TY - JOUR
T1 - EEG dynamical correlates of focal and diffuse causes of coma
AU - Kafashan, Mohammad Mehdi
AU - Ryu, Shoko
AU - Hargis, Mitchell J.
AU - Laurido-Soto, Osvaldo
AU - Roberts, Debra E.
AU - Thontakudi, Akshay
AU - Eisenman, Lawrence
AU - Kummer, Terrance T.
AU - Ching, Shi Nung
N1 - Funding Information:
This work was supported by grants 1R21NS096590 and CTSA UL1 TR000448 from the US National Institutes of Health. This work was partially supported by the University Strategic Alliance (URSA) program as Washington University in St. Louis. S.C. Holds a Career Award at the Scientific Interface from the Burroughs-Wellcome Fund. T.T.K. is supported by an American Heart Association Scientist Development Grant and a US National Institutes of Health K12 grant (ICTS UL1 TR000448 and KL2 TR000450). Funding agencies were not involved in study design, nor in the collection, analysis or interpretation of data.
Publisher Copyright:
© 2017 The Author(s).
PY - 2017/11/15
Y1 - 2017/11/15
N2 - Background: Rapidly determining the causes of a depressed level of consciousness (DLOC) including coma is a common clinical challenge. Quantitative analysis of the electroencephalogram (EEG) has the potential to improve DLOC assessment by providing readily deployable, temporally detailed characterization of brain activity in such patients. While used commonly for seizure detection, EEG-based assessment of DLOC etiology is less well-established. As a first step towards etiological diagnosis, we sought to distinguish focal and diffuse causes of DLOC through assessment of temporal dynamics within EEG signals. Methods: We retrospectively analyzed EEG recordings from 40 patients with DLOC with consensus focal or diffuse culprit pathology. For each recording, we performed a suite of time-series analyses, then used a statistical framework to identify which analyses (features) could be used to distinguish between focal and diffuse cases. Results: Using cross-validation approaches, we identified several spectral and non-spectral EEG features that were significantly different between DLOC patients with focal vs. diffuse etiologies, enabling EEG-based classification with an accuracy of 76%. Conclusions: Our findings suggest that DLOC due to focal vs. diffuse injuries differ along several electrophysiological parameters. These results may form the basis of future classification strategies for DLOC and coma that are more etiologically-specific and therefore therapeutically-relevant.
AB - Background: Rapidly determining the causes of a depressed level of consciousness (DLOC) including coma is a common clinical challenge. Quantitative analysis of the electroencephalogram (EEG) has the potential to improve DLOC assessment by providing readily deployable, temporally detailed characterization of brain activity in such patients. While used commonly for seizure detection, EEG-based assessment of DLOC etiology is less well-established. As a first step towards etiological diagnosis, we sought to distinguish focal and diffuse causes of DLOC through assessment of temporal dynamics within EEG signals. Methods: We retrospectively analyzed EEG recordings from 40 patients with DLOC with consensus focal or diffuse culprit pathology. For each recording, we performed a suite of time-series analyses, then used a statistical framework to identify which analyses (features) could be used to distinguish between focal and diffuse cases. Results: Using cross-validation approaches, we identified several spectral and non-spectral EEG features that were significantly different between DLOC patients with focal vs. diffuse etiologies, enabling EEG-based classification with an accuracy of 76%. Conclusions: Our findings suggest that DLOC due to focal vs. diffuse injuries differ along several electrophysiological parameters. These results may form the basis of future classification strategies for DLOC and coma that are more etiologically-specific and therefore therapeutically-relevant.
KW - Classification
KW - Coma
KW - Depressed level of consciousness
KW - Electroencephalogram
UR - http://www.scopus.com/inward/record.url?scp=85034605760&partnerID=8YFLogxK
U2 - 10.1186/s12883-017-0977-0
DO - 10.1186/s12883-017-0977-0
M3 - Article
C2 - 29141595
AN - SCOPUS:85034605760
VL - 17
JO - BMC Neurology
JF - BMC Neurology
SN - 1471-2377
IS - 1
M1 - 197
ER -