Creating anatomically-derived, standardized, customizable, and three-dimensional printable head caps for functional neuroimaging

Significance

Consistent and accurate probe placement is a crucial step towards enhancing the reproducibility of longitudinal and group-based functional neuroimaging studies. While the selection of headgear is central to these efforts, there does not currently exist a standardized design that can accommodate diverse probe configurations and experimental procedures.

Aim

We aim to provide the community with an open-source software pipeline for conveniently creating low-cost, 3-D printable neuroimaging head caps with anatomically significant landmarks integrated into the structure of the cap.

Approach

We utilize our advanced 3-D head mesh generation toolbox and 10-20 head landmark calculations to quickly convert a subject's anatomical scan or an atlas into a 3-D printable head cap model. The 3-D modeling environment of the open-source Blender platform permits advanced mesh processing features to customize the cap. The design process is streamlined into a Blender add-on named "NeuroCaptain".

Results

Using the intuitive user interface, we create various head cap models using brain atlases, and share those with the community. The resulting mesh-based head cap designs are readily 3-D printable using off-the-shelf printers and filaments while accurately preserving the head topology and landmarks.

Conclusions

The methods developed in this work result in a widely accessible tool for community members to design, customize and fabricate caps that incorporate anatomically derived landmarks. This not only permits personalized head cap designs to achieve improved accuracy, but also offers an open platform for the community to propose standardizable head caps to facilitate multi-centered data collection and sharing.

An efficient channel recurrent Criss-cross attention network for epileptic seizure prediction

Epilepsy is a chronic disease caused by repeated abnormal discharge of neurons in the brain. Accurately predicting the onset of epilepsy can effectively improve the quality of life for patients with the condition. While there are many methods for detecting epilepsy, EEG is currently considered one of the most effective analytical tools due to the abundant information it provides about brain activity. The aim of this study is to explore potential time-frequency and channel features from multi-channel epileptic EEG signals and to develop a patient-specific seizure prediction network. In this paper, an epilepsy EEG signal classification algorithm called Channel Recurrent Criss-cross Attention Network (CRCANet) is proposed. Firstly, the spectrograms processed by the short-time fourier transform is input into a Convolutional Neural Network (CNN). Then, the spectrogram feature map obtained in the previous step is input into the channel attention module to establish correlations between channels. Subsequently, the feature diagram containing channel attention characteristics is input into the recurrent criss-cross attention module to enhance the information content of each pixel. Finally, two fully connected layers are used for classification. We validated the method on 13 patients in the public CHB-MIT scalp EEG dataset, achieving an average accuracy of 93.8 %, sensitivity of 94.3 %, and specificity of 93.5 %. The experimental results indicate that CRCANet can effectively capture the time-frequency and channel characteristics of EEG signals while improving training efficiency.

Minimization of Parasitic Capacitance between Skin and Ag/AgCl Dry Electrodes

Conventional dry electrodes often yield unstable results due to the presence of parasitic capacitance between the flat electrode surface and the non-uniform skin interface. To address this issue, a gel is typically placed between the electrodes to minimize parasitic capacitance. However, this approach has the drawbacks of being unsuitable for repeated use, limited lifetime due to gel evaporation, and the possibility of developing skin irritation. This is particularly problematic in underserved areas since, due to the cost of disposable wet electrodes, they often sterilize and reuse dry electrodes. In this study, we propose a method to neutralize the effects of parasitic capacitance by attaching high-value capacitors to the electrodes in parallel, specifically when applied to pulse wave monitoring through bioimpedance. Skin capacitance can also be mitigated due to the serial connection, enabling stable reception of arterial pulse signals through bioimpedance circuits. A high-frequency structure simulator (HFSS) was first used to simulate the capacitance when injection currents flow into the arteries through the bioimpedance circuits. We also used the simulation to investigate the effects of add-on capacitors. Lastly, we conducted preliminary comparative analyses between wet electrodes and dry electrodes in vivo with added capacitance values ranging from 100 pF to 1 μF, altering capacitance magnitudes by factors of 100. As a result, we obtained a signal-to-noise ratio (SNR) that was 8.2 dB higher than that of dry electrodes. Performance was also shown to be comparable to wet electrodes, with a reduction of only 0.4 dB using 1 μF. The comparative results demonstrate that the addition of capacitors to the electrodes has the potential to allow for performance similar to that of wet electrodes for bioimpedance pulse rate monitoring and could potentially be used for other applications of dry electrodes.

Wireless Mouth Motion Recognition System Based on EEG-EMG Sensors for Severe Speech Impairments

This study aims to demonstrate the feasibility of using a new wireless electroencephalography (EEG)-electromyography (EMG) wearable approach to generate characteristic EEG-EMG mixed patterns with mouth movements in order to detect distinct movement patterns for severe speech impairments. This paper describes a method for detecting mouth movement based on a new signal processing technology suitable for sensor integration and machine learning applications. This paper examines the relationship between the mouth motion and the brainwave in an effort to develop nonverbal interfacing for people who have lost the ability to communicate, such as people with paralysis. A set of experiments were conducted to assess the efficacy of the proposed method for feature selection. It was determined that the classification of mouth movements was meaningful. EEG-EMG signals were also collected during silent mouthing of phonemes. A few-shot neural network was trained to classify the phonemes from the EEG-EMG signals, yielding classification accuracy of 95%. This technique in data collection and processing bioelectrical signals for phoneme recognition proves a promising avenue for future communication aids.

Brain Wearables: Validation Toolkit for Ear-Level EEG Sensors

EEG-enabled earbuds represent a promising frontier in brain activity monitoring beyond traditional laboratory testing. Their discrete form factor and proximity to the brain make them the ideal candidate for the first generation of discrete non-invasive brain-computer interfaces (BCIs). However, this new technology will require comprehensive characterization before we see widespread consumer and health-related usage. To address this need, we developed a validation toolkit that aims to facilitate and expand the assessment of ear-EEG devices. The first component of this toolkit is a desktop application ("EaR-P Lab") that controls several EEG validation paradigms. This application uses the Lab Streaming Layer (LSL) protocol, making it compatible with most current EEG systems. The second element of the toolkit introduces an adaptation of the phantom evaluation concept to the domain of ear-EEGs. Specifically, it utilizes 3D scans of the test subjects' ears to simulate typical EEG activity around and inside the ear, allowing for controlled assessment of different ear-EEG form factors and sensor configurations. Each of the EEG paradigms were validated using wet-electrode ear-EEG recordings and benchmarked against scalp-EEG measurements. The ear-EEG phantom was successful in acquiring performance metrics for hardware characterization, revealing differences in performance based on electrode location. This information was leveraged to optimize the electrode reference configuration, resulting in increased auditory steady-state response (ASSR) power. Through this work, an ear-EEG evaluation toolkit is made available with the intention to facilitate the systematic assessment of novel ear-EEG devices from hardware to neural signal acquisition.

Differentiation of subclinical and clinical electrographic events in long-term electroencephalographic recordings

OBJECTIVE

With the advent of ultra-long-term recordings for monitoring of epilepsies, the interpretation of results of isolated electroencephalographic (EEG) recordings covering only selected brain regions attracts considerable interest. In this context, the question arises of whether detected ictal EEG patterns correspond to clinically manifest seizures or rather to purely electrographic events, that is, subclinical events.

METHODS

EEG patterns from 268 clinical seizures and 252 subclinical electrographic events from 50 patients undergoing video-EEG monitoring were analyzed. Features extracted included predominant frequency band, duration, association with rhythmic muscle artifacts, spatial extent, and propagation patterns. Classification using logistic regression was performed based on data from the whole dataset of 10-20 system EEG recordings and from a subset of two temporal electrode contacts.

RESULTS

Correct separation of clinically manifest and purely electrographic events based on 10-20 system EEG recordings was possible in up to 83.8% of events, depending on the combination of features included. Correct classification based on two-channel recordings was only slightly inferior, achieving 78.6% accuracy; 74.4% and 74.8%, respectively, of events could be correctly classified when using duration alone with either electrode set, although classification accuracies were lower for some subgroups of seizures, particularly focal aware seizures and epileptic arousals.

SIGNIFICANCE

A correct classification of subclinical versus clinical EEG events was possible in 74%-83% of events based on full EEG recordings, and in 74%-78% when considering only a subset of two electrodes, matching the channel number available from new implantable diagnostic devices. This is a promising outcome, suggesting that ultra-long-term low-channel EEG recordings may provide sufficient information for objective seizure diaries. Intraindividual optimization using high numbers of ictal events may further improve separation, provided that supervised learning with external validation is feasible.

Design and verification of a wearable wireless 64-channel high-resolution EEG acquisition system with wi-fi transmission

Brain-computer interfaces (BCIs) allow communication between the brain and the external world. This type of technology has been extensively studied. However, BCI instruments with high signal quality are typically heavy and large. Thus, recording electroencephalography (EEG) signals is an inconvenient task. In recent years, system-on-chip (SoC) approaches have been integrated into BCI research, and sensors for wireless portable devices have been developed; however, there is still considerable work to be done. As neuroscience research has advanced, EEG signal analyses have come to require more accurate data. Due to the limited bandwidth of Bluetooth wireless transmission technology, EEG measurement systems with more than 16 channels must be used to reduce the sampling rate and prevent data loss. Therefore, the goal of this study was to develop a multichannel, high-resolution (24-bit), high-sampling-rate EEG BCI device that transmits signals via Wi-Fi. We believe that this system can be used in neuroscience research. The EEG acquisition system proposed in this work is based on a Cortex-M4 microcontroller with a Wi-Fi subsystem, providing a multichannel design and improved signal quality. This system is compatible with wet sensors, Ag/AgCl electrodes, and dry sensors. A LabVIEW-based user interface receives EEG data via Wi-Fi transmission and saves the raw data for offline analysis. In previous cognitive experiments, event tags have been communicated using Recommended Standard 232 (RS-232). The developed system was validated through event-related potential (ERP) and steady-state visually evoked potential (SSVEP) experiments. Our experimental results demonstrate that this system is suitable for recording EEG measurements and has potential in practical applications. The advantages of the developed system include its high sampling rate and high amplification. Additionally, in the future, Internet of Things (IoT) technology can be integrated into the system for remote real-time analysis or edge computing.

In-ear integrated sensor array for the continuous monitoring of brain activity and of lactate in sweat

Owing to the proximity of the ear canal to the central nervous system, in-ear electrophysiological systems can be used to unobtrusively monitor brain states. Here, by taking advantage of the ear's exocrine sweat glands, we describe an in-ear integrated array of electrochemical and electrophysiological sensors placed on a flexible substrate surrounding a user-generic earphone for the simultaneous monitoring of lactate concentration and brain states via electroencephalography, electrooculography and electrodermal activity. In volunteers performing an acute bout of exercise, the device detected elevated lactate levels in sweat concurrently with the modulation of brain activity across all electroencephalography frequency bands. Simultaneous and continuous unobtrusive in-ear monitoring of metabolic biomarkers and brain electrophysiology may allow for the discovery of dynamic and synergetic interactions between brain and body biomarkers in real-world settings for long-term health monitoring or for the detection or monitoring of neurodegenerative diseases.

Assessing focus through ear-EEG: a comparative study between conventional cap EEG and mobile in- and around-the-ear EEG systems

Introduction

As our attention is becoming a commodity that an ever-increasing number of applications are competing for, investing in modern day tools and devices that can detect our mental states and protect them from outside interruptions holds great value. Mental fatigue and distractions are impacting our ability to focus and can cause workplace injuries. Electroencephalography (EEG) may reflect concentration, and if EEG equipment became wearable and inconspicuous, innovative brain-computer interfaces (BCI) could be developed to monitor mental load in daily life situations. The purpose of this study is to investigate the potential of EEG recorded inside and around the human ear to determine levels of attention and focus.

Methods

In this study, mobile and wireless ear-EEG were concurrently recorded with conventional EEG (cap) systems to collect data during tasks related to focus: an N-back task to assess working memory and a mental arithmetic task to assess cognitive workload. The power spectral density (PSD) of the EEG signal was analyzed to isolate consistent differences between mental load conditions and classify epochs using step-wise linear discriminant analysis (swLDA).

Results and discussion

Results revealed that spectral features differed statistically between levels of cognitive load for both tasks. Classification algorithms were tested on spectral features from twelve and two selected channels, for the cap and the ear-EEG. A two-channel ear-EEG model evaluated the performance of two dry in-ear electrodes specifically. Single-trial classification for both tasks revealed above chance-level accuracies for all subjects, with mean accuracies of: 96% (cap-EEG) and 95% (ear-EEG) for the twelve-channel models, 76% (cap-EEG) and 74% (in-ear-EEG) for the two-channel model for the N-back task; and 82% (cap-EEG) and 85% (ear-EEG) for the twelve-channel, 70% (cap-EEG) and 69% (in-ear-EEG) for the two-channel model for the arithmetic task. These results suggest that neural oscillations recorded with ear-EEG can be used to reliably differentiate between levels of cognitive workload and working memory, in particular when multi-channel recordings are available, and could, in the near future, be integrated into wearable devices.

A novel noninvasive brain-computer interface by imagining isometric force levels

Physiological circuits differ across increasing isometric force levels during unilateral contraction. Therefore, we first explored the possibility of predicting the force level based on electroencephalogram (EEG) activity recorded during a single trial of unilateral 5% or 40% of maximal isometric voluntary contraction (MVC) in right-hand grip imagination. Nine healthy subjects were involved in this study. The subjects were required to randomly perform 20 trials for each force level while imagining a right-hand grip. We proposed the use of common spatial patterns (CSPs) and coherence between EEG signals as features in a support vector machine for force level prediction. The results showed that the force levels could be predicted through single-trial EEGs while imagining the grip (mean accuracy = 81.4 ± 13.29%). Additionally, we tested the possibility of online control of a ball game using the above paradigm through unilateral grip imagination at different force levels (i.e., 5% of MVC imagination and 40% of MVC imagination for right-hand movement control). Subjects played the ball games effectively by controlling direction with our novel BCI system (n = 9, mean accuracy = 76.67 ± 9.35%). Data analysis validated the use of our BCI system in the online control of a ball game. This information may provide additional commands for the control of robots by users through combinations with other traditional brain-computer interfaces, e.g., different limb imaginations.

Soft, adhesive and conductive composite for electroencephalogram signal quality improvement

Since electroencephalogram (EEG) is a very small electrical signal from the brain, it is very vulnerable to external noise or motion artifact, making it difficult to measure. Therefore, despite the excellent convenience of dry electrodes, wet electrodes have been used. To solve this problem, self-adhesive and conductive composites using carbon nanotubes (CNTs) in adhesive polydimethylsiloxane (aPDMS), which can have the advantages of both dry and wet electrodes, have been developed by mixing them uniformly with methyl group-terminated PDMS. The CNT/aPDMS composite has a low Young's modulus, penetrates the skin well, has a high contact area, and excellent adhesion and conductivity, so the signal quality is enhanced. As a result of the EEG measurement test, although it was a dry electrode, results comparable to those of a wet electrode were obtained in terms of impedance and motion noise. It also shows excellent biocompatibility in a human fibroblast cell test and a week-long skin reaction test, so it can measure EEG with high signal quality for a long period of time.

Novel dry EEG electrode with composite filler of PEDOT:PSS and carbon particles

We have developed a novel composite filler with Poly(3,4-ethylenedioxythiophene) : poly(styrenesulfonic acid) (PEDOT:PSS), a biocompatible organic conductive polymer, adsorbed on carbon particles for biological electrodes. This composite filler enables to fabricate high-performance biological electrodes simply by adding it to resin in the same way as conventional conductive fillers. The fabricated electrodes achieve ion exchange properties similar to those of PEDOT:PSS polymers and therefore low skin and electrode contact impedance. Electroencephalogram (EEG) measurements show that these electrodes capture various brain activities and exhibit high correlation (≥ 0.9) to commercially available wet and AgCl electrodes. Additionally, each electrode can be molded into various shapes and structures while retaining its electrode characteristics. Therefore, the proposed electrode is promising for EEG measurement, which requires high comfort and signal quality.

Design, implementation, and preliminary in-vivo assessment of a high-CMRR low-NEF wireless EEG miniaturized platform

This work presents the design, manufacture, test, and preliminary in-vivo assessment of the proof-of-concept of a miniaturized wireless platform for acquiring electroencephalography signals, where the input stage is a high-CMRR current-efficiency custom-made integrated neural preamplifier.Clinical relevance- Small, low-power consumption, wireless, wearable devices for chronically monitoring EEG recordings may contribute to the diagnosis of transient neurological events, the characterization and potential forecasting of epileptic seizures, and provide signals for controlling prosthetic and aid devices.

Optimizing Electrode Configurations for Wearable EEG Seizure Detection Using Machine Learning

Epilepsy, a prevalent neurological disorder, profoundly affects patients' quality of life due to the unpredictable nature of seizures. The development of a reliable and user-friendly wearable EEG system capable of detecting and predicting seizures has the potential to revolutionize epilepsy care. However, optimizing electrode configurations for such systems, which is crucial for balancing accuracy and practicality, remains to be explored. This study addresses this gap by developing a systematic approach to optimize electrode configurations for a seizure detection machine-learning algorithm. Our approach was applied to an extensive database of prolonged annotated EEG recordings from 158 epilepsy patients. Multiple electrode configurations ranging from one to eighteen were assessed to determine the optimal number of electrodes. Results indicated that the performance was initially maintained as the number of electrodes decreased, but a drop in performance was found to have occurred at around eight electrodes. Subsequently, a comprehensive analysis of all eight-electrode configurations was conducted using a computationally intensive workflow to identify the optimal configurations. This approach can inform the mechanical design process of an EEG system that balances seizure detection accuracy with the ease of use and portability. Additionally, this framework holds potential for optimizing hardware in other machine learning applications. The study presents a significant step towards the development of an efficient wearable EEG system for seizure detection.

A garment that measures brain activity: proof of concept of an EEG sensor layer fully implemented with smart textiles

This paper presents the first garment capable of measuring brain activity with accuracy comparable to that of state-of-the art dry electroencephalogram (EEG) systems. The main innovation is an EEG sensor layer (i.e., the electrodes, the signal transmission, and the cap support) made entirely of threads, fabrics, and smart textiles, eliminating the need for metal or plastic materials. The garment is connected to a mobile EEG amplifier to complete the measurement system. As a first proof of concept, the new EEG system (Garment-EEG) was characterized with respect to a state-of-the-art Ag/AgCl dry-EEG system (Dry-EEG) over the forehead area of healthy participants in terms of: (1) skin-electrode impedance; (2) EEG activity; (3) artifacts; and (4) user ergonomics and comfort. The results show that the Garment-EEG system provides comparable recordings to Dry-EEG, but it is more susceptible to artifacts under adverse recording conditions due to poorer contact impedances. The textile-based sensor layer offers superior ergonomics and comfort compared to its metal-based counterpart. We provide the datasets recorded with Garment-EEG and Dry-EEG systems, making available the first open-access dataset of an EEG sensor layer built exclusively with textile materials. Achieving user acceptance is an obstacle in the field of neurotechnology. The introduction of EEG systems encapsulated in wearables has the potential to democratize neurotechnology and non-invasive brain-computer interfaces, as they are naturally accepted by people in their daily lives. Furthermore, supporting the EEG implementation in the textile industry may result in lower cost and less-polluting manufacturing processes compared to metal and plastic industries.

EEG: Current relevance and promising quantitative analyses

Electroencephalography (EEG) remains an essential tool, characterized by an excellent temporal resolution and offering a real window on cerebral functions. Surface EEG signals are mainly generated by the postsynaptic activities of synchronously activated neural assemblies. EEG is also a low-cost tool, easy to use at bed-side, allowing to record brain electrical activities with a low number or up to 256 surface electrodes. For clinical purpose, EEG remains a critical investigation for epilepsies, sleep disorders, disorders of consciousness. Its temporal resolution and practicability also make EEG a necessary tool for cognitive neurosciences and brain-computer interfaces. EEG visual analysis is essential in clinical practice and the subject of recent progresses. Several EEG-based quantitative analyses may complete the visual analysis, such as event-related potentials, source localizations, brain connectivity and microstates analyses. Some developments in surface EEG electrodes appear also, potentially promising for long term continuous EEGs. We overview in this article some recent progresses in visual EEG analysis and promising quantitative analyses.

EEG-Based BCIs on Motor Imagery Paradigm Using Wearable Technologies: A Systematic Review

In recent decades, the automatic recognition and interpretation of brain waves acquired by electroencephalographic (EEG) technologies have undergone remarkable growth, leading to a consequent rapid development of brain-computer interfaces (BCIs). EEG-based BCIs are non-invasive systems that allow communication between a human being and an external device interpreting brain activity directly. Thanks to the advances in neurotechnologies, and especially in the field of wearable devices, BCIs are now also employed outside medical and clinical applications. Within this context, this paper proposes a systematic review of EEG-based BCIs, focusing on one of the most promising paradigms based on motor imagery (MI) and limiting the analysis to applications that adopt wearable devices. This review aims to evaluate the maturity levels of these systems, both from the technological and computational points of view. The selection of papers has been performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), leading to 84 publications considered in the last ten years (from 2012 to 2022). Besides technological and computational aspects, this review also aims to systematically list experimental paradigms and available datasets in order to identify benchmarks and guidelines for the development of new applications and computational models.

What a Single Electroencephalographic (EEG) Channel Can Tell us About Alzheimer's Disease Patients With Mild Cognitive Impairment

Abnormalities in cortical sources of resting-state eyes closed electroencephalographic (rsEEG) rhythms recorded by hospital settings (10-20 montage) with 19 scalp electrodes characterized Alzheimer's disease (AD) from preclinical to dementia stages. An intriguing rsEEG application is the monitoring and evaluation of AD progression in large populations with few electrodes in low-cost devices. Here we evaluated whether the above-mentioned abnormalities can be observed from fewer scalp electrodes in patients with mild cognitive impairment due to AD (ADMCI). Clinical and rsEEG data acquired in hospital settings (10-20 montage) from 75 ADMCI participants and 70 age-, education-, and sex-matched normal elderly controls (Nold) were available in an Italian-Turkish archive (PDWAVES Consortium; www.pdwaves.eu). Standard spectral fast fourier transform (FFT) analysis of rsEEG data for individual delta, theta, and alpha frequency bands was computed from 6 monopolar scalp electrodes to derive bipolar C3-P3, C4-P4, P3-O1, and P4-O2 markers. The ADMCI group showed increased delta and decreased alpha power density at the C3-P3, C4-P4, P3-O1, and P4-O2 bipolar channels compared to the Nold group. Increased theta power density for ADMCI patients was observed only at the C3-P3 bipolar channel. Best classification accuracy between the ADMCI and Nold individuals reached 81% (area under the receiver operating characteristic curve) using Alpha2/Theta power density computed at the C3-P3 bipolar channel. Standard rsEEG power density computed from six posterior bipolar channels characterized ADMCI status. These results may pave the way toward diffuse clinical applications in health monitoring of dementia using low-cost EEG systems with a strict number of electrodes in lower- and middle-income countries.

Fully Transparent, Ultrathin Flexible Organic Electrochemical Transistors with Additive Integration for Bioelectronic Applications

Optical transparency is highly desirable in bioelectronic sensors because it enables multimodal optical assessment during electronic sensing. Ultrathin (<5 µm) organic electrochemical transistors (OECTs) can be potentially used as a highly efficient bioelectronic transducer because they demonstrate high transconductance during low-voltage operation and close conformability to biological tissues. However, the fabrication of fully transparent ultrathin OECTs remains a challenge owing to the harsh etching processes of nanomaterials. In this study, fully transparent, ultrathin, and flexible OECTs are developed using additive integration processes of selective-wetting deposition and thermally bonded lamination. These processes are compatible with Ag nanowire electrodes and conducting polymer channels and realize unprecedented flexible OECTs with high visible transmittance (>90%) and high transconductance (≈1 mS) in low-voltage operations (<0.6 V). Further, electroencephalogram acquisition and nitrate ion sensing are demonstrated in addition to the compatibility of simultaneous assessments of optical blood flowmetry when the transparent OECTs are worn, owing to the transparency. These feasibility demonstrations show promise in contributing to human stress monitoring in bioelectronics.

Long-Term EEG Monitoring in Patients with Alzheimer's Disease Using Ear-EEG: A Feasibility Study

BACKGROUND

Previous studies have reported that epileptiform activity may be detectible in nearly half of patients with Alzheimer's disease (AD) on long-term electroencephalographic (EEG) recordings. However, such recordings can be uncomfortable, expensive, and difficult. Ear-EEG has shown promising results for long-term EEG monitoring, but it has not been used in patients with AD.

OBJECTIVE

To investigate if ear-EEG is a feasible method for long-term EEG monitoring in patients with AD.

METHODS

In this longitudinal, single-group feasibility study, ten patients with mild to moderate AD were recruited. A total of three ear-EEG recordings of up to 48 hours three months apart for six months were planned.

RESULTS

All patients managed to wear the ear-EEG for at least 24 hours and at least one full night. A total of 19 ear-EEG recordings were performed (self-reported recording, mean: 37.15 hours (SD: 8.96 hours)). After automatic pre-processing, a mean of 27.37 hours (SD: 7.19 hours) of data with acceptable quality in at least one electrode in each ear was found. Seven out of ten participants experienced mild adverse events. Six of the patients did not complete the study with three patients not wanting to wear the ear-EEG anymore due to adverse events.

CONCLUSION

It is feasible and safe to use ear-EEG for long-term EEG monitoring in patients with AD. Minor adjustments to the equipment may improve the comfort for the participants.

Selection of the optimal channel configuration for implementing wearable EEG devices for the diagnosis of mild cognitive impairment

Background

Early diagnosis of mild cognitive impairment (MCI) is essential for timely treatment planning. With recent advances in the wearable technology, interest has increasingly shifted toward computer-aided self-diagnosis of MCI using wearable electroencephalography (EEG) devices in daily life. However, no study so far has investigated the optimal electrode configurations for the efficient diagnosis of MCI while considering the design factors of wearable EEG devices. In this study, we aimed to determine the optimal channel configurations of wearable EEG devices for the computer-aided diagnosis of MCI.

Method

We employed an EEG dataset collected from 21 patients with MCI and 21 healthy control subjects. After evaluating the classification accuracies for all possible electrode configurations for the two-, four-, six-, and eight-electrode conditions using a support vector machine, the optimal electrode configurations that provide the highest diagnostic accuracy were suggested for each electrode condition.

Results

The highest classification accuracies of 74.04% ± 4.82, 82.43% ± 6.14, 86.28% ± 2.81, and 86.85% ± 4.97 were achieved for the optimal two-, four-, six-, and eight-electrode configurations, respectively, which demonstrated the possibility of precise machine-learning-based diagnosis of MCI with a limited number of EEG electrodes. Additionally, further simulations with the EEG dataset revealed that the optimal electrode configurations had significantly higher classification accuracies than commercial EEG devices with the same number of electrodes, which suggested the importance of electrode configuration optimization for wearable EEG devices based on clinical EEG datasets.

Conclusions

This study highlighted that the optimization of the electrode configuration, assuming the wearable EEG devices can potentially be utilized for daily life monitoring of MCI, is necessary to enhance the performance and portability.

Wearable electroencephalography and multi-modal mental state classification: A systematic literature review

BACKGROUND

Wearable multi-modal time-series classification applications outperform their best uni-modal counterparts and hold great promise. A modality that directly measures electrical correlates from the brain is electroencephalography. Due to varying noise sources, different key brain regions, key frequency bands, and signal characteristics like non-stationarity, techniques for data pre-processing and classification algorithms are task-dependent.

METHOD

Here, a systematic literature review on mental state classification for wearable electroencephalography is presented. Four search terms in different combinations were used for an in-title search. The search was executed on the 29th of June 2022, across Google Scholar, PubMed, IEEEXplore, and ScienceDirect. 76 most relevant publications were set into context as the current state-of-the-art in mental state time-series classification.

RESULTS

Pre-processing techniques, features, and time-series classification models were analyzed. Across publications, a window length of one second was mainly chosen for classification and spectral features were utilized the most. The achieved performance per time-series classification model is analyzed, finding linear discriminant analysis, decision trees, and k-nearest neighbors models outperform support-vector machines by a factor of up to 1.5. A historical analysis depicts future trends while under-reported aspects relevant to practical applications are discussed.

CONCLUSIONS

Five main conclusions are given, covering utilization of available area for electrode placement on the head, most often or scarcely utilized features and time-series classification model architectures, baseline reporting practices, as well as explainability and interpretability of Deep Learning. The importance of a 'test battery' assessing the influence of data pre-processing and multi-modality on time-series classification performance is emphasized.

Modeling Cognitive Load as a Self-Supervised Brain Rate with Electroencephalography and Deep Learning

The principal reason for measuring mental workload is to quantify the cognitive cost of performing tasks to predict human performance. Unfortunately, a method for assessing mental workload that has general applicability does not exist yet. This is due to the abundance of intuitions and several operational definitions from various fields that disagree about the sources or workload, its attributes, the mechanisms to aggregate these into a general model and their impact on human performance. This research built upon these issues and presents a novel method for mental workload modelling from EEG data employing deep learning. This method is self-supervised, employing a continuous brain rate, an index of cognitive activation, and does not require human declarative knowledge. The aim is to induce models automatically from data, supporting replicability, generalisability and applicability across fields and contexts. This specific method is a convolutional recurrent neural network trainable with spatially preserving spectral topographic head-maps from EEG data, aimed at fitting a novel brain rate variable. Findings demonstrate the capacity of the convolutional layers to learn meaningful high-level representations from EEG data since within-subject models had, on average, a test Mean Absolute Percentage Error of around 11%. The addition of a Long-Short Term Memory layer for handling sequences of high-level representations was not significant, although it did improve their accuracy. These findings point to the existence of quasi-stable blocks of automatically learnt high-level representations of cognitive activation because they can be induced through convolution and seem not to be dependent on each other over time, intuitively matching the non-stationary nature of brain responses. Additionally, across-subject models, induced with data from an increasing number of participants, thus trained with data containing more variability, obtained a similar accuracy to the within-subject models. This highlights the potential generalisability of the induced high-level representations across people, suggesting the existence of subject-independent cognitive activation patterns. This research contributes to the body of knowledge by providing scholars with a novel computational method for mental workload modelling that aims to be generally applicable and does not rely on ad hoc human crafted models.

A Novel Approach for Emotion Recognition Based on EEG Signal Using Deep Learning

Emotion can be defined as a voluntary or involuntary reaction to external factors. People express their emotions through actions, such as words, sounds, facial expressions, and body language. However, emotions expressed in such actions are sometimes manipulated by people and real feelings cannot be conveyed clearly. Therefore, understanding and analyzing emotions is essential. Recently, emotion analysis studies based on EEG signals appear to be in the foreground, due to the more reliable data collected. In this study, emotion analysis based on EEG signals was performed and a deep learning model was proposed. The study consists of four stages. In the first stage, EEG data were obtained from the GAMEEMO dataset. In the second stage, EEG signals were transformed with both VMD (variation mode decomposition) and EMD (empirical mode decomposition), and a total of 14 (nine from EMD, five from VMD) IMFs were obtained from each signal. In the third stage, statistical features were obtained from IMFs and maximum value, minimum value, and average values were used for this. In the last stage, both binary-class and multi-class classifications were made. The proposed deep learning model is compared with kNN (k nearest neighbor), SVM (support vector machines), and RF (random forest). At the end of the study, an accuracy of 70.89% in binary-class classification and 90.33% in multi-class classification was obtained with the proposed deep learning method.

TIE-EEGNet: Temporal Information Enhanced EEGNet for Seizure Subtype Classification

Electroencephalogram (EEG) based seizure subtype classification is very important in clinical diagnostics. However, manual seizure subtype classification is expensive and time-consuming, whereas automatic classification usually needs a large number of labeled samples for model training. This paper proposes an EEGNet-based slim deep neural network, which relieves the labeled data requirement in EEG-based seizure subtype classification. A temporal information enhancement module with sinusoidal encoding is used to augment the first convolution layer of EEGNet. A training strategy for automatic hyper-parameter selection is also proposed. Experiments on the public TUSZ dataset and our own CHSZ dataset with infants and children demonstrated that our proposed TIE-EEGNet outperformed several traditional and deep learning models in cross-subject seizure subtype classification. Additionally, it also achieved the best performance in a challenging transfer learning scenario. Both our code and the CHSZ dataset are publicized.

Detection of sleep apnea from single-channel electroencephalogram (EEG) using an explainable convolutional neural network (CNN)

Sleep apnea (SA) is a common disorder involving the cessation of breathing during sleep. It can cause daytime hypersomnia, accidents, and, if allowed to progress, serious, chronic conditions. Continuous positive airway pressure is an effective SA treatment. However, long waitlists impede timely diagnosis; overnight sleep studies involve trained technicians scoring a polysomnograph, which comprises multiple physiological signals including multi-channel electroencephalography (EEG). Therefore, it is important to develop simplified and automated approaches to detect SA. In the present study, we have developed an explainable convolutional neural network (CNN) to detect SA events from single-channel EEG recordings which generalizes across subjects. The network architecture consisted of three convolutional layers. We tuned hyperparameters using the Hyperband algorithm, optimized parameters using Adam, and quantified network performance with subjectwise 10-fold cross-validation. Our CNN performed with an accuracy of 69.9%, and a Matthews correlation coefficient (MCC) of 0.38. To explain the mechanisms of our trained network, we used critical-band masking (CBM): after training, we added bandlimited noise to test recordings; we parametrically varied the noise band center frequency and noise intensity, quantifying the deleterious effect on performance. We reconciled the effects of CBM with lesioning, wherein we zeroed the trained network's 1st-layer filter kernels in turn, quantifying the deleterious effect on performance. These analyses indicated that the network learned frequency-band information consistent with known SA biomarkers, specifically, delta and beta band activity. Our results indicate single-channel EEG may have clinical potential for SA diagnosis.

A novel online BCI system using speech imagery and ear-EEG for home appliances control

BACKGROUND AND OBJECTIVE

This paper investigates a novel way to interact with home appliances via a brain-computer interface (BCI), using electroencephalograph (EEG) signals acquired from around the user's ears with a custom-made wearable BCI headphone.

METHODS

The users engage in speech imagery (SI), a type of mental task where they imagine speaking out a specific word without producing any sound, to control an interactive simulated home appliance. In this work, multiple models are employed to improve the performance of the system. Temporally-stacked multi-band covariance matrix (TSMBC) method is used to represent the neural activities during SI tasks with spatial, temporal, and spectral information included. To further increase the usability of our proposed system in daily life, a calibration session, where the pre-trained models are fine-tuned, is added to maintain performance over time with minimal training. Eleven participants were recruited to evaluate our method over three different sessions: a training session, a calibration session, and an online session where users were given the freedom to achieve a given goal on their own.

RESULTS

In the offline experiment, all participants were able to achieve a classification accuracy significantly higher than the chance level. In the online experiments, a few participants were able to use the proposed system to freely control the home appliance with high accuracy and relatively fast command delivery speed. The best participant achieved an average true positive rate and command delivery time of 0.85 and 3.79 s/command, respectively.

CONCLUSION

Based on the positive experimental results and user surveys, the novel ear-EEG-SI-based BCI paradigm is a promising approach for the wearable BCI system for daily life.

An asynchronous artifact-enhanced electroencephalogram based control paradigm assisted by slight facial expression

In this study, an asynchronous artifact-enhanced electroencephalogram (EEG)-based control paradigm assisted by slight-facial expressions (sFE-paradigm) was developed. The brain connectivity analysis was conducted to reveal the dynamic directional interactions among brain regions under sFE-paradigm. The component analysis was applied to estimate the dominant components of sFE-EEG and guide the signal processing. Enhanced by the artifact within the detected electroencephalogram (EEG), the sFE-paradigm focused on the mainstream defect as the insufficiency of real-time capability, asynchronous logic, and robustness. The core algorithm contained four steps, including “obvious non-sFE-EEGs exclusion,” “interface ‘ON’ detection,” “sFE-EEGs real-time decoding,” and “validity judgment.” It provided the asynchronous function, decoded eight instructions from the latest 100 ms signal, and greatly reduced the frequent misoperation. In the offline assessment, the sFE-paradigm achieved 96.46% ± 1.07 accuracy for interface “ON” detection and 92.68% ± 1.21 for sFE-EEGs real-time decoding, with the theoretical output timespan less than 200 ms. This sFE-paradigm was applied to two online manipulations for evaluating stability and agility. In “object-moving with a robotic arm,” the averaged intersection-over-union was 60.03 ± 11.53%. In “water-pouring with a prosthetic hand,” the average water volume was 202.5 ± 7.0 ml. During online, the sFE-paradigm performed no significant difference (P = 0.6521 and P = 0.7931) with commercial control methods (i.e., FlexPendant and Joystick), indicating a similar level of controllability and agility. This study demonstrated the capability of sFE-paradigm, enabling a novel solution to the non-invasive EEG-based control in real-world challenges.

Antiepileptic Therapy of Abrus cantoniensis: Evidence from Network Pharmacology

The present study explores the mechanism of antiepileptic treatment of Abrus cantoniensis through network pharmacology. During this process, several databases were recruited, e.g., the TCMSP database, HERB database, and SwissTargetPrediction database were used to retrieve the active components and targets of Abrus cantoniensis; GeneCards database and OMIM database were used to retrieve the targets of epilepsy. The targets of epilepsy and Abrus cantoniensis were subjected to target intersection in venny2.1, and protein interaction analysis of Abrus cantoniensis in the String database. We set the Cyto NCA plug-in condition as betweenness; selected the first 8 genes of betweenness as the core genes; performed the integrative bioinformatics of candidates by GO analysis and KEGG analysis. Moreover, AutoDockTools and AutoDockVina software were used to perform the molecular docking; Pymol was used to perform the docking visualization. We obtained three active components of Abrus cantoniensis, which are mainly related to β-sitosterol and stigmasterol; 92 intersection targets of epilepsy of Abrus cantoniensis, including 9 core targets such as AKT1, ESR1, MMP9, CES1, SRC, HIF1A, ABCB1, CASP3, and SNCA; 8 core targets were flavanone constituent proteins. Define p value less than 0.05; according to the screening principle, the first 20 GO pathways and KEGG pathways were selected. We found that Abrus cantoniensis was mainly connected with epilepsy through the neuroactive ligand-receptor interaction signaling pathway, the neurodegeneration pathway, and multiple disease signaling pathway; the docking between ESR1 and components is the most stable among the core targets. Besides, the binding energies of the core targets were all less than −5 kcal mol⁻¹. Taken together, the current research provides a new strategy for the antiepileptic treatment of Abrus cantoniensis.

On-skin paintable biogel for long-term high-fidelity electroencephalogram recording

Long-term high-fidelity electroencephalogram (EEG) recordings are critical for clinical and brain science applications. Conductive liquid-like or solid-like wet interface materials have been conventionally used as reliable interfaces for EEG recording. However, because of their simplex liquid or solid phase, electrodes with them as interfaces confront inadequate dynamic adaptability to hairy scalp, which makes it challenging to maintain stable and efficient contact of electrodes with scalp for long-term EEG recording. Here, we develop an on-skin paintable conductive biogel that shows temperature-controlled reversible fluid-gel transition to address the abovementioned limitation. This phase transition endows the biogel with unique on-skin paintability and in situ gelatinization, establishing conformal contact and dynamic compliance of electrodes with hairy scalp. The biogel is demonstrated as an efficient interface for long-term high-quality EEG recording over several days and for the high-performance capture and classification of evoked potentials. The paintable biogel offers a biocompatible and long-term reliable interface for EEG-based systems.

Nanopower Integrated Gaussian Mixture Model Classifier for Epileptic Seizure Prediction

This paper presents a new analog front-end classification system that serves as a wake-up engine for digital back-ends, targeting embedded devices for epileptic seizure prediction. Predicting epileptic seizures is of major importance for the patient’s quality of life as they can lead to paralyzation or even prove fatal. Existing solutions rely on power hungry embedded digital inference engines that typically consume several μW or even mW. To increase the embedded device’s autonomy, a new approach is presented combining an analog feature extractor with an analog Gaussian mixture model-based binary classifier. The proposed classification system provides an initial, power-efficient prediction with high sensitivity to switch on the digital engine for the accurate evaluation. The classifier’s circuit is chip-area efficient, operating with minimal power consumption (180 nW) at low supply voltage (0.6 V), allowing long-term continuous operation. Based on a real-world dataset, the proposed system achieves 100% sensitivity to guarantee that all seizures are predicted and good specificity (69%), resulting in significant power reduction of the digital engine and therefore the total system. The proposed classifier was designed and simulated in a TSMC 90 nm CMOS process, using the Cadence IC suite.

Communication Requirements in 5G-Enabled Healthcare Applications: Review and Considerations

Fifth generation (5G) mobile communication technology can enable novel healthcare applications and augment existing ones. However, 5G-enabled healthcare applications demand diverse technical requirements for radio communication. Knowledge of these requirements is important for developers, network providers, and regulatory authorities in the healthcare sector to facilitate safe and effective healthcare. In this paper, we review, identify, describe, and compare the requirements for communication key performance indicators in relevant healthcare use cases, including remote robotic-assisted surgery, connected ambulance, wearable and implantable devices, and service robotics for assisted living, with a focus on quantitative requirements. We also compare 5G-healthcare requirements with the current state of 5G capabilities. Finally, we identify gaps in the existing literature and highlight considerations for this space.

Ambulatory EEG: Crossing the divide during a pandemic

The COVID-19 pandemic forced temporary closure of epilepsy monitoring units across the globe due to potential hospital-based contagion. As COVID-19 exposures and deaths continues to surge in the United States and around the world, other types of long-term EEG monitoring have risen to fill the gap and minimize hospital exposure. AEEG has high yield compared to standard EEG. Prolonged audio-visual video-EEG capability can record events and epileptiform activity with quality like inpatient video-EEG monitoring. Technological advances in AEEG using miniaturized hardware and wireless secure transmission have evolved to small portable devices that are perfect for people forced to stay at home during the pandemic. Application of seizure detection algorithms and Cloud-based storage with real-time access provides connectivity to AEEG interpreters during prolonged "shut-down". In this article we highlight the benefits of AEEG as an alternative to diagnostic inpatient VEM during the paradigm shift to mobile heath forced by the Coronavirus.

Wearable Reduced-Channel EEG System for Remote Seizure Monitoring

Epitel has developed Epilog, a miniature, wireless, wearable electroencephalography (EEG) sensor. Four Epilog sensors are combined as part of Epitel's Remote EEG Monitoring platform (REMI) to create 10 channels of EEG for remote patient monitoring. REMI is designed to provide comprehensive spatial EEG recordings that can be administered by non-specialized medical personnel in any medical center. The purpose of this study was to determine how accurate epileptologists are at remotely reviewing Epilog sensor EEG in the 10-channel “REMI montage,” with and without seizure detection support software. Three board certified epileptologists reviewed the REMI montage from 20 subjects who wore four Epilog sensors for up to 5 days alongside traditional video-EEG in the EMU, 10 of whom experienced a total of 24 focal-onset electrographic seizures and 10 of whom experienced no seizures or epileptiform activity. Epileptologists randomly reviewed the same datasets with and without clinical decision support annotations from an automated seizure detection algorithm tuned to be highly sensitive. Blinded consensus review of unannotated Epilog EEG in the REMI montage detected people who were experiencing electrographic seizure activity with 90% sensitivity and 90% specificity. Consensus detection of individual focal onset seizures resulted in a mean sensitivity of 61%, precision of 80%, and false detection rate (FDR) of 0.002 false positives per hour (FP/h) of data. With algorithm seizure detection annotations, the consensus review mean sensitivity improved to 68% with a slight increase in FDR (0.005 FP/h). As seizure detection software, the automated algorithm detected people who were experiencing electrographic seizure activity with 100% sensitivity and 70% specificity, and detected individual focal onset seizures with a mean sensitivity of 90% and mean false alarm rate of 0.087 FP/h. This is the first study showing epileptologists' ability to blindly review EEG from four Epilog sensors in the REMI montage, and the results demonstrate the clinical potential to accurately identify patients experiencing electrographic seizures. Additionally, the automated algorithm shows promise as clinical decision support software to detect discrete electrographic seizures in individual records as accurately as FDA-cleared predicates.

Towards Automatic Identification of Epileptic Recordings in Long-term EEG Monitoring

Electroencephalogram (EEG) is a crucial tool in the diagnosis and management of epilepsy. The process of analyzing EEG is time consuming leading to the development of seizure detection algorithms to aid its analysis. This approach is limited since it requires seizures to occur during monitoring periods and can often lead to misdiagnosis in cases where seizure occurrence is rare. For such cases, it has been shown that the interictal periods in EEG signals, which is the predominant state in long-term monitoring, can be useful for the diagnosis of epilepsy. This paper presents an algorithm, using the information in interictal periods, to discriminate between long-term EEG recordings of epilepsy patients and healthy subjects. It extracts several time and frequency-time domain features from the signals and classifies them using an ensemble classifier, achieving 100% sensitivity and 98.7% specificity in classifying 267 recordings from 105 subjects. The results demonstrate the feasibility of this approach to reliably identify EEG recordings of epilepsy subjects automatically which can be highly useful to facilitate screening and diagnosis of epilepsy, especially in those parts of the world where there is a lack of trained personnel for interpreting EEG signals.

Sensors for Context-Aware Smart Healthcare: A Security Perspective

The advances in the miniaturisation of electronic devices and the deployment of cheaper and faster data networks have propelled environments augmented with contextual and real-time information, such as smart homes and smart cities. These context-aware environments have opened the door to numerous opportunities for providing added-value, accurate and personalised services to citizens. In particular, smart healthcare, regarded as the natural evolution of electronic health and mobile health, contributes to enhance medical services and people's welfare, while shortening waiting times and decreasing healthcare expenditure. However, the large number, variety and complexity of devices and systems involved in smart health systems involve a number of challenging considerations to be considered, particularly from security and privacy perspectives. To this aim, this article provides a thorough technical review on the deployment of secure smart health services, ranging from the very collection of sensors data (either related to the medical conditions of individuals or to their immediate context), the transmission of these data through wireless communication networks, to the final storage and analysis of such information in the appropriate health information systems. As a result, we provide practitioners with a comprehensive overview of the existing vulnerabilities and solutions in the technical side of smart healthcare.

Review of wearable technologies and machine learning methodologies for systematic detection of mild traumatic brain injuries

Mild traumatic brain injuries (mTBIs) are the most common type of brain injury. Timely diagnosis of mTBI is crucial in making 'go/no-go' decision in order to prevent repeated injury, avoid strenuous activities which may prolong recovery, and assure capabilities of high-level performance of the subject. If undiagnosed, mTBI may lead to various short- and long-term abnormalities, which include, but are not limited to impaired cognitive function, fatigue, depression, irritability, and headaches. Existing screening and diagnostic tools to detect acute andearly-stagemTBIs have insufficient sensitivity and specificity. This results in uncertainty in clinical decision-making regarding diagnosis and returning to activity or requiring further medical treatment. Therefore, it is important to identify relevant physiological biomarkers that can be integrated into a mutually complementary set and provide a combination of data modalities for improved on-site diagnostic sensitivity of mTBI. In recent years, the processing power, signal fidelity, and the number of recording channels and modalities of wearable healthcare devices have improved tremendously and generated an enormous amount of data. During the same period, there have been incredible advances in machine learning tools and data processing methodologies. These achievements are enabling clinicians and engineers to develop and implement multiparametric high-precision diagnostic tools for mTBI. In this review, we first assess clinical challenges in the diagnosis of acute mTBI, and then consider recording modalities and hardware implementation of various sensing technologies used to assess physiological biomarkers that may be related to mTBI. Finally, we discuss the state of the art in machine learning-based detection of mTBI and consider how a more diverse list of quantitative physiological biomarker features may improve current data-driven approaches in providing mTBI patients timely diagnosis and treatment.

End-to-end learnable EEG channel selection for deep neural networks with Gumbel-softmax

Objective.To develop an efficient, embedded electroencephalogram (EEG) channel selection approach for deep neural networks, allowing us to match the channel selection to the target model, while avoiding the large computational burdens of wrapper approaches in conjunction with neural networks.Approach.We employ a concrete selector layer to jointly optimize the EEG channel selection and network parameters. This layer uses a Gumbel-softmax trick to build continuous relaxations of the discrete parameters involved in the selection process, allowing them be learned in an end-to-end manner with traditional backpropagation. As the selection layer was often observed to include the same channel twice in a certain selection, we propose a regularization function to mitigate this behavior. We validate this method on two different EEG tasks: motor execution and auditory attention decoding. For each task, we compare the performance of the Gumbel-softmax method with a baseline EEG channel selection approach tailored towards this specific task: mutual information and greedy forward selection with the utility metric respectively.Main results.Our experiments show that the proposed framework is generally applicable, while performing at least as well as (and often better than) these state-of-the-art, task-specific approaches.Significance.The proposed method offers an efficient, task- and model-independent approach to jointly learn the optimal EEG channels along with the neural network weights.

Classifying Multi-Level Stress Responses From Brain Cortical EEG in Nurses and Non-Health Professionals Using Machine Learning Auto Encoder

OBJECTIVE

Mental stress is a major problem in our society and has become an area of interest for many psychiatric researchers. One primary research focus area is the identification of bio-markers that not only identify stress but also predict the conditions (or tasks) that cause stress. Electroencephalograms (EEGs) have been used for a long time to study and identify bio-markers. While these bio-markers have successfully predicted stress in EEG studies for binary conditions, their performance is suboptimal for multiple conditions of stress.

METHODS

To overcome this challenge, we propose using latent based representations of the bio-markers, which have been shown to significantly improve EEG performance compared to traditional bio-markers alone. We evaluated three commonly used EEG based bio-markers for stress, the brain load index (BLI), the spectral power values of EEG frequency bands (alpha, beta and theta), and the relative gamma (RG), with their respective latent representations using four commonly used classifiers.

RESULTS

The results show that spectral power value based bio-markers had a high performance with an accuracy of 83%, while the respective latent representations had an accuracy of 91%.

Harnessing Mobile Health Technology for Secondary Cardiovascular Disease Prevention in Older Adults: A Scientific Statement From the American Heart Association

Secondary prevention of cardiovascular disease (CVD), the leading cause of morbidity and mortality, is critical to improving health outcomes and quality of life in our aging population. As mobile health (mHealth) technology gains universal leverage and popularity, it is becoming more user-friendly for older adults and an adjunct to manage CVD risk and improve overall cardiovascular health. With the rapid advances in mHealth technology and increasing technological engagement of older adults, a comprehensive understanding of the current literature and knowledge of gaps and barriers surrounding the impact of mHealth on secondary CVD prevention is essential. After a systematic review of the literature, 26 studies that used mHealth for secondary CVD prevention focusing on lifestyle behavior change and medication adherence in cohorts with a mean age of ≥60 years were identified. Improvements in health behaviors and medication adherence were observed, particularly when there was a short message service (ie, texting) component involved. Although mobile technologies are becoming more mainstream and are starting to blend more seamlessly with standard health care, there are still distinct barriers that limit implementation particularly in older adults, including affordability, usability, privacy, and security issues. Furthermore, studies on the type of mHealth that is the most effective for older adults with longer study duration are essential as the field continues to grow. As our population ages, identifying and implementing effective, widely accepted, cost-effective, and time-efficient mHealth interventions to improve CVD health in a vulnerable demographic group should be a top health priority.

Next-Generation Wearable Biosensors Developed with Flexible Bio-Chips

The development of biosensors that measure various biosignals from our body is an indispensable research field for health monitoring. In recent years, as the demand to monitor the health conditions of individuals in real time have increased, wearable-type biosensors have received more attention as an alternative to laboratory equipment. These biosensors have been embedded into smart watches, clothes, and accessories to collect various biosignals in real time. Although wearable biosensors attached to the human body can conveniently collect biosignals, there are reliability issues due to noise generated in data collection. In order for wearable biosensors to be more widely used, the reliability of collected data should be improved. Research on flexible bio-chips in the field of material science and engineering might help develop new types of biosensors that resolve the issues of conventional wearable biosensors. Flexible bio-chips with higher precision can be used to collect various human data in academic research and in our daily lives. In this review, we present various types of conventional biosensors that have been used and discuss associated issues such as noise and inaccuracy. We then introduce recent studies on flexible bio-chips as a solution to these issues.

EEG-Based Emotion Classification Using Long Short-Term Memory Network with Attention Mechanism

Recently, studies that analyze emotions based on physiological signals, such as electroencephalogram (EEG), by applying a deep learning algorithm have been actively conducted. However, the study of sequence modeling considering the change of emotional signals over time has not been fully investigated. To consider long-term interaction of emotion, in this study, we propose a long short-term memory network to consider changes in emotion over time and apply an attention mechanism to assign weights to the emotional states appearing at specific moments based on the peak–end rule in psychology. We used 32-channel EEG data from the DEAP database. Two-level (low and high) and three-level (low, middle, and high) classification experiments were performed on the valence and arousal emotion models. The results show accuracies of 90.1% and 87.9% using the two-level classification for the valence and arousal models with four-fold cross validation, respectively. In the case of the three-level classification, these values were obtained as 83.5% and 82.6%, respectively. Additional experiments were conducted using a network combining a convolutional neural network (CNN) submodule with the proposed model. The obtained results showed accuracies of 90.1% and 88.3% in the case of the two-level classification and 86.9% and 84.1% in the case of the three-level classification for the valence and arousal models with four-fold cross validation, respectively. In 10-fold cross validation, there were 91.8% for valence and 91.6% for arousal accuracy, respectively.

Optimal Versus Approximate Channel Selection Methods for EEG Decoding With Application to Topology-Constrained Neuro-Sensor Networks

Channel selection or electrode placement for neural decoding is a commonly encountered problem in electroencephalography (EEG). Since evaluating all possible channel combinations is usually infeasible, one usually has to settle for heuristic methods or convex approximations without optimality guarantees. To date, it remains unclear how large the gap is between the selection made by these approximate methods and the truly optimal selection. The goal of this paper is to quantify this optimality gap for several state-of-the-art channel selection methods in the context of least-squares based neural decoding. To this end, we reformulate the channel selection problem as a mixed-integer quadratic program (MIQP), which allows the use of efficient MIQP solvers to find the optimal channel combination in a feasible computation time for up to 100 candidate channels. As this reveals the exact solution to the combinatorial problem, it allows to quantify the performance losses when using state-of-the-art sub-optimal (yet faster) channel selection methods. In a context of auditory attention decoding, we find that a greedy channel selection based on the utility metric does not show a significant optimality gap compared to optimal channel selection, whereas other state-of-the-art greedy or l₁ -norm penalized methods do show a significant loss in performance. Furthermore, we demonstrate that the MIQP formulation also provides a natural way to incorporate topology constraints in the selection, e.g., for electrode placement in neuro-sensor networks with galvanic separation constraints. Furthermore, a combination of this utility-based greedy selection with an MIQP solver allows to perform a topology constrained electrode placement, even in large scale problems with more than 100 candidate positions.

Readiness among people with epilepsy to carry body-worn monitor devices in everyday life: A qualitative study

OBJECTIVE

There have been intensive efforts to design and develop new wearable technology for epileptic seizure detection. Several studies have focused on the technical aspects, but the readiness of patients with epilepsy (PWEs) to use wearables in everyday life, which is crucial, remains relatively unexplored.

METHODS

We conducted a qualitative interview study involving eight PWEs. The study was designed to provide insights into patient readiness to use wearables for home monitoring of epilepsy.

RESULTS

Three themes were identified: 1) making invisible situations visible, 2) having companionship within a troubled everyday life, and 3) sharing ownership of no recognizable moments. The analysis and interpretation revealed that the expectations of the participants for wearables were rooted in aspects that had a significant impact on their lives and self-image.

CONCLUSION

Patients with epilepsy disclosed that their readiness to use technology, specifically wearables, in everyday life relied on the assumption that they would provide an existential and comforting experience, in which the voids of their individual needs would be addressed in a more patient-friendly manner. Wearable design should consider the valuable insight that technology should be more than just technical tools that monitor symptoms; wearables are expected to be existential and esthetic artifacts that provide PWEs with meaningful experience.

A new era in electroencephalographic monitoring? Subscalp devices for ultra-long-term recordings

Inaccurate subjective seizure counting poses treatment and diagnostic challenges and thus suboptimal quality in epilepsy management. The limitations of existing hospital- and home-based monitoring solutions are motivating the development of minimally invasive, subscalp, implantable electroencephalography (EEG) systems with accompanying cloud-based software. This new generation of ultra-long-term brain monitoring systems is setting expectations for a sea change in the field of clinical epilepsy. From definitive diagnoses and reliable seizure logs to treatment optimization and presurgical seizure foci localization, the clinical need for continuous monitoring of brain electrophysiological activity in epilepsy patients is evident. This paper presents the converging solutions developed independently by researchers and organizations working at the forefront of next generation EEG monitoring. The immediate value of these devices is discussed as well as the potential drivers and hurdles to adoption. Additionally, this paper discusses what the expected value of ultra-long-term EEG data might be in the future with respect to alarms for especially focal seizures, seizure forecasting, and treatment personalization.

Visually evoked responses are enhanced when engaging in a video game

While it is well known that vision guides movement, less appreciated is that the motor cortex also provides input to the visual system. Here, we asked whether neural processing of visual stimuli is acutely modulated during motor activity, hypothesizing that visual evoked responses are enhanced when engaged in a motor task that depends on the visual stimulus. To test this, we told participants that their brain activity was controlling a video game that was in fact the playback of a prerecorded game. The deception, which was effective in half of participants, aimed to engage the motor system while avoiding evoked responses related to actual movement or somatosensation. In other trials, subjects actively played the game with keyboard control or passively watched a playback. The strength of visually evoked responses was measured as the temporal correlation between the continuous stimulus and the evoked potentials on the scalp. We found reduced correlation during passive viewing, but no difference between active and sham play. Alpha‐band (8–12 Hz) activity was reduced over central electrodes during sham play, indicating recruitment of motor cortex despite the absence of overt movement. To account for the potential increase of attention during gameplay, we conducted a second study with subjects counting screen items during viewing. We again found increased correlation during sham play, but no difference between counting and passive viewing. While we cannot fully rule out the involvement of attention, our findings do demonstrate an enhancement of visual evoked responses during active vision.