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Dang R, Yu T, Hu B, Wang Y, Pan Z, Luo R, Wang Q. Temporal transformer-spatial graph convolutional network: an intelligent classification model for anti N-methyl-D-aspartate receptor encephalitis based on electroencephalogram signal. Front Neurosci 2023; 17:1223077. [PMID: 37700752 PMCID: PMC10493270 DOI: 10.3389/fnins.2023.1223077] [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: 05/15/2023] [Accepted: 08/15/2023] [Indexed: 09/14/2023] Open
Abstract
Encephalitis is a disease typically caused by viral infections or autoimmunity. The most common type of autoimmune encephalitis is anti-N-methyl-D-aspartate receptor (NMDAR) antibody-mediated, known as anti-NMDA receptor encephalitis, which is a rare disease. Specific EEG patterns, including "extreme delta brush" (EDB), have been reported in patients with anti-NMDA receptor encephalitis. The aim of this study was to develop an intelligent diagnostic model for encephalitis based on EEG signals. A total of 131 Participants were selected based on reasonable inclusion criteria and divided into three groups: health control (35 participants), viral encephalitis (58 participants), and anti NMDAR receptor encephalitis (55 participants). Due to the low prevalence of anti-NMDAR receptor encephalitis, it took several years to collect participants' EEG signals while they were in an awake state. EEG signals were collected and analyzed following the international 10-20 system layout. We proposed a model called Temporal Transformer-Spatial Graph Convolutional Network (TT-SGCN), which consists of a Preprocess Module, a Temporal Transformer Module (TTM), and a Spatial Graph Convolutional Module (SGCM). The raw EEG signal was preprocessed according to traditional procedures, including filtering, averaging, and Independent Component Analysis (ICA) method. The EEG signal was then segmented and transformed using short-time Fourier transform (STFT) to produce concatenated power density (CPD) maps, which served as inputs for the proposed model. TTM extracted the time-frequency features of each channel, and SGCM fused these features using graph convolutional methods based on the location of electrodes. The model was evaluated in two experiments: classification of the three groups and pairwise classification among the three groups. The model was trained using two stages and achieved the performance, with an accuracy of 82.23%, recall of 80.75%, precision of 82.51%, and F1 score of 81.23% in the classification of the three groups. The proposed model has the potential to become an intelligent auxiliary diagnostic tool for encephalitis.
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Affiliation(s)
- Ruochen Dang
- Key Laboratory of Spectral Imaging Technology, Xi’an Institute of Optics and Precision Mechanics (XIOPM), Chinese Academy of Sciences, Xi’an, China
- School of Electronic and Information Engineering, Xi’an Jiaotong University, Xi’an, China
- University of Chinese Academy of Sciences, Beijing, China
- Key Laboratory of Biomedical Spectroscopy of Xi’an, Xi’an Institute of Optics and Precision Mechanics (XIOPM), Chinese Academy of Sciences, Xi’an, China
| | - Tao Yu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, China
| | - Bingliang Hu
- Key Laboratory of Spectral Imaging Technology, Xi’an Institute of Optics and Precision Mechanics (XIOPM), Chinese Academy of Sciences, Xi’an, China
- Key Laboratory of Biomedical Spectroscopy of Xi’an, Xi’an Institute of Optics and Precision Mechanics (XIOPM), Chinese Academy of Sciences, Xi’an, China
| | - Yuqi Wang
- Key Laboratory of Spectral Imaging Technology, Xi’an Institute of Optics and Precision Mechanics (XIOPM), Chinese Academy of Sciences, Xi’an, China
- Key Laboratory of Biomedical Spectroscopy of Xi’an, Xi’an Institute of Optics and Precision Mechanics (XIOPM), Chinese Academy of Sciences, Xi’an, China
| | - Zhibin Pan
- School of Electronic and Information Engineering, Xi’an Jiaotong University, Xi’an, China
| | - Rong Luo
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, China
| | - Quan Wang
- Key Laboratory of Spectral Imaging Technology, Xi’an Institute of Optics and Precision Mechanics (XIOPM), Chinese Academy of Sciences, Xi’an, China
- Key Laboratory of Biomedical Spectroscopy of Xi’an, Xi’an Institute of Optics and Precision Mechanics (XIOPM), Chinese Academy of Sciences, Xi’an, China
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Rocha ND, de Moura SK, da Silva GAB, Mattiello R, Sato DK. Neurological sequelae after encephalitis associated with herpes simplex virus in children: systematic review and meta-analysis. BMC Infect Dis 2023; 23:55. [PMID: 36703115 PMCID: PMC9878875 DOI: 10.1186/s12879-023-08007-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Encephalitis is an inflammation of the cerebral parenchyma manifested by acute symptoms such as fever, headaches, and other neurological disorders. Its etiology is mostly viral, with herpes simplex virus being a frequent etiological agent in children. The development of neurological sequelae is a serious outcome associated with this infection. OBJECTIVE To assess the general prevalence and types of neurological sequelae in children after a case of acute viral encephalitis caused by HSV. METHODS This systematic review and meta-analysis was developed following the PRISMA guidelines. The literature search was carried out in the MEDLINE, Embase, SciELO, LILACS, Cochrane, CINAHL, PsycINFO, and Web of Science databases. Studies were included of children with confirmed HSV infection and that presented a description of neurological sequelae associated with that infection. For the meta-analysis of general prevalence and of the types of neurological sequelae a random effects model was used. RESULTS Of the 2827 articles chosen in the initial search, nine studies were included in the systematic review and meta-analysis. The general prevalence of neurological sequelae was 50.7% (95% CI 39.2-62.2). The most frequent sequelae were related to mental disability, with a 42.1% prevalence (95% CI 30-55.2); on the other hand, the least frequent sequelae were those related with visual impairment, with a 5.9% prevalence (95% CI 2.2-14.6). The included studies presented regular quality and substantial heterogeneity. CONCLUSION Even with antiviral therapy, half of patients will develop some type of disability.
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Affiliation(s)
- Natalie Duran Rocha
- Programa de Pós-Graduação em Pediatria e Saúde da Criança da PUCRS, Pontifícia Universidade Católica do Rio Grande Do Sul, Av. Ipiranga, 6681 - Bairro Partenon, Porto Alegre, RS, 90619-900, Brazil.
| | - Sara Kvitko de Moura
- Programa de Pós-Graduação em Pediatria e Saúde da Criança da PUCRS, Pontifícia Universidade Católica do Rio Grande Do Sul, Av. Ipiranga, 6681 - Bairro Partenon, Porto Alegre, RS, 90619-900, Brazil
| | - Gabriel Aude Bueno da Silva
- Curso de Graduação em Medicina da Escola de Medicina da PUCRS - Pontifícia Universidade Católica do Rio Grande do Sul, Av. Ipiranga, 6681 - Bairro Partenon, Porto Alegre, RS, 90619-900, Brazil
| | - Rita Mattiello
- Programa de Pós-Graduação em Epidemiologia Universidade Federal do Rio Grande do Sul, Av. Paulo Gama, n° 110 -Bairro Farroupilha,, Porto Alegre, RS, 90040-060, Brazil
| | - Douglas Kazutoshi Sato
- Programa de Pós-Graduação em Pediatria e Saúde da Criança da PUCRS, Pontifícia Universidade Católica do Rio Grande Do Sul, Av. Ipiranga, 6681 - Bairro Partenon, Porto Alegre, RS, 90619-900, Brazil
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Gupta A, Singh A. An Intelligent Healthcare Cyber Physical Framework for Encephalitis Diagnosis Based on Information Fusion and Soft-Computing Techniques. NEW GENERATION COMPUTING 2022; 40:1093-1123. [PMID: 35730007 PMCID: PMC9195408 DOI: 10.1007/s00354-022-00175-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 05/24/2022] [Indexed: 05/02/2023]
Abstract
Viral encephalitis is a contagious disease that causes life insecurity and is considered one of the major health concerns worldwide. It causes inflammation of the brain and, if left untreated, can have persistent effects on the central nervous system. Conspicuously, this paper proposes an intelligent cyber-physical healthcare framework based on the IoT-fog-cloud collaborative network, employing soft-computing technology and information fusion. The proposed framework uses IoT-based sensors, electronic medical records, and user devices for data acquisition. The fog layer, composed of numerous nodes, processes the most specific encephalitis symptom-related data to classify possible encephalitis cases in real time to issue an alarm when a significant health emergency occurs. Furthermore, the cloud layer involves a multi-step data processing scheme for in-depth data analysis. First, data obtained across multiple data generation sources are fused to obtain a more consistent, accurate, and reliable feature set. Data preprocessing and feature selection techniques are applied to the fused data for dimensionality reduction over the cloud computing platform. An adaptive neuro-fuzzy inference system is applied in the cloud to determine the risk of a disease and classify the results into one of four categories: no risk, probable risk, low risk, and acute risk. Moreover, the alerts are generated and sent to the stakeholders based on the risk factor. Finally, the computed results are stored in the cloud database for future use. For validation purposes, various experiments are performed using real-time datasets. The analysis results performed on the fog and cloud layers show higher performance than the existing models. Future research will focus on the resource allocation in the cloud layer while considering various security aspects to improve the utility of the proposed work.
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Affiliation(s)
- Aditya Gupta
- Dr. B R Ambedkar National Institute of Technology, Jalandhar, India
| | - Amritpal Singh
- Dr. B R Ambedkar National Institute of Technology, Jalandhar, India
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Zamani R, Pouremamali R, Rezaei N. Central neuroinflammation in Covid-19: a systematic review of 182 cases with encephalitis, acute disseminated encephalomyelitis, and necrotizing encephalopathies. Rev Neurosci 2021; 33:397-412. [PMID: 34536341 DOI: 10.1515/revneuro-2021-0082] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/19/2021] [Indexed: 12/11/2022]
Abstract
Growing evidence demonstrates the association of encephalitis, meningoencephalitis or encephalomyelitis, with SARS-CoV-2 infection. This study aims to determine the profile and possible mechanisms behind CNS inflammatory diseases in the context of Covid-19. We conducted a systematic review of case reports on Covid-19-related encephalitis, meningoencephalitis, acute necrotizing encephalitis, and acute disseminated encephalomyelitis in adults, published before January 2021. A total of 182 cases (encephalitis = 109, meningoencephalitis = 26, acute disseminated encephalomyelitis = 35, acute necrotizing (hemorrhagic) encephalitis = 12) were included. While cerebrospinal fluid (CSF) pleocytosis and increased protein level was present in less than 50%, magnetic resonance imaging (MRI) and electroencephalogram (EEG) were abnormal in 78 and 93.2% of all cases, respectively. Viral particles were detected in cerebrospinal fluid of only 13 patients and autoantibodies were present in seven patients. All patients presented with altered mental status, either in the form of impaired consciousness or psychological/cognitive decline. Seizure, cranial nerve signs, motor, and reflex abnormalities were among associated symptoms. Covid-19-associated encephalitis presents with a distinctive profile requiring thorough diagnosis and thereby a comprehensive knowledge of the disease. The clinical profile of brain inflammation in Covid-19 exhibits majority of abnormal imaging and electroencephalography findings with mild/moderate pleocytosis or proteinorrhachia as prevalent as normal cerebrospinal fluid (CSF). Oligoclonal bands and autoantibody assessments are useful in further evaluating neuro-covid patients, as supported by our pooled evidence. Despite the possibility that direct viral invasion cannot be easily estimated, it is still more likely that immune-mediated or autoimmune reactions play a more important role in SARS-CoV-2 neuroinflammation.
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Affiliation(s)
- Raha Zamani
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, Tehran, 14194, Iran.,Research Center for Immunodeficiencies, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, Tehran, 14194, Iran
| | - Rozhina Pouremamali
- School of Medicine, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, Tehran, 14194, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences (TUMS), Children's Medical Center Hospital, Dr. Qarib St., Keshavarz Blvd, Tehran, 14194, Iran.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran,1419733151, Iran
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Yang H, Chi Y, Chen Z, Fan Y, Wu H, Hu X, Wu T, Xiao B, Zhang M. Differential Diagnosis and Hospital Emergency Management for Fastlane Treatment of Central Nervous System Infection Under the COVID-19 Epidemic in Changsha, China. Front Neurol 2020; 11:555202. [PMID: 33192989 PMCID: PMC7606862 DOI: 10.3389/fneur.2020.555202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/09/2020] [Indexed: 01/08/2023] Open
Abstract
Importance: Corona virus disease 2019 (COVID-19) has long latent period, strong infectivity, and non-specific symptoms and signs in the upper respiratory tract. Some initial neurological symptoms appear, including dizziness, headache, seizures, slurred speech, disturbance of consciousness, and limb paralysis among a few COVID-19 patients, which share similar manifestations with central nervous system (CNS) infection. Improving the diagnostic efficiency of suspected CNS infection patients on the basis of preventing and controlling COVID-19 plays a key role in preventing nosocomial and cross infections. This study intends to formulate a hospital emergency management system of fastlane treatment of CNS infection for epidemic prevention and control, aiming at providing references and guidelines for the government and medical institutions to improve the efficiency of treating CNS infection patients in the clinical practice during COVID-19. Observations: This study formulated a framework of a fastlane treatment of CNS infection based on the cooperation of resources and experience, aiming at the key and difficult problems faced by the hospital emergency management system during the COVID-19 outbreak in Changsha, China. The main problem of formulating the hospital emergency management system is efficiently identifying whether CNS infection was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The framework improves the efficiency of diagnosing and treating CNS infections by standardizing the diagnosis and treatment process of patients in emergency observation and strengthening the management of inpatient wards, aiming at assisting medical staff during clinical practice. Conclusions and Relevance: The hospital emergency management system of a fastlane treatment of CNS infection for epidemic prevention and control of the COVID-19 outbreak is a professional and multisystem project, which needs the cooperation of various resources and the experience of clinical leadership.
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Affiliation(s)
- Haojun Yang
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, China
| | | | - Zhuohui Chen
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, China
| | - Yishu Fan
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, China
| | - Haiyue Wu
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, China
| | - Xinhang Hu
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, China
| | - Tong Wu
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, China
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, China
| | - Mengqi Zhang
- Department of Neurology, Xiangya Hospital of Central South University, Changsha, China
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