000, SIAM J. Matrix Anal. Appl..