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Scarciglia A, Catrambone V, Bonanno C, Valenza G. Multiscale partition-based Kolmogorov-Sinai Entropy: a preliminary HRV study on Heart Failure vs. Atrial Fibrillation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:131-134. [PMID: 36085961 DOI: 10.1109/embc48229.2022.9871728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Several approaches for estimating complexity in physiological time series at various time scales have recently been developed, with a special focus on heart rate variability (HRV) series. While numerous multiscale complexity quantifiers have been investigated, a multiscale Kolmogorov-Sinai (K-S) entropy for the characterization of cardiovascular dynamics still has to be properly assessed. In this pilot study, we investigate the Algorithmic Information Content, which is calculated using an effective compression algorithm, to quantify multiscale partition- based K-S entropy on experimental HRV series. Data were gathered from publicly available datasets comprising long-term, unstructured recordings from 10 healthy subjects, as well as 10 patients with congestive heart failure (CHF) and 10 patients with atrial fibrillation. Results show that multiple time scales and domain partitions statistically discern healthy vs. pathological cardiovascular dynamics. We conclude that the proposed multiscale partition-based K-S entropy may constitute a viable tool for the complexity assessment of cardiovascular variability series.
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Catrambone V, Patron E, Gentili C, Valenza G. Complexity Modulation in functional Brain-Heart Interplay series driven by Emotional Stimuli: an early study using Fuzzy Entropy. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:2306-2309. [PMID: 36085864 DOI: 10.1109/embc48229.2022.9871938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Increasing attention has recently been devoted to the multidisciplinary investigation of functional brain-heart interplay (BHI), which has provided meaningful insights in neuroscience and clinical domains including cardiology, neurology, clinical psychology, and psychiatry. While neural (brain) and heartbeat series show high nonlinear and complex dynamics, a complexity analysis on BHI series has not been performed yet. To this end, in this preliminary study, we investigate BHI complexity modulation in 17 healthy subjects undergoing a 3-minute resting state and emotional elicitation through standardized image slideshow. Electroencephalographic and heart rate variability series were the inputs of an adhoc BHI model, which provides directional (from-heart-to-brain and from-brain-to-heart) estimates at different frequency bands. A Fuzzy entropy analysis was performed channel-wise on the model output for the two experimental conditions. Results suggest that BHI complexity increases in the emotional elicitation phase with respect to a resting state, especially in the functional direction from the heart to the brain. We conclude that BHI complexity may be a viable computational tool to characterize neurophysiological and pathological states under different experimental conditions.
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Manzoni D, Catrambone V, Valenza G. Causal Symbolic Information Transfer for the Assessment of functional Brain-Heart Interplay through EEG Microstates Occurrences: a proof-of-concept study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:255-258. [PMID: 36086149 DOI: 10.1109/embc48229.2022.9871000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Electroencephalography (EEG) microstates analysis provides a sequence of topographies representing the scalp-related electric field over time, and each microstate is synthetically represented by a symbol. Despite recent advances on functional brain-heart interplay (BHI) assessment, to our knowledge no methodology takes EEG microstates into account to relate the causal heartbeat dynamics. Moreover, standard BHI methods are tailored to a single EEG-channel analysis, neglecting the comprehensive information associated with a multichannel cluster or a whole-brain activity. To overcome these limitations, we devised a novel methodological frame-work for the assessment of functional BHI that exploits the symbolic representation of both EEG microstates and heart rate variability (HRV) series. Directional BHI quantification is then performed through Kullback-Leibler Divergence (KLD) and Transfer Entropy. The proposed methodology is here preliminarily tested on a dataset gathered from healthy subjects undergoing a resting state and a mental arithmetic task. Except for the KLD in the from-brain-to-heart direction, all other estimates showed significant differences between the two experimental conditions. We conclude that the proposed frame-work may promisingly provide novel insights on brain-heart phenomena through a whole-brain symbolic representation.
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Carli V, Petros NG, Hadlaczky G, Vitcheva T, Berchialla P, Bianchi S, Carletto S, Christinaki E, Citi L, Dinis S, Gentili C, Geraldes V, Giovinazzo L, Gonzalez-Martinez S, Meyer B, Ostacoli L, Ottaviano M, Ouakinin S, Papastylianou T, Paradiso R, Poli R, Rocha I, Settanta C, Scilingo EP, Valenza G. The NEVERMIND e-health system in the treatment of depressive symptoms among patients with severe somatic conditions: A multicentre, pragmatic randomised controlled trial. EClinicalMedicine 2022; 48:101423. [PMID: 35706482 PMCID: PMC9092507 DOI: 10.1016/j.eclinm.2022.101423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Background This study assessed the effectiveness of the NEVERMIND e-health system, consisting of a smart shirt and a mobile application with lifestyle behavioural advice, mindfulness-based therapy, and cognitive behavioural therapy, in reducing depressive symptoms among patients diagnosed with severe somatic conditions. Our hypothesis was that the system would significantly decrease the level of depressive symptoms in the intervention group compared to the control group. Methods This pragmatic, randomised controlled trial included 425 patients diagnosed with myocardial infarction, breast cancer, prostate cancer, kidney failure, or lower limb amputation. Participants were recruited from hospitals in Turin and Pisa (Italy), and Lisbon (Portugal), and were randomly assigned to either the NEVERMIND intervention or to the control group. Clinical interviews and structured questionnaires were administered at baseline, 12 weeks, and 24 weeks. The primary outcome was depressive symptoms at 12 weeks measured by the Beck Depression Inventory II (BDI-II). Intention-to-treat analyses included 425 participants, while the per-protocol analyses included 333 participants. This trial is registered in the German Clinical Trials Register, DRKS00013391. Findings Patients were recruited between Dec 4, 2017, and Dec 31, 2019, with 213 assigned to the intervention and 212 to the control group. The sample had a mean age of 59·41 years (SD=10·70), with 44·24% women. Those who used the NEVERMIND system had statistically significant lower depressive symptoms at the 12-week follow-up (mean difference=-3·03, p<0·001; 95% CI -4·45 to -1·62) compared with controls, with a clinically relevant effect size (Cohen's d=0·39). Interpretation The results of this study show that the NEVERMIND system is superior to standard care in reducing and preventing depressive symptoms among patients with the studied somatic conditions. Funding The NEVERMIND project received funding from the European Union's Horizon 2020 Research and Innovation Programme under grant agreement No. 689691.
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Candia-Rivera D, Catrambone V, Barbieri R, Valenza G. Functional assessment of bidirectional cortical and peripheral neural control on heartbeat dynamics: a brain-heart study on thermal stress. Neuroimage 2022; 251:119023. [PMID: 35217203 DOI: 10.1016/j.neuroimage.2022.119023] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 12/12/2022] Open
Abstract
The study of functional brain-heart interplay (BHI) from non-invasive recordings has gained much interest in recent years. Previous endeavors aimed at understanding how the two dynamical systems exchange information, providing novel holistic biomarkers and important insights on essential cognitive aspects and neural system functioning. However, the interplay between cardiac sympathovagal and cortical oscillations still has much room for further investigation. In this study, we introduce a new computational framework for a functional BHI assessment, namely the Sympatho-Vagal Synthetic Data Generation Model, combining cortical (electroencephalography, EEG) and peripheral (cardiac sympathovagal) neural dynamics. The causal, bidirectional neural control on heartbeat dynamics was quantified on data gathered from 26 human volunteers undergoing a cold-pressor test. Results show that thermal stress induces heart-to-brain functional interplay sustained by EEG oscillations in the delta and gamma bands, primarily originating from sympathetic activity, whereas brain-to-heart interplay originates over central brain regions through sympathovagal control. The proposed methodology provides a viable computational tool for the functional assessment of the causal interplay between cortical and cardiac neural control.
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Valenza G, Faes L, Toschi N, Barbieri R. Advanced computation in cardiovascular physiology: new challenges and opportunities. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2021; 379:20200265. [PMID: 34689624 DOI: 10.1098/rsta.2020.0265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 06/13/2023]
Abstract
Recent developments in computational physiology have successfully exploited advanced signal processing and artificial intelligence tools for predicting or uncovering characteristic features of physiological and pathological states in humans. While these advanced tools have demonstrated excellent diagnostic capabilities, the high complexity of these computational 'black boxes' may severely limit scientific inference, especially in terms of biological insight about both physiology and pathological aberrations. This theme issue highlights current challenges and opportunities of advanced computational tools for processing dynamical data reflecting autonomic nervous system dynamics, with a specific focus on cardiovascular control physiology and pathology. This includes the development and adaptation of complex signal processing methods, multivariate cardiovascular models, multiscale and nonlinear models for central-peripheral dynamics, as well as deep and transfer learning algorithms applied to large datasets. The width of this perspective highlights the issues of specificity in heartbeat-related features and supports the need for an imminent transition from the black-box paradigm to explainable and personalized clinical models in cardiovascular research. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.
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Saul JP, Valenza G. Heart rate variability and the dawn of complex physiological signal analysis: methodological and clinical perspectives. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2021; 379:20200255. [PMID: 34689622 DOI: 10.1098/rsta.2020.0255] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/14/2021] [Indexed: 06/13/2023]
Abstract
Spontaneous beat-to-beat variations of heart rate (HR) have intrigued scientists and casual observers for centuries; however, it was not until the 1970s that investigators began to apply engineering tools to the analysis of these variations, fostering the field we now know as heart rate variability or HRV. Since then, the field has exploded to not only include a wide variety of traditional linear time and frequency domain applications for the HR signal, but also more complex linear models that include additional physiological parameters such as respiration, arterial blood pressure, central venous pressure and autonomic nerve signals. Most recently, the field has branched out to address the nonlinear components of many physiological processes, the complexity of the systems being studied and the important issue of specificity for when these tools are applied to individuals. When the impact of all these developments are combined, it seems likely that the field of HRV will soon begin to realize its potential as an important component of the toolbox used for diagnosis and therapy of patients in the clinic. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.
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Catrambone V, Barbieri R, Wendt H, Abry P, Valenza G. Functional brain-heart interplay extends to the multifractal domain. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2021; 379:20200260. [PMID: 34689620 PMCID: PMC8543048 DOI: 10.1098/rsta.2020.0260] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/12/2021] [Indexed: 05/09/2023]
Abstract
The study of functional brain-heart interplay has provided meaningful insights in cardiology and neuroscience. Regarding biosignal processing, this interplay involves predominantly neural and heartbeat linear dynamics expressed via time and frequency domain-related features. However, the dynamics of central and autonomous nervous systems show nonlinear and multifractal behaviours, and the extent to which this behaviour influences brain-heart interactions is currently unknown. Here, we report a novel signal processing framework aimed at quantifying nonlinear functional brain-heart interplay in the non-Gaussian and multifractal domains that combines electroencephalography (EEG) and heart rate variability series. This framework relies on a maximal information coefficient analysis between nonlinear multiscale features derived from EEG spectra and from an inhomogeneous point-process model for heartbeat dynamics. Experimental results were gathered from 24 healthy volunteers during a resting state and a cold pressor test, revealing that synchronous changes between brain and heartbeat multifractal spectra occur at higher EEG frequency bands and through nonlinear/complex cardiovascular control. We conclude that significant bodily, sympathovagal changes such as those elicited by cold-pressure stimuli affect the functional brain-heart interplay beyond second-order statistics, thus extending it to multifractal dynamics. These results provide a platform to define novel nervous-system-targeted biomarkers. This article is part of the theme issue 'Advanced computation in cardiovascular physiology: new challenges and opportunities'.
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Ghouse A, Faes L, Valenza G. Inferring directionality of coupled dynamical systems using Gaussian process priors: Application on neurovascular systems. Phys Rev E 2021; 104:064208. [PMID: 35030953 DOI: 10.1103/physreve.104.064208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 11/09/2021] [Indexed: 06/14/2023]
Abstract
Dynamical system theory has recently shown promise for uncovering causality and directionality in complex systems, particularly using the method of convergent cross mapping (CCM). In spite of its success in the literature, the presence of process noise raises concern about CCM's ability to uncover coupling direction. Furthermore, CCM's capacity to detect indirect causal links may be challenged in simulated unidrectionally coupled Rossler-Lorenz systems. To overcome these limitations, we propose a method that places a Gaussian process prior on a cross mapping function (named GP-CCM) to impose constraints on local state space neighborhood comparisons. Bayesian posterior likelihood and evidence ratio tests, as well as surrogate data analyses are performed to obtain a robust statistic for dynamical coupling directionality. We demonstrate GP-CCM's performance with respect to CCM in synthetic data simulation as well as in empirical electroencephelography (EEG) and functional near infrared spectroscopy (fNIRS) activity data. Our findings show that GP-CCM provides a statistic that consistently reports indirect causal structures in non-separable unidirectional system interactions; GP-CCM also provides coupling direction estimates in noisy physiological signals, showing that EEG likely causes, i.e., drives, fNIRS dynamics.
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Sorriento A, Cafarelli A, Valenza G, Ricotti L. Ex-vivo quantitative ultrasound assessment of cartilage degeneration. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:2976-2980. [PMID: 34891870 DOI: 10.1109/embc46164.2021.9630198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Osteoarthritis is a common disease that implies joint degeneration and that strongly affects the quality of life. Conventional radiography remains currently the most used diagnostic method, even if it allows only an indirect assessment of the articular cartilage and employ the use of ionizing radiations. A non-invasive, continuous and reliable diagnosis is crucial to detect impairments and to improve the treatment outcomes.Quantitative ultrasound techniques have proved to be very useful in providing an objective diagnosis of several soft tissues. In this study, we propose quantitative ultrasound parameters, based on the analysis of radiofrequency data derived from both healthy and osteoarthritis-mimicking (through chemical degradation) ex-vivo cartilage samples. Using a transmission frequency typically employed in the clinical practice (7.5-15 MHz) with an external ultrasound probe, we found results in terms of reflection at the cartilage surface and sample thickness comparable to those reported in the literature by exploiting arthroscopic transducers at high frequency (from 20 to 55 MHz). Moreover, for the first time, we introduce an objective metric based on the phase entropy calculation, able to discriminate the healthy cartilage from the degenerated one.Clinical Relevance- This preliminary study proposes a novel and quantitative method to discriminate healthy from degenerated cartilage. The obtained results pave the way to the use of quantitative ultrasound in the diagnosis and monitoring of knee osteoarthritis.
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Ghiasi S, Dell'Acqua C, Benvenuti SM, Scilingo EP, Gentili C, Valenza G, Greco A. Classifying subclinical depression using EEG spectral and connectivity measures. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:2050-2053. [PMID: 34891691 DOI: 10.1109/embc46164.2021.9630044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Detecting depression on its early stages helps preventing the onset of severe depressive episodes. In this study, we propose an automatic classification pipeline to detect subclinical depression (i.e., dysphoria) through the electroencephalography (EEG) signal. To this aim, we recorded the EEG signals in resting condition from 26 female participants with dysphoria and 38 female controls. The EEG signals were processed to extract several spectral and functional connectivity features to feed a nonlinear Support Vector Machine (SVM) classifier embedded with a Recursive Feature Elimination (RFE) algorithm. Our recognition pipeline obtained a maximum classification accuracy of 83.91% in recognizing dysphoria patients with a combination of connectivity and spectral measures. Moreover, an accuracy of 76.11% was achieved with only the 4 most informative functional connections, suggesting a central role of cortical connectivity in the theta band for early depression recognition. The present study can facilitate the diagnosis of subclinical conditions of depression and may provide reliable indicators of depression for the clinical community.
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Alfeo AL, Catrambone V, Cimino MGCA, Vaglini G, Valenza G. Recognizing motor imagery tasks from EEG oscillations through a novel ensemble-based neural network architecture. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:5983-5986. [PMID: 34892481 DOI: 10.1109/embc46164.2021.9629900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Brain-Computer Interfaces (BCI) provide effective tools aimed at recognizing different brain activities, translate them into actions, and enable humans to directly communicate through them. In this context, the need for strong recognition performances results in increasingly sophisticated machine learning (ML) techniques, which may result in poor performance in a real application (e.g., limiting a real-time implementation). Here, we propose an ensemble approach to effectively balance between ML performance and computational costs in a BCI framework. The proposed model builds a classifier by combining different ML models (base-models) that are specialized to different classification sub-problems. More specifically, we employ this strategy with an ensemble-based architecture consisting of multi-layer perceptrons, and test its performance on a publicly available electroencephalography-based BCI dataset with four-class motor imagery tasks. Compared to previously proposed models tested on the same dataset, the proposed approach provides greater average classification performances and lower inter-subject variability.
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Scarciglia A, Catrambone V, Bonanno C, Valenza G. Quantifying partition-based Kolmogorov-Sinai Entropy on Heart Rate Variability: a young vs. elderly study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:5469-5472. [PMID: 34892363 DOI: 10.1109/embc46164.2021.9630975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In the last decades, a considerable effort has been devoted to quantify complexity in physiological time series, with a particular focus on heart rate variability (HRV). To this end, exemplary quantifiers including Approximate Entropy and Sample Entropy have successfully been applied by leveraging on statistical approximation and further parametrization through the definition of tolerance and embedding dimension, among others. In this study, we investigate the use of the Algorithmic Information Content, which is estimated through an effective compression algorithm, to quantify partition-based Kolmogorov-Sinai (K-S) entropy on HRV series. We test such a K-S estimate on real data gathered from the Fantasia database, aiming to discern young vs. elderly complex dynamics. Experimental results show that elderly people are associated with a lower HRV complexity and a more predictable behavior, with significantly lower partition-based K-S entropy than the young adults. We conclude that partition-based K-S entropy may effectively be used to investigate pathological conditions in the cardiovascular system, complementing state-of-the-art methods for complexity assessment.
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Cavaliere L, Catrambone V, Bianchi M, Rocha AP, Valenza G. Characterization of upper limb movement-related EEG dynamics through fractional integrated autoregressive modeling. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:5987-5990. [PMID: 34892482 DOI: 10.1109/embc46164.2021.9630051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The analysis of electroencephalographic (EEG) series associated with movement performance is important for understanding the cortical neural control on motor tasks. While the existence of long-range correlations in physiological dynamics has been reported in previous studies, such a characterization in EEG series gathered during upper-limb movements has not been performed yet. To this end, here we report on a fractional integrated autoregressive analysis of EEG series during different functional classes of motor actions and resting phase, and data were gathered from 33 healthy volunteers. Results show significant differences in EEG long-range correlations on EEG series from characteristic topography.
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Nardelli M, Catrambone V, Grandi G, Banfi T, Bruno RM, Scilingo EP, Faraguna U, Valenza G. Activation of brain-heart axis during REM sleep: a trigger for dreaming. Am J Physiol Regul Integr Comp Physiol 2021; 321:R951-R959. [PMID: 34704848 DOI: 10.1152/ajpregu.00306.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dreams may be recalled after awakening from sleep following a defined electroencephalographic pattern that involves local decreases in low-frequency activity in the posterior cortical regions. While a dreaming experience implies bodily changes at many organ-, system-, and timescale-levels, the entity and causal role of such peripheral changes in a conscious dream experience are unknown. We performed a comprehensive, causal, multivariate analysis of physiological signals acquired during REM sleep at night, including high-density EEG and peripheral dynamics including electrocardiography and blood pressure. In this preliminary study, we investigated multiple recalls and non-recalls of dream experiences using data from nine healthy volunteers. The aim was not only to investigate the changes in central and autonomic dynamics associated with dream recalls and non-recalls, but also to characterize the central-peripheral dynamical and (causal) directional interactions, and the temporal relations of the related arousals upon awakening. We uncovered a brain-body network that drives a conscious dreaming experience that acts with specific interaction and time delays. Such a network is sustained by the blood pressure dynamics and the increasing functional information transfer from the neural heartbeat regulation to the brain. We conclude that bodily changes play a crucial and causative role in a conscious dream experience during REM sleep.
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Bartoletti R, Greco A, Di Vico T, Durante J, Ficarra V, Scilingo EP, Valenza G. Bioelectric Impedance Analysis Test Improves the Detection of Prostate Cancer in Biopsy Candidates: A Multifeature Decision Support System. Front Oncol 2021; 11:555277. [PMID: 34513653 PMCID: PMC8430220 DOI: 10.3389/fonc.2021.555277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/28/2021] [Indexed: 11/13/2022] Open
Abstract
Prostate cancer (PCa) gold-standard diagnosis relies on prostate biopsy, which is currently overly recommended since other available noninvasive tools such as prostate-specific antigen (PSA) multiparametric MRI (mMRI) showed low diagnostic accuracy or high costs, respectively. The aim of the study was to determine the accuracy of a novel Bioelectric Impedance Analysis (BIA) test endorectal probe for the selection of patients candidate to prostate biopsy and in particular the clinical value of three different parameters such as resistance (R), reactance (Xc), and phase angle (PA) degree. One-hundred twenty-three consecutive candidates to prostate biopsy and 40 healthy volunteers were enrolled. PSA and PSA density (PSAD) determinations, Digital Rectal Examination (DRE), and the novel BIA test were analyzed in patients and controls. A 16-core prostate biopsy was performed after a mMRI test. The study endpoints were to determine accuracy of BIA test in comparison with PSA, PSAD levels, and mMRI and obtain prostate cancer (PCa) prediction by BIA test. The Mann-Whitney U-test, the Wilkoxon rank test, and the Holm-Bonferroni's method were adopted for statistical analyses, and a computational approach was also applied to differentiate patients with PCa from those with benign disease. Combined PSA, PSAD, DRE, and trans-rectal ultrasound test failed to discern patients with PCa from those with benign disease (62.86% accuracy). mMRI PIRADS ≥3 showed a sensitivity of 83% and a specificity of 59%. The accuracy in discerning PCa increased up to 75% by BIA test (sensitivity 63.33% and specificity 83.75%). The novel finger probe BIA test is a cheap and reliable test that may help to improve clinical multifeature noninvasive diagnosis for PCa and reduce unnecessary biopsies.
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Marín-Morales J, Higuera-Trujillo JL, Guixeres J, Llinares C, Alcañiz M, Valenza G. Heart rate variability analysis for the assessment of immersive emotional arousal using virtual reality: Comparing real and virtual scenarios. PLoS One 2021; 16:e0254098. [PMID: 34197553 PMCID: PMC8248697 DOI: 10.1371/journal.pone.0254098] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 06/19/2021] [Indexed: 11/18/2022] Open
Abstract
Many affective computing studies have developed automatic emotion recognition models, mostly using emotional images, audio and videos. In recent years, virtual reality (VR) has been also used as a method to elicit emotions in laboratory environments. However, there is still a need to analyse the validity of VR in order to extrapolate the results it produces and to assess the similarities and differences in physiological responses provoked by real and virtual environments. We investigated the cardiovascular oscillations of 60 participants during a free exploration of a real museum and its virtualisation viewed through a head-mounted display. The differences between the heart rate variability features in the high and low arousal stimuli conditions were analysed through statistical hypothesis testing; and automatic arousal recognition models were developed across the real and the virtual conditions using a support vector machine algorithm with recursive feature selection. The subjects' self-assessments suggested that both museums elicited low and high arousal levels. In addition, the real museum showed differences in terms of cardiovascular responses, differences in vagal activity, while arousal recognition reached 72.92% accuracy. However, we did not find the same arousal-based autonomic nervous system change pattern during the virtual museum exploration. The results showed that, while the direct virtualisation of a real environment might be self-reported as evoking psychological arousal, it does not necessarily evoke the same cardiovascular changes as a real arousing elicitation. These contribute to the understanding of the use of VR in emotion recognition research; future research is needed to study arousal and emotion elicitation in immersive VR.
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Candia-Rivera D, Catrambone V, Barbieri R, Valenza G. Integral pulse frequency modulation model driven by sympathovagal dynamics: Synthetic vs. real heart rate variability. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102736] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Candia-Rivera D, Catrambone V, Valenza G. The role of electroencephalography electrical reference in the assessment of functional brain-heart interplay: From methodology to user guidelines. J Neurosci Methods 2021; 360:109269. [PMID: 34171310 DOI: 10.1016/j.jneumeth.2021.109269] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 06/16/2021] [Accepted: 06/18/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND The choice of EEG reference has been widely studied. However, the choice of the most appropriate re-referencing for EEG data is still debated. Moreover, the role of EEG reference in the estimation of functional Brain-Heart Interplay (BHI), together with different multivariate modelling strategies, has not been investigated yet. METHODS This study identifies the best methodology combining a proper EEG electrical reference and signal processing methods for an effective functional BHI assessment. The effects of the EEG reference among common average, mastoids average, Laplacian reference, Cz reference, and the reference electrode standardization technique (REST) were explored throughout different BHI methods including synthetic data generation (SDG) model, heartbeat-evoked potentials, heartbeat-evoked oscillations, and maximal information coefficient. RESULTS The SDG model exhibited high robustness between EEG references, whereas the maximal information coefficient method exhibited a high sensitivity. The common average and REST references for EEG showed a good consistency in the between-method comparisons. Laplacian, and Cz references significantly bias a BHI measurement. COMPARISON WITH EXISTING METHODS The use of EEG reference based on a common average outperforms on the use of other references for consistency in estimating directed functional BHI. We do not recommend the use of EEG references based on analytical derivations as the experimental conditions may not meet the requirements of their optimal estimation, particularly in clinical settings. CONCLUSION The use of a common average for EEG electrical reference is concluded to be the most appropriate choice for a quantitative, functional BHI assessment.
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Averta G, Barontini F, Catrambone V, Haddadin S, Handjaras G, Held JPO, Hu T, Jakubowitz E, Kanzler CM, Kühn J, Lambercy O, Leo A, Obermeier A, Ricciardi E, Schwarz A, Valenza G, Bicchi A, Bianchi M. U-Limb: A multi-modal, multi-center database on arm motion control in healthy and post-stroke conditions. Gigascience 2021; 10:giab043. [PMID: 34143875 PMCID: PMC8212873 DOI: 10.1093/gigascience/giab043] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/26/2021] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Shedding light on the neuroscientific mechanisms of human upper limb motor control, in both healthy and disease conditions (e.g., after a stroke), can help to devise effective tools for a quantitative evaluation of the impaired conditions, and to properly inform the rehabilitative process. Furthermore, the design and control of mechatronic devices can also benefit from such neuroscientific outcomes, with important implications for assistive and rehabilitation robotics and advanced human-machine interaction. To reach these goals, we believe that an exhaustive data collection on human behavior is a mandatory step. For this reason, we release U-Limb, a large, multi-modal, multi-center data collection on human upper limb movements, with the aim of fostering trans-disciplinary cross-fertilization. CONTRIBUTION This collection of signals consists of data from 91 able-bodied and 65 post-stroke participants and is organized at 3 levels: (i) upper limb daily living activities, during which kinematic and physiological signals (electromyography, electro-encephalography, and electrocardiography) were recorded; (ii) force-kinematic behavior during precise manipulation tasks with a haptic device; and (iii) brain activity during hand control using functional magnetic resonance imaging.
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Catrambone V, Messerotti Benvenuti S, Gentili C, Valenza G. Intensification of functional neural control on heartbeat dynamics in subclinical depression. Transl Psychiatry 2021; 11:221. [PMID: 33854037 PMCID: PMC8046790 DOI: 10.1038/s41398-021-01336-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/30/2021] [Indexed: 01/06/2023] Open
Abstract
Subclinical depression (dysphoria) is a common condition that may increase the risk of major depression and leads to impaired quality of life and severe comorbid somatic diseases. Despite its prevalence, specific biological markers are unknown; consequently, the identification of dysphoria currently relies exclusively on subjective clinical scores and structured interviews. Based on recent neurocardiology studies that link brain and cardiovascular disorders, it was hypothesized that multi-system biomarkers of brain-body interplay may effectively characterize dysphoria. Thus, an ad hoc computational technique was developed to quantify the functional bidirectional brain-heart interplay. Accordingly, 32-channel electroencephalographic and heart rate variability series were obtained from 24 young dysphoric adults and 36 healthy controls. All participants were females of a similar age, and results were obtained during a 5-min resting state. The experimental results suggest that a specific feature of dysphoria is linked to an augmented functional central-autonomic control to the heart, which originates from central, frontopolar, and occipital oscillations and acts through cardiovascular sympathovagal activity. These results enable further development of a large set of novel biomarkers for mood disorders based on comprehensive brain-body measurements.
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Ghiasi S, Greco A, Faes L, Javorka M, Barbieri R, Scilingo EP, Valenza G. Quantifying multidimensional control mechanisms of cardiovascular dynamics during multiple concurrent stressors. Med Biol Eng Comput 2021; 59:775-785. [PMID: 33665768 DOI: 10.1007/s11517-020-02311-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 12/30/2020] [Indexed: 10/22/2022]
Abstract
Heartbeat regulation is achieved through different routes originating from central autonomic network sources, as well as peripheral control mechanisms. While previous studies successfully characterized cardiovascular regulatory mechanisms during a single stressor, to the best of our knowledge, a combination of multiple concurrent elicitations leading to the activation of different autonomic regulatory routes has not been investigated yet. Therefore, in this study, we propose a novel modeling framework for the quantification of heartbeat regulatory mechanisms driven by different neural routes. The framework is evaluated using two heartbeat datasets gathered from healthy subjects undergoing physical and mental stressors, as well as their concurrent administration. Experimental results indicate that more than 70% of the heartbeat regulatory dynamics is driven by the physical stressor when combining physical and cognitive/emotional stressors. The proposed framework provides quantitative insights and novel perspectives for neural activity on cardiac control dynamics, likely highlighting new biomarkers in the psychophysiology and physiopathology fields. A Matlab implementation of the proposed tool is available online.
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Catrambone V, Averta G, Bianchi M, Valenza G. Toward brain-heart computer interfaces: a study on the classification of upper limb movements using multisystem directional estimates. J Neural Eng 2021; 18. [PMID: 33601354 DOI: 10.1088/1741-2552/abe7b9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/18/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Brain-computer interfaces (BCI) exploit computational features from brain signals to perform a given task. Despite recent neurophysiology and clinical findings indicating the crucial role of functional interplay between brain and cardiovascular dynamics in locomotion, heartbeat information remains to be included in common BCI systems. In this study, we exploit the multidimensional features of directional and functional interplay between electroencephalographic and heartbeat spectra to classify upper limb movements into three classes. APPROACH We gathered data from 26 healthy volunteers that performed 90 movements; the data were processed using a recently proposed framework for brain-heart interplay (BHI) assessment based on synthetic physiological data generation. Extracted BHI features were employed to classify, through sequential forward selection scheme and k-nearest neighbors algorithm, among resting state and three classes of movements according to the kind of interaction with objects. MAIN RESULTS The results demonstrated that the proposed brain-heart computer interface (BHCI) system could distinguish between rest and movement classes automatically with an average 90% of accuracy. SIGNIFICANCE Further, this study provides neurophysiology insights indicating the crucial role of functional interplay originating at the cortical level onto the heart in the upper limb neural control. The inclusion of functional BHI insights might substantially improve the neuroscientific knowledge about motor control, and this may lead to advanced BHCI systems performances.
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Dell'Acqua C, Ghiasi S, Messerotti Benvenuti S, Greco A, Gentili C, Valenza G. Increased functional connectivity within alpha and theta frequency bands in dysphoria: A resting-state EEG study. J Affect Disord 2021; 281:199-207. [PMID: 33326893 DOI: 10.1016/j.jad.2020.12.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/20/2020] [Accepted: 12/05/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND The understanding of neurophysiological correlates underlying the risk of developing depression may have a significant impact on its early and objective identification. Research has identified abnormal resting-state electroencephalography (EEG) power and functional connectivity patterns in major depression. However, the entity of dysfunctional EEG dynamics in dysphoria is yet unknown. METHODS 32-channel EEG was recorded in 26 female individuals with dysphoria and in 38 age-matched, female healthy controls. EEG power spectra and alpha asymmetry in frontal and posterior channels were calculated in a 4-minute resting condition. An EEG functional connectivity analysis was conducted through phase locking values, particularly mean phase coherence. RESULTS While individuals with dysphoria did not differ from controls in EEG spectra and asymmetry, they exhibited dysfunctional brain connectivity. Particularly, in the theta band (4-8 Hz), participants with dysphoria showed increased connectivity between right frontal and central areas and right temporal and left occipital areas. Moreover, in the alpha band (8-12 Hz), dysphoria was associated with increased connectivity between right and left prefrontal cortex and between frontal and central-occipital areas bilaterally. LIMITATIONS All participants belonged to the female gender and were relatively young. Mean phase coherence did not allow to compute the causal and directional relation between brain areas. CONCLUSIONS An increased EEG functional connectivity in the theta and alpha bands characterizes dysphoria. These patterns may be associated with the excessive self-focus and ruminative thinking that typifies depressive symptoms. EEG connectivity patterns may represent a promising measure to identify individuals with a higher risk of developing depression.
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Sorriento A, Poliziani A, Cafarelli A, Valenza G, Ricotti L. A novel quantitative and reference-free ultrasound analysis to discriminate different concentrations of bone mineral content. Sci Rep 2021; 11:301. [PMID: 33432022 PMCID: PMC7801603 DOI: 10.1038/s41598-020-79365-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 12/07/2020] [Indexed: 12/19/2022] Open
Abstract
Bone fracture is a continuous process, during which bone mineral matrix evolves leading to an increase in hydroxyapatite and calcium carbonate content. Currently, no gold standard methods are available for a quantitative assessment of bone fracture healing. Moreover, the available tools do not provide information on bone composition. Whereby, there is a need for objective and non-invasive methods to monitor the evolution of bone mineral content. In general, ultrasound can guarantee a quantitative characterization of tissues. However, previous studies required measurements on reference samples. In this paper we propose a novel and reference-free parameter, based on the entropy of the phase signal calculated from the backscattered data in combination with amplitude information, to also consider absorption and scattering phenomena. The proposed metric was effective in discriminating different hydroxyapatite (from 10 to 50% w/v) and calcium carbonate (from 2 to 6% w/v) concentrations in bone-mimicking phantoms without the need for reference measurements, paving the way to their translational use for the diagnosis of tissue healing. To the best of our knowledge this is the first time that the phase entropy of the backscattered ultrasound signals is exploited for monitoring changes in the mineral content of bone-like materials.
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