Peak and averaged bicoherence for different EEG patterns during general anaesthesia

Changes in electroencephalographic power and bicoherence spectra according to depth of dexmedetomidine sedation in patients undergoing spinal anesthesia

Background: Assessment the depth of dexmedetomidine sedation using electroencephalographic (EEG) features can improve the quality of procedural sedation. Previous volunteer studies of dexmedetomidine-induced EEG changes need to be validated, and changes in bicoherence spectra during dexmedetomidine sedation has not been revealed yet. We aimed to investigate the dexmedetomidine-induced EEG change using power spectral and bicoherence analyses in the clinical setting. Patients and Methods: Thirty-six patients undergoing orthopedic surgery under spinal anesthesia were enrolled in this study. Dexmedetomidine sedation was conducted by the stepwise increase in target effect site concentration (Ce) while assessing sedation levels. Bispectral index (BIS) and frontal electroencephalography were recorded continuously, and the performance of BIS and changes in power and bicoherence spectra were analyzed with the data from the F3 electrode. Results: The prediction probability values for detecting different sedation levels were 0.847, 0.841, and 0.844 in BIS, 95% spectral edge frequency, and dexmedetomidine Ce, respectively. As the depth of sedation increased, δ power increased, but high β and γ power decreased significantly (P <0.001). α and spindle power increased significantly under light and moderate sedation (P <0.001 in light vs baseline and deep sedation; P = 0.002 and P <0.001 in moderate sedation vs baseline and deep sedation, respectively). The bicoherence peaks of the δ and α-spindle regions along the diagonal line of the bicoherence matrix emerged during moderate and deep sedation. Peak bicoherence in the δ area showed sedation-dependent increases (29.93%±7.38%, 36.72%±9.70%, 44.88%±12.90%; light, moderate, and deep sedation; P = 0.008 and P <0.001 in light sedation vs moderate and deep sedation, respectively; P = 0.007 in moderate sedation vs deep sedation), whereas peak bicoherence in the α-spindle area did not change (22.92%±4.90%, 24.72%±4.96%, and 26.96%±8.42%, respectively; P=0.053). Conclusions: The increase of δ power and the decrease of high-frequency power were associated with the gradual deepening of dexmedetomidine sedation. The δ bicoherence peak increased with increasing sedation level and can serve as an indicator reflecting dexmedetomidine sedation levels.

Anaesthesia-dependent oscillatory EEG features in the super-elderly

OBJECTIVE

Although the characteristics of electroencephalograms (EEGs) have been reported to change with age, anaesthesia-dependent oscillatory features and reactivity of the super-elderly EEG to anaesthesia have not been examined in detail.

METHODS

Participants comprised 20 super-elderly patients (age; mean ± standard deviation, 87.1 ± 3.8 years) and 20 young adult patients (35.5 ± 8.5 years). At three levels of sevoflurane anaesthesia (minimum alveolar concentration [MAC] of 0.3, 0.7, and 1.4), oscillatory features of the frontal EEG were examined by analysing quadratic phase coupling (bicoherence) and power spectrum in α and δ-θ areas and compared in an anaesthesia-dependent manner, using the Friedman test.

RESULTS

Among super-elderly individuals, bicoherences in the δ-θ area showed anaesthesia-dependent increases (median [interquartile range], 12.9% [5.2%], 19.2% [9.1%], 23.3% [8.7%]; 0.3, 0.7, 1.4 MAC sevoflurane, p = 0.000), whereas bicoherence in the α area did not change at these different anaesthesia levels (11.2% [3.9%], 12.5% [4.4%], 14.1% [5.7%], respectively; p = 0.142), counter to the results found in young adult patients, where both δ-θ and α bicoherences changed with anaesthesia.

CONCLUSIONS

In the super-elderly, δ-θ bicoherence of EEG shows anaesthesia- dependent changes, whereas α activity remains small irrespective of anaesthesia level.

SIGNIFICANCE

Quantification of δ-θ bicoherence is a candidate for anaesthesia monitoring in the super-elderly.

Electroencephalography quadratic phase self-coupling correlates with consciousness states and restoration in patients with disorders of consciousness

OBJECTIVE

The objective of this study was to explore the role for quadratic phase coupling within electroencephalography (EEG) oscillations in the diagnosis of consciousness and consciousness restoration for disorders of consciousness (DOC).

METHODS

Fifty-one DOC patients were enrolled in this study. For each patient, a Coma Recovery Scale-Revised (CRS-R) score and 20-min resting-state EEG were recorded. Consciousness recovery was assessed with a CRS-R score at a three-month follow-up. Twenty healthy subjects were included as controls. General harmonic wavelet transform-based bicoherence was used to quantify the quadratic phase coupling characteristics of the EEG oscillations.

RESULTS

Quadratic phase self-coupling (QPSC) at the delta (QPSC_delta), theta (QPSC_theta) and alpha (QPSC_alpha) bands were closely correlated with patient CRS-R scores. Particularly, the QPSC_theta value could significantly differentiate between vegetative state (VS) patients, minimally conscious state (MCS) patients and healthy control subjects. As compared to VS patients, patients with MCS had a lower QPSC_theta value on the left as well as a higher QPSC_alpha value in right frontal regions. The frontal QPSC_theta value showed significant differences between recovered and unrecovered patients.

CONCLUSION

QPSC characteristics could differentiate between consciousness states and show a predictive ability for the recovery of consciousness in DOC patients.

SIGNIFICANCE

Changes in QPSC accompany consciousness injury and restoration in DOC patients. A QPSC assessment is helpful in the diagnosis and prognosis of DOC patients.

ENHANCING IMPLICIT LEARNING WITH POSTHYPNOTIC SUGGESTION: An ERP Study

Can posthypnotic suggestion (PHS) enhance cognitive abilities? The authors tested behaviorally and with event-related potentials (ERP) if sequential learning (SL), the ability to learn statistical regularities, can be enhanced with PHS. Thirty adults were assessed with the Stanford Hypnotic Susceptibility Scale (Form C) and an auditory SL task. Before this task, half the sample received a PHS to enhance SL, and the other half received the same suggestion under normal waking state. Response times and ERPs indicated a strong effect of PHS. Compared to the control group, PHS inverted, attenuated, or left unaffected the response time SL effect in low, medium, and high hypnotizability participants, respectively. These results suggest that PHS cannot be used to enhance SL.

Effect of pattern awareness on the behavioral and neurophysiological correlates of visual statistical learning

Statistical learning is the ability to extract predictive patterns from structured input. A common assumption is that statistical learning is a type of implicit learning that does not result in explicit awareness of learned patterns. However, there is also some evidence that statistical learning may involve explicit processing to some extent. The purpose of this study was to examine the effect of pattern awareness on behavioral and neurophysiological correlates of visual statistical learning. Participants completed a visual learning task while behavioral responses and event-related potentials were recorded. Following the completion of the task, awareness of statistical patterns was assessed through a questionnaire scored by three independent raters. Behavioral findings indicated learning only for participants exhibiting high pattern awareness levels. Neurophysiological data indicated that only the high-pattern awareness group showed expected P300 event-related potential learning effects, although there was also some indication that the low awareness groups showed a sustained mid- to late-latency negativity. Linear mixed-model analyses confirmed that only the high awareness group showed neurophysiological indications of learning. Finally, source estimation results revealed left hemispheric activation was associated with statistical learning extending from frontal to occipital and parietal regions. Further analyses suggested that left insula, left parahippocampal, and right precentral regions showed different levels of activation based on pattern awareness. To conclude, we found that pattern awareness, a dimension associated with explicit processing, strongly influences the behavioral and neurophysiological correlates of visual statistical learning.

Non-linear Analysis of Scalp EEG by Using Bispectra: The Effect of the Reference Choice

Bispectral analysis is a signal processing technique that makes it possible to capture the non-linear and non-Gaussian properties of the EEG signals. It has found various applications in EEG research and clinical practice, including the assessment of anesthetic depth, the identification of epileptic seizures, and more recently, the evaluation of non-linear cross-frequency brain functional connectivity. However, the validity and reliability of the indices drawn from bispectral analysis of EEG signals are potentially biased by the use of a non-neutral EEG reference. The present study aims at investigating the effects of the reference choice on the analysis of the non-linear features of EEG signals through bicoherence, as well as on the estimation of cross-frequency EEG connectivity through two different non-linear measures, i.e., the cross-bicoherence and the antisymmetric cross-bicoherence. To this end, four commonly used reference schemes were considered: the vertex electrode (Cz), the digitally linked mastoids, the average reference, and the Reference Electrode Standardization Technique (REST). The reference effects were assessed both in simulations and in a real EEG experiment. The simulations allowed to investigated: (i) the effects of the electrode density on the performance of the above references in the estimation of bispectral measures; and (ii) the effects of the head model accuracy in the performance of the REST. For real data, the EEG signals recorded from 10 subjects during eyes open resting state were examined, and the distortions induced by the reference choice in the patterns of alpha-beta bicoherence, cross-bicoherence, and antisymmetric cross-bicoherence were assessed. The results showed significant differences in the findings depending on the chosen reference, with the REST providing superior performance than all the other references in approximating the ideal neutral reference. In conclusion, this study highlights the importance of considering the effects of the reference choice in the interpretation and comparison of the results of bispectral analysis of scalp EEG.

Cross-frequency coupling during isoflurane anaesthesia as revealed by electroencephalographic harmonic wavelet bicoherence

BACKGROUND

Fourier bicoherence has previously been applied to investigate phase coupling in the EEG in anaesthesia. However, there are significant theoretical limitations regarding its sensitivity in detecting transient episodes of inter-frequency coupling. Therefore, we used a recently developed wavelet bicoherence method to investigate the cross-frequency coupling in the EEG of patients under isoflurane anaesthesia; examining the relationship between the patterns of wavelet bicoherence and the isoflurane concentrations.

METHODS

We analysed a set of previously published EEG data, obtained from 29 patients who underwent elective abdominal surgery under isoflurane anaesthesia. Artifact-free, 1 min EEG segments at different isoflurane concentrations were extracted from each subject and the wavelet bicoherence calculated for all pairs of frequencies from 0.5 to 20 Hz.

RESULTS

Isoflurane caused two peaks in the α (6-13 Hz) and slow δ (<1 Hz) regions of the bicoherence matrix diagonal. Higher concentrations of isoflurane shifted the α peak to lower frequencies [11.3 (0.9) Hz at 0.3% to 7.1 (1.2) Hz at 1.5%], as has been previously observed in the power spectra. Outside the diagonal, we also found a significant α peak that was phase-coupled to the slow δ waves; higher concentrations of isoflurane shifted this peak to lower frequencies [10.8 (1.2) to 7.7 (0.7) Hz].

CONCLUSIONS

Isoflurane caused cross-frequency coupling between α and slow δ waves. Increasing isoflurane concentration slowed the α frequencies where the coupling had occurred. This phenomenon of α-δ coupling suggests that slow cortical oscillations organize the higher α band activity, which is consistent with other studies in natural sleep.

Changes in N400 topography following intensive speech language therapy for individuals with aphasia

Our goal was to characterize the effects of intensive aphasia therapy on the N400, an electrophysiological index of lexical-semantic processing. Immediately before and after 4 weeks of intensive speech-language therapy, people with aphasia performed a task in which they had to determine whether spoken words were a 'match' or a 'mismatch' to pictures of objects. Pre-therapy, people with aphasia exhibited an N400 mismatch effect that started over right hemisphere electrodes. Post-therapy, gains were seen in clinical measures of language ability, and the onset of the N400 was left-lateralized. No changes in the scalp distribution of the N400 were observed in healthy controls tested twice over the same 4 week interval. Since the distribution of the N400 after aphasia therapy differed from that of healthy controls, we conclude that it reflects the engagement of compensatory neural mechanisms for language processing rather than a return to a "normal" pattern of brain activation.

The influence of language proficiency on lexical semantic processing in native and late learners of English

We investigated the influence of English proficiency on ERPs elicited by lexical semantic violations in English sentences, in both native English speakers and native Spanish speakers who learned English in adulthood. All participants were administered a standardized test of English proficiency, and data were analyzed using linear mixed effects (LME) modeling. Relative to native learners, late learners showed reduced amplitude and delayed onset of the N400 component associated with reading semantic violations. As well, after the N400 late learners showed reduced anterior negative scalp potentials and increased posterior potentials. In both native and late learners, N400 amplitudes to semantically appropriate words were larger for people with lower English proficiency. N400 amplitudes to semantic violations, however, were not influenced by proficiency. Although both N400 onset latency and the late ERP effects differed between L1 and L2 learners, neither correlated with proficiency. Different approaches to dealing with the high degree of correlation between proficiency and native/late learner group status are discussed in the context of LME modeling. The results thus indicate that proficiency can modulate ERP effects in both L1 and L2 learners, and for some measures (in this case, N400 amplitude), L1-L2 differences may be entirely accounted for by proficiency. On the other hand, not all effects of L2 learning can be attributed to proficiency. Rather, the differences in N400 onset and the post-N400 violation effects appear to reflect fundamental differences in L1-L2 processing.

Real-time feature extraction of P300 component using adaptive nonlinear principal component analysis

BACKGROUND

The electroencephalography (EEG) signals are known to involve the firings of neurons in the brain. The P300 wave is a high potential caused by an event-related stimulus. The detection of P300s included in the measured EEG signals is widely investigated. The difficulties in detecting them are that they are mixed with other signals generated over a large brain area and their amplitudes are very small due to the distance and resistivity differences in their transmittance.

METHODS

A novel real-time feature extraction method for detecting P300 waves by combining an adaptive nonlinear principal component analysis (ANPCA) and a multilayer neural network is proposed. The measured EEG signals are first filtered using a sixth-order band-pass filter with cut-off frequencies of 1 Hz and 12 Hz. The proposed ANPCA scheme consists of four steps: pre-separation, whitening, separation, and estimation. In the experiment, four different inter-stimulus intervals (ISIs) are utilized: 325 ms, 350 ms, 375 ms, and 400 ms.

RESULTS

The developed multi-stage principal component analysis method applied at the pre-separation step has reduced the external noises and artifacts significantly. The introduced adaptive law in the whitening step has made the subsequent algorithm in the separation step to converge fast. The separation performance index has varied from -20 dB to -33 dB due to randomness of source signals. The robustness of the ANPCA against background noises has been evaluated by comparing the separation performance indices of the ANPCA with four algorithms (NPCA, NSS-JD, JADE, and SOBI), in which the ANPCA algorithm demonstrated the shortest iteration time with performance index about 0.03. Upon this, it is asserted that the ANPCA algorithm successfully separates mixed source signals.

CONCLUSIONS

The independent components produced from the observed data using the proposed method illustrated that the extracted signals were clearly the P300 components elicited by task-related stimuli. The experiment using 350 ms ISI showed the best performance. Since the proposed method does not use down-sampling and averaging, it can be used as a viable tool for real-time clinical applications.

Spectral features of electroencephalogram in characterizing various brain states under anesthesia

The administration of the anesthetic agents is known to alter the electroencephalogram (EEG) signal significantly with the brain being their primary target. In this study, we analyzed the EEG recorded from six ASA I/II patients undergoing a 1-2 hour surgery. The EEG was collected before and during induction, maintenance and recovery of anesthesia using the 10/20 lead-system. A combination of fentanyl and propofol (± rocuronium) was used for induction and a Sevoflurane in air/O(2) mixture was administered through an endotracheal tube to achieve the steady minimum alveolar concentration (MAC). This study showed that 0 to 4 Hz signal power was most sensitive to the changes associated with induction of anesthesia whereas the 4 to 12 Hz power was important in classifying states during maintenance of anesthesia. Anesthesia also promoted heightened phase coherence in 8 to 16 Hz and 16 to 30 Hz ranges during maintenance and induction of anesthesia, respectively. Additionally, strong cross-frequency coupling between 7 to 20 Hz and 10 to 40 Hz was observed during anesthesia suggesting alteration of neural coding.