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Sangare A, Rohaut B, Borden A, Zyss J, Velazquez A, Doyle K, Naccache L, Claassen J. A Novel Approach to Screen for Somatosensory Evoked Potentials in Critical Care. Neurocrit Care 2024; 40:237-250. [PMID: 36991177 DOI: 10.1007/s12028-023-01710-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/27/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Somatosensory evoked potentials (SSEPs) help prognostication, particularly in patients with diffuse brain injury. However, use of SSEP is limited in critical care. We propose a novel, low-cost approach allowing acquisition of screening SSEP using widely available intensive care unit (ICU) equipment, specifically a peripheral "train-of-four" stimulator and standard electroencephalograph. METHODS The median nerve was stimulated using a train-of-four stimulator, and a standard 21-channel electroencephalograph was recorded to generate the screening SSEP. Generation of the SSEP was supported by visual inspection, univariate event-related potentials statistics, and a multivariate support vector machine (SVM) decoding algorithm. This approach was validated in 15 healthy volunteers and validated against standard SSEPs in 10 ICU patients. The ability of this approach to predict poor neurological outcome, defined as death, vegetative state, or severe disability at 6 months, was tested in an additional set of 39 ICU patients. RESULTS In each of the healthy volunteers, both the univariate and the SVM methods reliably detected SSEP responses. In patients, when compared against the standard SSEP method, the univariate event-related potentials method matched in nine of ten patients (sensitivity = 94%, specificity = 100%), and the SVM had 100% sensitivity and specificity when compared with the standard method. For the 49 ICU patients, we performed both the univariate and the SVM methods: a bilateral absence of short latency responses (n = 8) predicted poor neurological outcome with 0% FPR (sensitivity = 21%, specificity = 100%). CONCLUSIONS Somatosensory evoked potentials can reliably be recorded using the proposed approach. Given the very good but slightly lower sensitivity of absent SSEPs in the proposed screening approach, confirmation of absent SSEP responses using standard SSEP recordings is advised.
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Affiliation(s)
- Aude Sangare
- Brain Institute, ICM, CNRS, Sorbonne Université, Inserm U1127, UMR 7225, Paris, France.
- Department of Neurophysiology, Pitié-Salpêtrière, Groupe Hospitalier Universitaire Assistance Publique-Hôpitaux de Paris Sorbonne Université, Paris, France.
- Sorbonne University, Paris, France.
| | - Benjamin Rohaut
- Brain Institute, ICM, CNRS, Sorbonne Université, Inserm U1127, UMR 7225, Paris, France
- Department of Neurophysiology, Pitié-Salpêtrière, Groupe Hospitalier Universitaire Assistance Publique-Hôpitaux de Paris Sorbonne Université, Paris, France
- Neurological Intensive Care Unit, Department of Neurology, Pitié-Salpêtrière, Groupe Hospitalier Universitaire Assistance Publique-Hôpitaux de Paris Sorbonne Université, Paris, France
- Department of Neurology, Columbia University, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
| | - Alaina Borden
- Department of Neurophysiology, Pitié-Salpêtrière, Groupe Hospitalier Universitaire Assistance Publique-Hôpitaux de Paris Sorbonne Université, Paris, France
| | - Julie Zyss
- Department of Neurophysiology, Pitié-Salpêtrière, Groupe Hospitalier Universitaire Assistance Publique-Hôpitaux de Paris Sorbonne Université, Paris, France
| | | | - Kevin Doyle
- Department of Neurology, Columbia University, New York, NY, USA
| | - Lionel Naccache
- Brain Institute, ICM, CNRS, Sorbonne Université, Inserm U1127, UMR 7225, Paris, France
- Department of Neurophysiology, Pitié-Salpêtrière, Groupe Hospitalier Universitaire Assistance Publique-Hôpitaux de Paris Sorbonne Université, Paris, France
- Sorbonne University, Paris, France
| | - Jan Claassen
- Department of Neurology, Columbia University, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
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Hackley SA, Hirao T, Onoda K, Ogawa K, Masaki H. Anterior insula activity and the effect of agency on the Stimulus‐Preceding Negativity. Psychophysiology 2020; 57:e13519. [DOI: 10.1111/psyp.13519] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 01/07/2023]
Affiliation(s)
- Steven A. Hackley
- Department of Psychological Sciences University of Missouri‐Columbia Columbia MO USA
| | - Takahiro Hirao
- Faculty of Sport Sciences Waseda University Tokorozawa Japan
| | - Keiichi Onoda
- Department of Neurology Shimane University Izumo-shi Japan
| | - Keiko Ogawa
- Graduate School of Integrated Arts and Sciences Hiroshima University Hiroshima Japan
| | - Hiroaki Masaki
- Faculty of Sport Sciences Waseda University Tokorozawa Japan
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