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Oczka D, Augustynek M, Penhaker M, Kubicek J. Electrogastrography measurement systems and analysis methods used in clinical practice and research: comprehensive review. Front Med (Lausanne) 2024; 11:1369753. [PMID: 39011457 PMCID: PMC11248517 DOI: 10.3389/fmed.2024.1369753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 06/03/2024] [Indexed: 07/17/2024] Open
Abstract
Electrogastrography (EGG) is a non-invasive method with high diagnostic potential for the prevention of gastroenterological pathologies in clinical practice. In this study, a review of the measurement systems, procedures, and methods of analysis used in electrogastrography is presented. A critical review of historical and current literature is conducted, focusing on electrode placement, measurement apparatus, measurement procedures, and time-frequency domain methods of filtration and analysis of the non-invasively measured electrical activity of the stomach. As a result, 129 relevant articles with primary aim on experimental diet were reviewed in this study. Scopus, PubMed, and Web of Science databases were used to search for articles in English language, according to the specific query and using the PRISMA method. The research topic of electrogastrography has been continuously growing in popularity since the first measurement by professor Alvarez 100 years ago, and there are many researchers and companies interested in EGG nowadays. Measurement apparatus and procedures are still being developed in both commercial and research settings. There are plenty variable electrode layouts, ranging from minimal numbers of electrodes for ambulatory measurements to very high numbers of electrodes for spatial measurements. Most authors used in their research anatomically approximated layout with two++ active electrodes in bipolar connection and commercial electrogastrograph with sampling rate of 2 or 4 Hz. Test subjects were usually healthy adults and diet was controlled. However, evaluation methods are being developed at a slower pace, and usually the signals are classified only based on dominant frequency. The main review contributions include the overview of spectrum of measurement systems and procedures for electrogastrography developed by many authors, but a firm medical standard has not yet been defined. Therefore, it is not possible to use this method in clinical practice for objective diagnosis. Systematic Review Registration https://www.prisma-statement.org/.
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Affiliation(s)
- David Oczka
- Department of Cybernetics and Biomedical Engineering, VSB-Technical University of Ostrava, Ostrava, Czechia
| | - Martin Augustynek
- Department of Cybernetics and Biomedical Engineering, VSB-Technical University of Ostrava, Ostrava, Czechia
| | - Marek Penhaker
- Department of Cybernetics and Biomedical Engineering, VSB-Technical University of Ostrava, Ostrava, Czechia
| | - Jan Kubicek
- Department of Cybernetics and Biomedical Engineering, VSB-Technical University of Ostrava, Ostrava, Czechia
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Erickson JC, Stepanyan E, Hassid E. Comparison of Dry and Wet Electrodes for Detecting Gastrointestinal Activity Patterns from Body Surface Electrical Recordings. Ann Biomed Eng 2023; 51:1310-1321. [PMID: 36656453 DOI: 10.1007/s10439-023-03137-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 12/25/2022] [Indexed: 01/20/2023]
Abstract
Gastrointestinal motility patterns can be mapped via electrical signals measured non-invasively on the body surface. However, short-term (≈ 2-4 h) meal response studies as well as long-term monitoring (≥ 24 h) may be hindered by skin irritation inherent with traditional Ag/AgCl pre-gelled ("wet") electrodes. The aim of this work was to investigate the practical utility of using dry electrodes for GI body-surface electrical measurements. To directly compare dry vs. wet electrodes, we simultaneously recorded electrical signals from both types arranged in a 9-electrode array during an ≈ 2.5 h colonic meal-response study. Wavelet-based analyses were used to identify the signature post-meal colonic cyclic motor patterns. Blinded comparison of signal quality was carried out by four expert manual reviewers in order to assess the practical utility of each electrode type for identifying GI activity patterns. Dry electrodes recorded high-quality GI signals with signal-to-noise ratio of 10.0 ± 3.5 dB, comparable to that of wet electrodes (9.9 ± 3.6 dB). Although users rated dry electrodes as slightly more difficult to self-apply, they caused no skin irritation and were thus better tolerated overall. Dry electrodes are a more comfortable alternative to conventional wet electrode systems, and may offer a potentially viable option for long-term GI monitoring studies.
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Affiliation(s)
- Jonathan C Erickson
- Department of Physics and Engineering, Washington and Lee University, Lexington, VA, USA.
| | - Elen Stepanyan
- Department of Physics and Engineering, Washington and Lee University, Lexington, VA, USA
| | - Emily Hassid
- Department of Physics and Engineering, Washington and Lee University, Lexington, VA, USA
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Makeyev O, Ye-Lin Y, Prats-Boluda G, Garcia-Casado J. Finite element method modeling to confirm the results of comprehensive optimization of the tripolar concentric ring electrode based on its finite dimensions model. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:7244-7247. [PMID: 34892770 DOI: 10.1109/embc46164.2021.9629784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Concentric ring electrodes are noninvasive and wearable sensors for electrophysiological measurement capable of estimating the surface Laplacian (second spatial derivative of surface potential) at each electrode. Significant progress has been made toward optimization of inter-ring distances (distances between the recording surfaces of the electrode), maximizing the accuracy of the surface Laplacian estimate based on the negligible dimensions model of the electrode. However, novel finite dimensions model offers comprehensive optimization including all of the electrode parameters simultaneously by including the radius of the central disc and the widths of the concentric rings into the model. Recently, such comprehensive optimization problem has been solved analytically for the tripolar electrode configuration. This study, for the first time, introduces a finite dimensions model based finite element method model (as opposed to the negligible dimensions model based one used in the past) to confirm the analytic results. Specifically, finite element method modeling results confirmed that previously proposed linearly increasing inter-ring distances and constant inter-ring distances configurations of tripolar concentric ring electrodes correspond to an almost two-fold and more than three-fold increases in relative and normalized maximum errors of Laplacian estimation when directly compared to the optimal tripolar concentric ring electrode configuration of the same size.Clinical Relevance- This study assesses and confirms the electrode configuration that maximizes the accuracy of the estimated Laplacian recorded via concentric ring electrodes. Therefore, it is potentially useful for designing future concentric ring electrodes for diagnostic purposes such as localization of epileptic foci.
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Makeyev O, Ye-Lin Y, Prats-Boluda G, Garcia-Casado J. Comprehensive Optimization of the Tripolar Concentric Ring Electrode Based on Its Finite Dimensions Model and Confirmed by Finite Element Method Modeling. SENSORS 2021; 21:s21175881. [PMID: 34502772 PMCID: PMC8434583 DOI: 10.3390/s21175881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/13/2021] [Accepted: 08/28/2021] [Indexed: 11/16/2022]
Abstract
The optimization performed in this study is based on the finite dimensions model of the concentric ring electrode as opposed to the negligible dimensions model used in the past. This makes the optimization problem comprehensive, as all of the electrode parameters including, for the first time, the radius of the central disc and individual widths of concentric rings, are optimized simultaneously. The optimization criterion used is maximizing the accuracy of the surface Laplacian estimation, as the ability to estimate the Laplacian at each electrode constitutes primary biomedical significance of concentric ring electrodes. For tripolar concentric ring electrodes, the optimal configuration was compared to previously proposed linearly increasing inter-ring distances and constant inter-ring distances configurations of the same size and based on the same finite dimensions model. The obtained analytic results suggest that previously proposed configurations correspond to almost two-fold and more than three-fold increases in the Laplacian estimation error compared with the optimal configuration proposed in this study, respectively. These analytic results are confirmed using finite element method modeling, which was adapted to the finite dimensions model of the concentric ring electrode for the first time. Moreover, the finite element method modeling results suggest that optimal electrode configuration may also offer improved sensitivity and spatial resolution.
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Affiliation(s)
- Oleksandr Makeyev
- School of STEM, Diné College, Tsaile, AZ 86556, USA
- Correspondence: ; Tel.: +1-928-724-6960
| | - Yiyao Ye-Lin
- Centro de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, 46022 Valencia, Spain; (Y.Y.-L.); (G.P.-B.); (J.G.-C.)
| | - Gema Prats-Boluda
- Centro de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, 46022 Valencia, Spain; (Y.Y.-L.); (G.P.-B.); (J.G.-C.)
| | - Javier Garcia-Casado
- Centro de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, 46022 Valencia, Spain; (Y.Y.-L.); (G.P.-B.); (J.G.-C.)
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Garcia-Casado J, Prats-Boluda G, Ye-Lin Y, Restrepo-Agudelo S, Perez-Giraldo E, Orozco-Duque A. Evaluation of Swallowing Related Muscle Activity by Means of Concentric Ring Electrodes. SENSORS (BASEL, SWITZERLAND) 2020; 20:s20185267. [PMID: 32942616 PMCID: PMC7570555 DOI: 10.3390/s20185267] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/07/2020] [Accepted: 09/10/2020] [Indexed: 06/11/2023]
Abstract
Surface electromyography (sEMG) can be helpful for evaluating swallowing related muscle activity. Conventional recordings with disc electrodes suffer from significant crosstalk from adjacent muscles and electrode-to-muscle fiber orientation problems, while concentric ring electrodes (CREs) offer enhanced spatial selectivity and axial isotropy. The aim of this work was to evaluate CRE performance in sEMG recordings of the swallowing muscles. Bipolar recordings were taken from 21 healthy young volunteers when swallowing saliva, water and yogurt, first with a conventional disc and then with a CRE. The signals were characterized by the root-mean-square amplitude, signal-to-noise ratio, myopulse, zero-crossings, median frequency, bandwidth and bilateral muscle cross-correlations. The results showed that CREs have advantages in the sEMG analysis of swallowing muscles, including enhanced spatial selectivity and the associated reduction in crosstalk, the ability to pick up a wider range of EMG frequency components and easier electrode placement thanks to its radial symmetry. However, technical changes are recommended in the future to ensure that the lower CRE signal amplitude does not significantly affect its quality. CREs show great potential for improving the clinical monitoring and evaluation of swallowing muscle activity. Future work on pathological subjects will assess the possible advantages of CREs in dysphagia monitoring and diagnosis.
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Affiliation(s)
- Javier Garcia-Casado
- Centro de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, 46022 Valencia, Spain; (G.P.-B.); (Y.Y.-L.)
| | - Gema Prats-Boluda
- Centro de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, 46022 Valencia, Spain; (G.P.-B.); (Y.Y.-L.)
| | - Yiyao Ye-Lin
- Centro de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, 46022 Valencia, Spain; (G.P.-B.); (Y.Y.-L.)
| | - Sebastián Restrepo-Agudelo
- Grupo de Investigación e Innovación Biomédica, Instituto Tecnológico Metropolitano, Medellín 050012, Colombia; (S.R.-A.); (E.P.-G.); (A.O.-D.)
| | - Estefanía Perez-Giraldo
- Grupo de Investigación e Innovación Biomédica, Instituto Tecnológico Metropolitano, Medellín 050012, Colombia; (S.R.-A.); (E.P.-G.); (A.O.-D.)
| | - Andrés Orozco-Duque
- Grupo de Investigación e Innovación Biomédica, Instituto Tecnológico Metropolitano, Medellín 050012, Colombia; (S.R.-A.); (E.P.-G.); (A.O.-D.)
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Estrada-Petrocelli L, Torres A, Sarlabous L, Rafols-de-Urquia M, Ye-Lin Y, Prats-Boluda G, Jane R, Garcia-Casado J. Evaluation of Respiratory Muscle Activity by Means of Concentric Ring Electrodes. IEEE Trans Biomed Eng 2020; 68:1005-1014. [PMID: 32746073 DOI: 10.1109/tbme.2020.3012385] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Surface electromyography (sEMG) can be used for the evaluation of respiratory muscle activity. Recording sEMG involves the use of surface electrodes in a bipolar configuration. However, electrocardiographic (ECG) interference and electrode orientation represent considerable drawbacks to bipolar acquisition. As an alternative, concentric ring electrodes (CREs) can be used for sEMG acquisition and offer great potential for the evaluation of respiratory muscle activity due to their enhanced spatial resolution and simple placement protocol, which does not depend on muscle fiber orientation. The aim of this work was to analyze the performance of CREs during respiratory sEMG acquisitions. Respiratory muscle sEMG was applied to the diaphragm and sternocleidomastoid muscles using a bipolar and a CRE configuration. Thirty-two subjects underwent four inspiratory load spontaneous breathing tests which was repeated after interchanging the electrode positions. We calculated parameters such as (1) spectral power and (2) median frequency during inspiration, and power ratios of inspiratory sEMG without ECG in relation to (3) basal sEMG without ECG (Rins/noise), (4) basal sEMG with ECG (Rins/cardio) and (5) expiratory sEMG without ECG (Rins/exp). Spectral power, Rins/noise and Rins/cardio increased with the inspiratory load. Significantly higher values (p < 0.05) of Rins/cardio and significantly higher median frequencies were obtained for CREs. Rins/noise and Rins/exp were higher for the bipolar configuration only in diaphragm sEMG recordings, whereas no significant differences were found in the sternocleidomastoid recordings. Our results suggest that the evaluation of respiratory muscle activity by means of sEMG can benefit from the remarkably reduced influence of cardiac activity, the enhanced detection of the shift in frequency content and the axial isotropy of CREs which facilitates its placement.
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Aghaei-Lasboo A, Inoyama K, Fogarty AS, Kuo J, Meador KJ, Walter JJ, Le ST, Graber KD, Razavi B, Fisher RS. Tripolar concentric EEG electrodes reduce noise. Clin Neurophysiol 2019; 131:193-198. [PMID: 31809982 DOI: 10.1016/j.clinph.2019.10.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/21/2019] [Accepted: 10/26/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assay EEG signal quality recorded with tripolar concentric ring electrodes (TCREs) compared to regular EEG electrodes. METHODS EEG segments were recorded simultaneously by TCREs and regular electrodes, low-pass filtered at 35 Hz (REG35) and 70 Hz (REG70). Clips were rated blindly by nine electroencephalographers for presence or absence of key EEG features, relative to the "gold-standard" of the clinical report. RESULTS TCRE showed less EMG artifact (F = 15.4, p < 0.0001). Overall quality rankings were not significantly different. Focal slowing was better detected by TCRE and spikes were better detected by regular electrodes. Seizures (n = 85) were detected by TCRE in 64 cases (75.3%), by REG70 in 75 (88.2%) and REG35 in 69 (81.2%) electrodes. TCRE detected 9 (10.6%) seizures not detected by one of the other 2 methods. In contrast, 14 seizures (16.5%) were not detected by TCRE, but were by REG35 electrodes. Each electrode detected interictal spikes when the other did not. CONCLUSIONS TCRE produced similar overall quality and confidence ratings versus regular electrodes, but less muscle artifact. TCRE recordings detected seizures in 7% of instances where regular electrodes did not. SIGNIFICANCE The combination of the two types increased detection of epileptiform events compared to either alone.
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Affiliation(s)
- Anahita Aghaei-Lasboo
- Bass Medical Group, Department of Neurology, Suite 301, 400 Taylor Blvd, Pleasant Hill, CA 94523, USA
| | - Katherine Inoyama
- NYU Langone Comprehensive Epilepsy Center, 240 East 38th Street, New York, NY 10016, USA
| | - Adam S Fogarty
- Stanford University Department of Neurology and Neurological Sciences, Palo Alto, CA 94304, USA
| | - Jonathan Kuo
- Clinical Neurology, Keck School of Medicine USC, 1520 San Pablo St, Suite 3000, Los Angeles, CA 90033, USA
| | - Kimford J Meador
- Stanford University Department of Neurology and Neurological Sciences, Palo Alto, CA 94304, USA
| | - Jessica J Walter
- Stanford University Department of Neurology and Neurological Sciences, Palo Alto, CA 94304, USA
| | - Scheherazade T Le
- Stanford University Department of Neurology and Neurological Sciences, Palo Alto, CA 94304, USA
| | - Kevin D Graber
- Stanford University Department of Neurology and Neurological Sciences, Palo Alto, CA 94304, USA
| | - Babak Razavi
- Stanford University Department of Neurology and Neurological Sciences, Palo Alto, CA 94304, USA
| | - Robert S Fisher
- Stanford University Department of Neurology and Neurological Sciences, Palo Alto, CA 94304, USA.
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Evaluation of Bipolar, Tripolar, and Quadripolar Laplacian Estimates of Electrocardiogram via Concentric Ring Electrodes. SENSORS 2019; 19:s19173780. [PMID: 31480426 PMCID: PMC6749387 DOI: 10.3390/s19173780] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 08/22/2019] [Accepted: 08/28/2019] [Indexed: 12/17/2022]
Abstract
Surface Laplacian estimates via concentric ring electrodes (CREs) have proven to enhance spatial resolution compared to conventional disc electrodes, which is of great importance for P-wave analysis. In this study, Laplacian estimates for traditional bipolar configuration (BC), two tripolar configurations with linearly decreasing and increasing inter-ring distances (TCLDIRD and TCLIIRD, respectively), and quadripolar configuration (QC) were obtained from cardiac recordings with pentapolar CREs placed at CMV1 and CMV2 positions. Normalized P-wave amplitude (NAP) was computed to assess the contrast to study atrial activity. Signals were of good quality (20-30 dB). Atrial activity was more emphasized at CMV1 (NAP ≃ 0.19-0.24) compared to CMV2 (NAP ≃ 0.08-0.10). Enhanced spatial resolution of TCLIIRD and QC resulted in higher NAP values than BC and TCLDIRD. Comparison with simultaneous standard 12-lead ECG proved that Laplacian estimates at CMV1 outperformed all the limb and chest standard leads in the contrast to study P-waves. Clinical recordings with CRE at this position could allow more detailed observation of atrial activity and facilitate the diagnosis of associated pathologies. Furthermore, such recordings would not require additional electrodes on limbs and could be performed wirelessly, so it should also be suitable for ambulatory monitoring, for example, using cardiac Holter monitors.
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