1
|
Armoundas AA, Narayan SM, Arnett DK, Spector-Bagdady K, Bennett DA, Celi LA, Friedman PA, Gollob MH, Hall JL, Kwitek AE, Lett E, Menon BK, Sheehan KA, Al-Zaiti SS. Use of Artificial Intelligence in Improving Outcomes in Heart Disease: A Scientific Statement From the American Heart Association. Circulation 2024; 149:e1028-e1050. [PMID: 38415358 PMCID: PMC11042786 DOI: 10.1161/cir.0000000000001201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
A major focus of academia, industry, and global governmental agencies is to develop and apply artificial intelligence and other advanced analytical tools to transform health care delivery. The American Heart Association supports the creation of tools and services that would further the science and practice of precision medicine by enabling more precise approaches to cardiovascular and stroke research, prevention, and care of individuals and populations. Nevertheless, several challenges exist, and few artificial intelligence tools have been shown to improve cardiovascular and stroke care sufficiently to be widely adopted. This scientific statement outlines the current state of the art on the use of artificial intelligence algorithms and data science in the diagnosis, classification, and treatment of cardiovascular disease. It also sets out to advance this mission, focusing on how digital tools and, in particular, artificial intelligence may provide clinical and mechanistic insights, address bias in clinical studies, and facilitate education and implementation science to improve cardiovascular and stroke outcomes. Last, a key objective of this scientific statement is to further the field by identifying best practices, gaps, and challenges for interested stakeholders.
Collapse
|
2
|
Jiang Y, Sleigh J. Consciousness and General Anesthesia: Challenges for Measuring the Depth of Anesthesia. Anesthesiology 2024; 140:313-328. [PMID: 38193734 DOI: 10.1097/aln.0000000000004830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
The optimal consciousness level required for general anesthesia with surgery is unclear, but in existing practice, anesthetic oblivion, may be incomplete. This article discusses the concept of consciousness, how it is altered by anesthetics, the challenges for assessing consciousness, currently used technologies for assessing anesthesia levels, and future research directions. Wakefulness is marked by a subjective experience of existence (consciousness), perception of input from the body or the environment (connectedness), the ability for volitional responsiveness, and a sense of continuity in time. Anesthetic drugs may selectively impair some of these components without complete extinction of the subjective experience of existence. In agreement with Sanders et al. (2012), the authors propose that a state of disconnected consciousness is the optimal level of anesthesia, as it likely avoids both awareness and the possible dangers of oversedation. However, at present, there are no reliably tested indices that can discriminate between connected consciousness, disconnected consciousness, and complete unconsciousness.
Collapse
Affiliation(s)
- Yandong Jiang
- Department of Anesthesiology, Critical Care and Pain Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
| | - Jamie Sleigh
- Department of Anesthesiology, University of Auckland, Hamilton, New Zealand
| |
Collapse
|
3
|
Gordillo D, Ramos da Cruz J, Moreno D, Garobbio S, Herzog MH. Do we really measure what we think we are measuring? iScience 2023; 26:106017. [PMID: 36844457 PMCID: PMC9947309 DOI: 10.1016/j.isci.2023.106017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/18/2022] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
Tests used in the empirical sciences are often (implicitly) assumed to be representative of a given research question in the sense that similar tests should lead to similar results. Here, we show that this assumption is not always valid. We illustrate our argument with the example of resting-state electroencephalogram (EEG). We used multiple analysis methods, contrary to typical EEG studies where one analysis method is used. We found, first, that many EEG features correlated significantly with cognitive tasks. However, these EEG features correlated weakly with each other. Similarly, in a second analysis, we found that many EEG features were significantly different in older compared to younger participants. When we compared these EEG features pairwise, we did not find strong correlations. In addition, EEG features predicted cognitive tasks poorly as shown by cross-validated regression analysis. We discuss several explanations of these results.
Collapse
Affiliation(s)
- Dario Gordillo
- Laboratory of Psychophysics, Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
- Corresponding author
| | - Janir Ramos da Cruz
- Laboratory of Psychophysics, Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
- Institute for Systems and Robotics – Lisboa (LARSyS), Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisbon, Portugal
- Wyss Center for Bio and Neuroengineering, CH-1202 Geneva, Switzerland
| | - Dana Moreno
- Laboratory of Psychophysics, Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - Simona Garobbio
- Laboratory of Psychophysics, Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - Michael H. Herzog
- Laboratory of Psychophysics, Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| |
Collapse
|
4
|
Alves CL, Cury RG, Roster K, Pineda AM, Rodrigues FA, Thielemann C, Ciba M. Application of machine learning and complex network measures to an EEG dataset from ayahuasca experiments. PLoS One 2022; 17:e0277257. [PMID: 36525422 PMCID: PMC9757568 DOI: 10.1371/journal.pone.0277257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/23/2022] [Indexed: 12/23/2022] Open
Abstract
Ayahuasca is a blend of Amazonian plants that has been used for traditional medicine by the inhabitants of this region for hundreds of years. Furthermore, this plant has been demonstrated to be a viable therapy for a variety of neurological and mental diseases. EEG experiments have found specific brain regions that changed significantly due to ayahuasca. Here, we used an EEG dataset to investigate the ability to automatically detect changes in brain activity using machine learning and complex networks. Machine learning was applied at three different levels of data abstraction: (A) the raw EEG time series, (B) the correlation of the EEG time series, and (C) the complex network measures calculated from (B). Further, at the abstraction level of (C), we developed new measures of complex networks relating to community detection. As a result, the machine learning method was able to automatically detect changes in brain activity, with case (B) showing the highest accuracy (92%), followed by (A) (88%) and (C) (83%), indicating that connectivity changes between brain regions are more important for the detection of ayahuasca. The most activated areas were the frontal and temporal lobe, which is consistent with the literature. F3 and PO4 were the most important brain connections, a significant new discovery for psychedelic literature. This connection may point to a cognitive process akin to face recognition in individuals during ayahuasca-mediated visual hallucinations. Furthermore, closeness centrality and assortativity were the most important complex network measures. These two measures are also associated with diseases such as Alzheimer's disease, indicating a possible therapeutic mechanism. Moreover, the new measures were crucial to the predictive model and suggested larger brain communities associated with the use of ayahuasca. This suggests that the dissemination of information in functional brain networks is slower when this drug is present. Overall, our methodology was able to automatically detect changes in brain activity during ayahuasca consumption and interpret how these psychedelics alter brain networks, as well as provide insights into their mechanisms of action.
Collapse
Affiliation(s)
- Caroline L. Alves
- BioMEMS Lab, Aschaffenburg University of Applied Sciences (UAS), Aschaffenburg, Germany
- Institute of Mathematical and Computer Sciences, University of São Paulo (USP), São Paulo, Brazil
- * E-mail:
| | - Rubens Gisbert Cury
- Department of Neurology, Movement Disorders Center, University of São Paulo (USP), São Paulo, Brazil
| | - Kirstin Roster
- Institute of Mathematical and Computer Sciences, University of São Paulo (USP), São Paulo, Brazil
| | - Aruane M. Pineda
- Institute of Mathematical and Computer Sciences, University of São Paulo (USP), São Paulo, Brazil
| | - Francisco A. Rodrigues
- Institute of Mathematical and Computer Sciences, University of São Paulo (USP), São Paulo, Brazil
| | - Christiane Thielemann
- BioMEMS Lab, Aschaffenburg University of Applied Sciences (UAS), Aschaffenburg, Germany
| | - Manuel Ciba
- BioMEMS Lab, Aschaffenburg University of Applied Sciences (UAS), Aschaffenburg, Germany
| |
Collapse
|
5
|
Schmidt D, English G, Gent TC, Yanik MF, von der Behrens W. Machine learning reveals interhemispheric somatosensory coherence as indicator of anesthetic depth. Front Neuroinform 2022; 16:971231. [PMID: 36172256 PMCID: PMC9510780 DOI: 10.3389/fninf.2022.971231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
The goal of this study was to identify features in mouse electrocorticogram recordings that indicate the depth of anesthesia as approximated by the administered anesthetic dosage. Anesthetic depth in laboratory animals must be precisely monitored and controlled. However, for the most common lab species (mice) few indicators useful for monitoring anesthetic depth have been established. We used electrocorticogram recordings in mice, coupled with peripheral stimulation, in order to identify features of brain activity modulated by isoflurane anesthesia and explored their usefulness in monitoring anesthetic depth through machine learning techniques. Using a gradient boosting regressor framework we identified interhemispheric somatosensory coherence as the most informative and reliable electrocorticogram feature for determining anesthetic depth, yielding good generalization and performance over many subjects. Knowing that interhemispheric somatosensory coherence indicates the effectively administered isoflurane concentration is an important step for establishing better anesthetic monitoring protocols and closed-loop systems for animal surgeries.
Collapse
Affiliation(s)
- Dominik Schmidt
- Institute of Neuroinformatics, Department of Information Technology and Electrical Engineering (D-ITET), ETH Zurich, University of Zurich, Zurich, Switzerland
| | - Gwendolyn English
- Institute of Neuroinformatics, Department of Information Technology and Electrical Engineering (D-ITET), ETH Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), Eidgenössische Technische Hochschule Zürich (ETH), University of Zurich, Zurich, Switzerland
| | - Thomas C. Gent
- Institute of Neuroinformatics, Department of Information Technology and Electrical Engineering (D-ITET), ETH Zurich, University of Zurich, Zurich, Switzerland
- Anaesthesiology Section, Vetsuisse Faculty, Department of Clinical Diagnostics and Services, University of Zurich, Zurich, Switzerland
| | - Mehmet Fatih Yanik
- Institute of Neuroinformatics, Department of Information Technology and Electrical Engineering (D-ITET), ETH Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), Eidgenössische Technische Hochschule Zürich (ETH), University of Zurich, Zurich, Switzerland
| | - Wolfger von der Behrens
- Institute of Neuroinformatics, Department of Information Technology and Electrical Engineering (D-ITET), ETH Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), Eidgenössische Technische Hochschule Zürich (ETH), University of Zurich, Zurich, Switzerland
- *Correspondence: Wolfger von der Behrens
| |
Collapse
|
6
|
A novel approach for detection of consciousness level in comatose patients from EEG signals with 1-D convolutional neural network. Biocybern Biomed Eng 2022. [DOI: 10.1016/j.bbe.2021.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
7
|
Martinek R, Ladrova M, Sidikova M, Jaros R, Behbehani K, Kahankova R, Kawala-Sterniuk A. Advanced Bioelectrical Signal Processing Methods: Past, Present and Future Approach-Part II: Brain Signals. SENSORS (BASEL, SWITZERLAND) 2021; 21:6343. [PMID: 34640663 PMCID: PMC8512967 DOI: 10.3390/s21196343] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/12/2021] [Accepted: 09/14/2021] [Indexed: 12/14/2022]
Abstract
As it was mentioned in the previous part of this work (Part I)-the advanced signal processing methods are one of the quickest and the most dynamically developing scientific areas of biomedical engineering with their increasing usage in current clinical practice. In this paper, which is a Part II work-various innovative methods for the analysis of brain bioelectrical signals were presented and compared. It also describes both classical and advanced approaches for noise contamination removal such as among the others digital adaptive and non-adaptive filtering, signal decomposition methods based on blind source separation, and wavelet transform.
Collapse
Affiliation(s)
- Radek Martinek
- Department of Cybernetics and Biomedical Engineering, VSB-Technical University Ostrava—FEECS, 708 00 Ostrava-Poruba, Czech Republic; (M.L.); (M.S.); (R.J.); (R.K.)
| | - Martina Ladrova
- Department of Cybernetics and Biomedical Engineering, VSB-Technical University Ostrava—FEECS, 708 00 Ostrava-Poruba, Czech Republic; (M.L.); (M.S.); (R.J.); (R.K.)
| | - Michaela Sidikova
- Department of Cybernetics and Biomedical Engineering, VSB-Technical University Ostrava—FEECS, 708 00 Ostrava-Poruba, Czech Republic; (M.L.); (M.S.); (R.J.); (R.K.)
| | - Rene Jaros
- Department of Cybernetics and Biomedical Engineering, VSB-Technical University Ostrava—FEECS, 708 00 Ostrava-Poruba, Czech Republic; (M.L.); (M.S.); (R.J.); (R.K.)
| | - Khosrow Behbehani
- College of Engineering, The University of Texas in Arlington, Arlington, TX 76019, USA;
| | - Radana Kahankova
- Department of Cybernetics and Biomedical Engineering, VSB-Technical University Ostrava—FEECS, 708 00 Ostrava-Poruba, Czech Republic; (M.L.); (M.S.); (R.J.); (R.K.)
| | - Aleksandra Kawala-Sterniuk
- Faculty of Electrical Engineering, Automatic Control and Informatics, Opole University of Technology, 45-758 Opole, Poland
| |
Collapse
|