DOCSLIB.ORG

Amplitude-Integrated Electroencephalography Interpretation During Therapeutic Hypothermia: an Educational Program and Novel Teaching Tool

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Amplitude-Integrated Electroencephalography Interpretation During Therapeutic Hypothermia: an Educational Program and Novel Teaching Tool Amplitude-Integrated Electroencephalography Interpretation During Therapeutic Hypothermia: An Educational Program and Novel Teaching Tool Lauren Sacco, DNP, ARNP, NNP-BC, RN Continuing Nursing Education ABSTRACT (CNE) Credit Therapeutic hypothermia (TH) is now considered a standard in tertiary NICUs. Amplitude-integrated A total of 4.3 contact hours may be earned as CNE credit electroencephalography (aEEG) is an important adjunct to this therapy and is gaining acceptance for for reading the articles in this issue use on the neonatal population. It can be easily incorporated into practice with appropriate education identified as CNE and for completing and training. Current publications are lacking regarding nursing care of neonatal patients undergoing an online posttest and evaluation. To be successful the learner must TH with the use of aEEG. This article presents a broad educational program as well as novel teaching obtain a grade of at least 80% on tool for neonatal nurses caring for this population. the test. Test expires three (3) years from publication date. Disclosure: The author/planning committee Keywords: amplitude-integrated electroencephalography (aEEG); hypoxic-ischemic encephalopathy has no relevant financial interest (HIE); therapeutic hypothermia; nursing; education or affiliations with any commercial interests related to the subjects discussed within this article. No commercial support or sponsorship was provided for this educational activity. ANN/ANCC does not endorse any commercial products discussed/displayed in conjunction with this educational activity. ACH YEAR IN THE UNITED STATES, THERE infants with HIE.5–7 The use of aEEG allows The Academy of Neonatal Nursing is are an estimated four million births.1 the bedside provider to identify seizure activ- accredited as a provider of continuing E nursing education by the American Of those births, there are one to four infants ity that is not always recognized by visual Nurses Credentialing Center’s per 1,000 who will experience an insult assessment. The aEEG use and interpreta- Commission on Accreditation. at birth that results in hypoxic-ischemic tion can be incorporated into the practice Provider, Academy of Neonatal 2 Nursing, approved by the California encephalopathy (HIE). Globally, up to two- of the bedside provider with an appropriate Board of Registered Nursing, thirds of newborns who develop HIE die, education program and adequate resources. Provider #CEP 6261; and Florida Board of Nursing, Provider #FBN and approximately one-fourth of those who With appropriate training, the provider may 3218, content code 2505. survive will have severe neurodevelopmental be able to identify and treat seizure activity 3 The purpose of this article is to provide sequelae. Brain injury caused by HIE is the that could be overlooked otherwise and may nurses with evidence-based rationale top contributing cause of neurodevelopmen- minimize the neurologic damage sustained for the use of aEEG interpretation 4 8,9 during TH, including all of the tools tal disabilities, the most common being cere- during HIE. and products for the staff education. bral palsy (CP). Several tools are required in order for the provider and bedside nurse to accurately PATHOPHYSIOLOGY identify and quickly treat newborns affected OF BRAIN INJURY by HIE. One of those tools is the amplitude- HI E is caused by either placental, fetal, or integrated electroencephalogram (aEEG). maternal insult or injury that results in neo- The aEEG is an important adjunct in the pre- natal brain hypoxia. The brain injury that diction of long-term neurologic outcomes for occurs following a hypoxic-ischemic insult Accepted for publication November 2015. N EONATAL N ETWORK 78 © 2016 Springer Publishing Company MARCH/APRIL 2016, VOL. 35, NO. 2 http://dx.doi.org/10.1891/0730-0832.35.2.78 occurs in two phases. In the first phase, the neonatal brain publications regarding nursing care for these infants iden- responds by converting to anaerobic metabolism, leading to tified, the mechanics of how aEEG is used described, and depletion of adenosine triphosphate, increased lactic acid pro- models of teaching about aEEG and cooling therapy to other duction, and a disturbance in normal metabolic activity. This clinical groups reviewed. A broad educational program for response disrupts intercellular pumps in the brain and causes neonatal nurses, including innovative teaching tools, imple- a buildup of sodium, calcium, and water, which produces mentation, and systems change, will be presented. accumulation of fatty acids and oxygen-free radicals. These events, together, cause cell apoptosis. Preceding the initial injury to the neonatal brain, a second phase of injury will SIGNIFICANCE ensue if intervention is not initiated.4,10,11 T he use of the aEEG monitor by bedside providers for early T he second phase of HIE, which involves several pro- identification and detection of seizure activity is an important cesses and is not well understood, includes accumulation of aspect in the management of infants with HIE undergoing excitatory neurotransmitters and cell apoptosis. Once the TH. Because TH is offered in institutions of different levels, second phase begins, any brain injury that occurs in this aEEG monitoring by bedside providers is especially benefi- phase is irreversible.11 cial within institutions, where neurologists or neurophysicists Seizures occur in this population as a result of the brain are not readily available to assess the infant and evaluate for injury sustained during a hypoxic event. Seizures are one of seizure activity.18,21 the most common signs of neurologic dysfunction and can When abnormal background and seizure activity is iden- occur very early, even before the second phase, postnatally. tified, monitored, and treated effectively and efficiently, the If left unnoticed or untreated, frequent seizures can further associated negative outcomes are significantly reduced.5,6 increase the amount of damage to the neonatal brain. The Because of increased risk of seizure activity associated with diagnosis of neonatal seizures can be challenging because as HIE, it may be advantageous for the bedside nurse to have many as 80 percent of infants have clinical signs that are subtle the ability to assess with aEEG. The bedside nurse provides or absent. This can be especially difficult in seizures that are a ongoing care and assessment of these infants on a contin- result of brain injury from HIE because many of these infants ual basis, making him or her critical for the identification of require intubation and paralytics, further masking the clini- changes in aEEG. It is imperative that nurses are educated cal signs of seizure activity.12,13 regarding aEEG use and interpretation to correctly identify T reatment for HIE must occur rapidly to avoid further the subtle changes that can occur on the aEEG and report to damage. Therapeutic hypothermia (TH) for treatment of the provider quickly and efficiently. HIE has become the gold standard and has demonstrated It has been demonstrated that nurses who are provided positive outcomes for mild to moderate cases of HIE.4,11,14 with critical thinking education and subsequent protocols are Currently, there are two forms of cooling: selective head the most effective caregivers for the neonatal population.22–24 cooling15 and total body cooling.16 Both methods have Although there are many published articles related to the use proven effective with minimal side effects. The benefits of of aEEG for seizure identification in infants treated with TH, this intervention outweigh the side effects and, therefore, there are no published articles in which innovative tools for this intervention has been implemented in many centers after teaching interpretation of aEEG are presented. proper training has occurred.2,17,18 Specific protocols have been developed for each method of cooling, which have been easily translated to practice in both community and academic EVIDENCE APPRAISAL centers. Infants who meet HIE criteria, as defined in each T he focus of the review and appraisal of the literature is protocol, are cooled to 33.5°–35°C within six hours after on the aEEG, including its benefits for infants with HIE who birth and are maintained at that temperature for 72 hours, receive TH, interpretation, and training with the focus on following a slow rewarming process.15,16,19 neonatal data. This evidence appraisal was the basis for the I nfants are monitored closely by various methods, includ- approach and content of the development of the educational ing aEEG. The aEEG is a cerebral function monitor that program. The literature search was performed between time-compresses, rectifies, and filters the conventional elec- January 2013 and June 2014. Many searches were done troencephalogram (cEEG), which can be visualized and using PubMed, Cochrane Database of Systematic Reviews, interpreted by the bedside provider. The aEEG is easily set Academic Search Complete (EBSCO), and Cumulative up at the bedside and can be applied by the bedside nurse.8,20 Index for Nursing and Allied Health Literature databases. Although cEEG is considered the gold standard for the accu- The search terms included neonates/newborns/infants, rate detection of seizure activity in the neonate, it is tedious HIE, TH, aEEG, interpretation, nurses, and training. to apply and requires evaluation by a neurologist or neuro- Included in this evidence appraisal are one meta-analysis, five physicist specially trained in reading the neonatal cEEG. randomized controlled trials, one nonrandomized controlled In this article, the importance of aEEG for bedside seizure trial, three systematic reviews, and three retrospective chart identification in infants will be established, the lack of existing reviews. N EONATAL N ETWORK VOL. 35, NO. 2, MARCH/APRIL 2016 79 BENEFITS OF aEEG DURING to severe birth asphyxia with normal aEEG data after 24 hours THERAPEUTIC HYPOTHERMIA of life had normal outcomes at one year of life. Limitations A n aEEG, when applied prior to initiation of TH, pro- to this study are the small sample size and lack of long-term vides an assessment of baseline brain background pattern follow-up evaluation beyond one year of life.
Load more

Recommended publications
  • Electroencephalography (EEG)-Based Brain Computer Interfaces for Rehabilitation
    Virginia Commonwealth University VCU Scholars Compass Theses and Dissertations Graduate School 2012 Electroencephalography (EEG)-based brain computer interfaces for rehabilitation Dandan Huang Virginia Commonwealth University Follow this and additional works at: https://scholarscompass.vcu.edu/etd Part of the Biomedical Engineering and Bioengineering Commons © The Author Downloaded from https://scholarscompass.vcu.edu/etd/2761 This Dissertation is brought to you for free and open access by the Graduate School at VCU Scholars Compass. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of VCU Scholars Compass. For more information, please contact [email protected]. School of Engineering Virginia Commonwealth University This is to certify that the dissertation prepared by Dandan Huang entitled “Electroencephalography (EEG)-based brain computer interfaces for rehabilitation” has been approved by her committee as satisfactory completion of the dissertation requirement for the degree of Doctoral of Philosophy. Ou Bai, Ph.D., Director of Dissertation, School of Engineering Ding-Yu Fei, Ph.D., School of Engineering Azhar Rafiq, M.D., School of Medicine Martin L. Lenhardt, Ph.D., School of Engineering Kayvan Najarian, Ph.D., School of Engineering Gerald Miller, Ph.D., Chair, Department of Biomedical Engineering, School of Engineering Rosalyn Hobson, Ph.D., Associate Dean of Graduate Studies, School of Engineering Charles J. Jennett, Ph.D., Dean, School of Engineering F. Douglas Boudinot, Ph.D., Dean of the Graduate School ______________________________________________________________________ Date © Dandan Huang 2012 All Rights Reserved ELECTROENCEPHALOGRAPHY-BASED BRAIN-COMPUTER INTERFACES FOR REHABILITATION A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University.
    [Show full text]
  • A National Review of Amplitude Integrated Electroencephalography (Aeeg) A
    Issue: Ir Med J; Vol 113; No. 9; P192 A National Review of Amplitude Integrated Electroencephalography (aEEG) A. Jenkinson1, M.A. Boyle2, D. Sweetman1 1. The National Maternity Hospital, Dublin. 2. The Rotunda Hospital, Dublin. Dear Sir, The use of amplitude integrated encephalography (aEEG) has become well integrated into routine care in the neonatal intensive care unit (NICU), to monitor brain function where encephalopathy or seizures are suspected.1 Early aEEG abnormalities and their rate of resolution have clinical and prognostic significance in severely ill newborns with altered levels of consciousness. 2 The most common use of aEEG is in infants with neonatal encephalopathy undergoing therapeutic hypothermia (TH). While TH is performed in tertiary centres, local and regional centres play an important role in the diagnosis and initial management of these infants. The Therapeutic Hypothermia Working Group National Report from 2018 reported that 28/69 (40%) of infants requiring Therapeutic Hypothermia were outborn in local or regional units requiring transfer.3 The report also highlighted that early and accurate aEEG interpretation is important in the care of these infants with many seizures being sub-clinical or electrographic without clinical correlation. We performed a national audit on aEEG in neonatal services in Ireland, surveying 18 neonatal units that are divided into Level 1 (Local), Level 2 (Regional) and Level 3 (Tertiary). One unit was excluded from our study as it provides a continuous EEG monitoring service on a 24-hour basis as part of the Neonatal Brain Research Group. Our findings showed that while no Level 1 unit had aEEG, it is widely available in Level 2 and Level 3 units [3/4 (75%) and 3/3 (100%)] respectively.
    [Show full text]
  • Using Amplitude-Integrated EEG in Neonatal Intensive Care
    Journal of Perinatology (2010) 30, S73–S81 r 2010 Nature America, Inc. All rights reserved. 0743-8346/10 www.nature.com/jp REVIEW Using amplitude-integrated EEG in neonatal intensive care JD Tao and AM Mathur Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA monitoring can be applied, for example, to infants admitted with The implementation of amplitude-integrated electroencephalography encephalopathy, seizures or other brain malformations. Both term (aEEG) has enhanced the neurological monitoring of critically ill infants. and preterm infants may benefit from the clinical application of Limited channel leads are applied to the patient and data are displayed in a aEEG findings. Much similar to continuous monitoring of vital semilogarithmic, time-compressed scale. Several classifications are currently signs, bedside aEEG can help guide decision-making in real time in use to describe patient tracings, incorporating voltage criteria, pattern for infants admitted to the NICU. This article will review the recognition, cyclicity, and the presence or absence of seizures. In term history, classification and application of aEEG in both term and neonates, aEEG has been used to determine the prognosis and treatment for preterm infants. those affected by hypoxic–ischemic encephalopathy, seizures, meningitis and even congenital heart disease. Its application as inclusion criteria for therapeutic hypothermia remains controversial. In preterm infants, Background normative values and patterns corresponding to gestational age are being 2 established. As these standards emerge, the predictive value of aEEG Starting in the 1960s, Maynard et al., developed the first use of increases, especially in the setting of preterm brain injury and an instrument to study cerebral activity in resuscitated patients with intraventricular hemorrhage.
    [Show full text]
  • Electroencephalography Source Connectivity: Toward High Time/Space Resolution Brain Networks
    Electroencephalography source connectivity: toward high time/space resolution brain networks Hassan M.1, 2 and Wendling F.1, 2 1 University of Rennes 1, LTSI, F-35000 Rennes, France 2INSERM, U1099, F-35000 Rennes, France Abstract— The human brain is a large-scale network which function depends on dynamic interactions between spatially-distributed regions. In the rapidly-evolving field of network neuroscience, two yet unresolved challenges are potential breakthroughs. First, functional brain networks should be estimated from noninvasive and easy to use neuroimaging techniques. Second, the time/space resolution of these techniques should be high enough to assess the dynamics of identified networks. Emerging evidence suggests that Electroencephalography (EEG) source connectivity method may offer solutions to both issues provided that scalp EEG signals are appropriately processed. Therefore, the performance of EEG source connectivity method strongly depends on signal processing (SP) that involves various methods such as preprocessing techniques, inverse solutions, statistical couplings between signals and network science. The main objective of this tutorial-like review is to provide an overview on EEG source connectivity. We describe the major contributions that the SP community brought to this research field. We emphasize the methodological issues that need to be carefully addressed to obtain relevant results and we stress the current limitations that need further investigation. We also report results obtained in concrete applications, in both normal and pathological brain states. Future directions in term of signal processing methods and applications are eventually provided. Index Terms— EEG signal processing, functional brain networks, EEG source connectivity, statistical couplings, inverse solutions. 1 I. INTRODUCTION Over the past decades, neuroscience research has significantly improved our understanding of the normal brain.
    [Show full text]
  • BIDS-EEG: an Extension to the Brain Imaging Data Structure (BIDS) Specification for Electroencephalography
    BIDS-EEG: an extension to the Brain Imaging Data Structure (BIDS) Specification for electroencephalography Cyril R Perneta,∗, Stefan Appelhoffb,∗, Guillaume Flandinc, Christophe Phillipsd, Arnaud Delormee,f, Robert Oostenveldg,h aThe University of Edinburgh, Centre for Clinical Brain Sciences (CCBS), Chancellor’s Building, 49 Little France Crescent, Edinburgh EH16 4SB bCenter for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany cWellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK dGIGA Institute, University of Liège, Liège, Belgium eSCCN, INC, UCSD, La Jolla, CA 95404, USA fCerco, CNRS/UPS, Toulouse, France gRadboud University, Donders Institute for Brain, Cognition and Behaviour. P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands hNatMEG, Karolinska Institutet, Stockholm, Sweden Abstract The Brain Imaging Data Structure (BIDS) project is a quickly evolving effort among the human brain imaging research community to create standards allowing researchers to readily organize and share study data within and between laboratories. The first BIDS standard was proposed for the MRI/fMRI research community and has now been widely adopted. More recently a magnetoencephalography (MEG) data extension, BIDS-MEG, has been published. Here we present an extension to BIDS for electroencephalography (EEG) data, BIDS-EEG, along with tools and references to a series of public EEG datasets organized using this new standard. Keywords: Electroencephalography, EEG, Brain Imaging Data Structure (BIDS), BIDS-EEG, standardization, datasets, formatting, archive Introduction Electroencephalography (EEG) is now almost a century old, with its first application in humans in the 1920s (Berger, 1929). EEG records the electric potential fluctuations at the scalp, primarily from locally synchronous post-synaptic activity in the apical dendrites of pyramidal cells in the cortex.
    [Show full text]
  • Magnetoencephalography: Clinical and Research Practices
    brain sciences Review Magnetoencephalography: Clinical and Research Practices Jennifer R. Stapleton-Kotloski 1,2,*, Robert J. Kotloski 3,4 ID , Gautam Popli 1 and Dwayne W. Godwin 1,5 1 Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA; [email protected] (G.P.); [email protected] (D.W.G.) 2 Research and Education, W. G. “Bill” Hefner Salisbury VAMC, Salisbury, NC 28144, USA 3 Department of Neurology, William S Middleton Veterans Memorial Hospital, Madison, WI 53705, USA; [email protected] 4 Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53726, USA 5 Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA * Correspondence: [email protected]; Tel.: +1-336-716-5243 Received: 28 June 2018; Accepted: 11 August 2018; Published: 17 August 2018 Abstract: Magnetoencephalography (MEG) is a neurophysiological technique that detects the magnetic fields associated with brain activity. Synthetic aperture magnetometry (SAM), a MEG magnetic source imaging technique, can be used to construct both detailed maps of global brain activity as well as virtual electrode signals, which provide information that is similar to invasive electrode recordings. This innovative approach has demonstrated utility in both clinical and research settings. For individuals with epilepsy, MEG provides valuable, nonredundant information. MEG accurately localizes the irritative zone associated with interictal spikes, often detecting epileptiform activity other methods cannot, and may give localizing information when other methods fail. These capabilities potentially greatly increase the population eligible for epilepsy surgery and improve planning for those undergoing surgery. MEG methods can be readily adapted to research settings, allowing noninvasive assessment of whole brain neurophysiological activity, with a theoretical spatial range down to submillimeter voxels, and in both humans and nonhuman primates.
    [Show full text]
  • Noninvasive Electroencephalography Equipment for Assistive, Adaptive, and Rehabilitative Brain–Computer Interfaces: a Systematic Literature Review
    sensors Systematic Review Noninvasive Electroencephalography Equipment for Assistive, Adaptive, and Rehabilitative Brain–Computer Interfaces: A Systematic Literature Review Nuraini Jamil 1 , Abdelkader Nasreddine Belkacem 2,* , Sofia Ouhbi 1 and Abderrahmane Lakas 2 1 Department of Computer Science and Software Engineering, College of Information Technology, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; [email protected] (N.J.); sofi[email protected] (S.O.) 2 Department of Computer and Network Engineering, College of Information Technology, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates; [email protected] * Correspondence: [email protected] Abstract: Humans interact with computers through various devices. Such interactions may not require any physical movement, thus aiding people with severe motor disabilities in communicating with external devices. The brain–computer interface (BCI) has turned into a field involving new elements for assistive and rehabilitative technologies. This systematic literature review (SLR) aims to help BCI investigator and investors to decide which devices to select or which studies to support based on the current market examination. This examination of noninvasive EEG devices is based on published BCI studies in different research areas. In this SLR, the research area of noninvasive Citation: Jamil, N.; Belkacem, A.N.; BCIs using electroencephalography (EEG) was analyzed by examining the types of equipment used Ouhbi, S.; Lakas, A. Noninvasive for assistive, adaptive, and rehabilitative BCIs. For this SLR, candidate studies were selected from Electroencephalography Equipment the IEEE digital library, PubMed, Scopus, and ScienceDirect. The inclusion criteria (IC) were limited for Assistive, Adaptive, and to studies focusing on applications and devices of the BCI technology.
    [Show full text]
  • Dynamic Analysis of Human Brain in the Pain State by Electroencephalography
    Dynamic Analysis of Human Brain in the Pain State by Electroencephalography Mahsa Tavasoli Islamic Azad University Tehran North Branch zahra einalou ( [email protected] ) Islamic Azad University Tehran North Branch Reza Akhondzadeh Jondi Shapoor University of Medical Sciences: Ahvaz Jondishapour University of Medical Sciences Research note Keywords: Cold pressor test, EEG, Pain, Phasic pain, RQA Posted Date: March 2nd, 2021 DOI: https://doi.org/10.21203/rs.3.rs-275018/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Dynamic Analysis of Human Brain in the Pain State by Electroencephalography Mahsa Tavasoli1, Zahra Einalou1*, Reza Akhondzadeh2 *1 Department of Biomedical Engineering, North Tehran Branch, Islamic Azad University, Tehran, Iran Email: [email protected] 2 Department of Anesthesiology, Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Email: [email protected] Corresponding Author: Zahra Einalou Department of Biomedical Engineering, North Tehran Branch, Islamic Azad University, Tehran, Iran Email: [email protected] Tel: 00989121754711 1 Abstract Objective: Pain is an unpleasant sensation that is important in all therapeutic conditions. So far, some studies have focused on pain assessment and cognition through different tests and methods. Considering the occurrence of pain causes, along with the activation of a long network in brain regions, recognizing the dynamical changes of the brain in pain states is helpful for pain detection using the electroencephalogram (EEG) signal. Therefore, the present study addressed the above-mentioned issue by applying EEG at the time of inducing phasic pain. Results: Phasic pain was produced using coldness and then dynamical features via EEG were analyzed by the Recurrence Quantification Analysis (RQA) method, and finally, the Rough neural network classifier was utilized for achieving accuracy regarding detecting and categorizing pain and non-pain states, which was 95.25 4%.
    [Show full text]
  • Q5: What Is the Added Advantage of Doing an Electroencephalography (EEG) in People with Convulsive Epilepsy in Non- Specialist S
    Role of EEG in management of convulsive epilepsy Q5: What is the added advantage of doing an electroencephalography (EEG) in people with convulsive epilepsy in non- specialist settings in low and middle income countries? Background The EEG is a technical instrument that can be used to support the diagnosis of seizures, classify epilepsy and to provide information on risk factors for seizure recurrence. Epilepsy is, by definition, a clinical condition characterized by two or more unprovoked seizures 24 hours apart (ILAE, 1993). However, this diagnostic and prognostic aid has several limitations which need to be emphasized in light of the available literature. An evidence-based approach is thus needed to put the EEG into a correct perspective. For this reason, the main indications of the EEG (i.e., use in support for the diagnosis of seizures and epilepsy, recognition of specific epilepsy syndromes to predict efficacy and tolerability of treatment, and prognostic value) must be assessed separately. In this light, the validity, reliability and overall utility of the EEG must be assessed with reference to different settings, especially LAMIC. Population/Intervention(s)/Comparison/Outcomes (PICO) Population: children and adults with epilepsy from population-based and clinic-based settings Interventions: EEG Comparison: not applicable Outcomes: appropriate diagnosis management (seizure recurrence, mortality, adverse effects) sensitivity, specificity and predictive values of EEG for the diagnosis of epilepsy risk of seizure recurrence after the
    [Show full text]
  • Seizure Incidence in the Acute Postneurosurgical Period Diagnosed Using Continuous Electroencephalography
    CLINICAL ARTICLE J Neurosurg 130:1203–1209, 2019 Seizure incidence in the acute postneurosurgical period diagnosed using continuous electroencephalography Brin Freund, MD, John C. Probasco, MD, and Eva K. Ritzl, MD Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland OBJECTIVE Delay in diagnosis and subsequent treatment of nonconvulsive seizures can lead to worsened outcomes. The gold standard in detecting nonconvulsive seizures is continuous video-electroencephalography (cEEG). Compared to routine, 30-minute EEG, the use of cEEG increases the likelihood of capturing intermittent nonconvulsive seizures. Studies of critically ill patients in intensive care units demonstrate a particularly high rate of nonconvulsive seizures. Some of these studies included postneurosurgical patients, but often subanalyses of specific populations were not done. In particular, few studies have specifically evaluated postneurosurgical patients by using cEEG in the acute postoperative setting. Therefore, the incidence and predictors of acute postneurosurgical seizures are unclear. METHODS In this study, the authors focused on patients who were admitted to the neurological critical care unit follow- ing neurosurgery and who underwent cEEG monitoring within 72 hours of surgery. RESULTS A total of 105 cEEG studies were performed in 102 patients. Twenty-nine patients demonstrated electro- graphic (subclinical) seizures, of whom 10 had clinical seizures clearly documented either before or during cEEG moni- toring. Twenty-two patients had subclinical seizures only detected on cEEG, 19 of whom did not have clinical seizure activity at any point during hospitalization. Those with seizures were more likely to have had a history of epilepsy (p = 0.006). The EEG studies of patients with seizures were more likely to show lateralized periodic discharges (p = 0.012) and lateralized rhythmic delta activity (p = 0.012).
    [Show full text]
  • Continuous Sensorimotor Rhythm Based Brain Computer Interface
    www.nature.com/scientificdata OPEN Continuous sensorimotor rhythm DATA DescriPTOR based brain computer interface learning in a large population James R. Stieger1,2, Stephen A. Engel2 & Bin He 1 ✉ Brain computer interfaces (BCIs) are valuable tools that expand the nature of communication through bypassing traditional neuromuscular pathways. The non-invasive, intuitive, and continuous nature of sensorimotor rhythm (SMR) based BCIs enables individuals to control computers, robotic arms, wheel- chairs, and even drones by decoding motor imagination from electroencephalography (EEG). Large and uniform datasets are needed to design, evaluate, and improve the BCI algorithms. In this work, we release a large and longitudinal dataset collected during a study that examined how individuals learn to control SMR-BCIs. The dataset contains over 600 hours of EEG recordings collected during online and continuous BCI control from 62 healthy adults, (mostly) right hand dominant participants, across (up to) 11 training sessions per participant. The data record consists of 598 recording sessions, and over 250,000 trials of 4 diferent motor-imagery-based BCI tasks. The current dataset presents one of the largest and most complex SMR-BCI datasets publicly available to date and should be useful for the development of improved algorithms for BCI control. Background & Summary Millions of individuals live with paralysis1. Te emerging feld of neural prosthetics seeks to provide relief to these individuals by forging new pathways of communication and control2–6. Invasive techniques directly record neural activity from the cortex and translate neural spiking into actionable commands such as moving a robotic arm or even individuals’ own muscles7–13. However, one major limitation of this approach is that roughly half of all implantations fail within the frst year14.
    [Show full text]
  • Biosignal Processing and Computational Methods to Enhance Sensory Motor Neuroprosthetics Mitsuhiro Hayashibe, David Guiraud, Jose L
    Editorial: Biosignal processing and computational methods to enhance sensory motor neuroprosthetics Mitsuhiro Hayashibe, David Guiraud, Jose L. Pons, Dario Farina To cite this version: Mitsuhiro Hayashibe, David Guiraud, Jose L. Pons, Dario Farina. Editorial: Biosignal processing and computational methods to enhance sensory motor neuroprosthetics. Frontiers in Neuroscience, Frontiers, 2015, 9 (#434), 10.3389/fnins.2015.00434. lirmm-01235841 HAL Id: lirmm-01235841 https://hal-lirmm.ccsd.cnrs.fr/lirmm-01235841 Submitted on 17 May 2019 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. EDITORIAL published: 05 November 2015 doi: 10.3389/fnins.2015.00434 Editorial: Biosignal processing and computational methods to enhance sensory motor neuroprosthetics Mitsuhiro Hayashibe 1*, David Guiraud 1, Jose L. Pons 2 and Dario Farina 3 1 French Institute for Research in Computer Science and Automation, University of Montpellier, Montpellier, France, 2 Spanish National Research Council, Madrid, Spain, 3 Department of Neurorehabilitation Engineering, University Medical
    [Show full text]