1
|
Ighalo J, Kirby ED, Song X, Fickling SD, Pawlowski G, Hajra SG, Liu CC, Menon C, Shah SA, Knoefel F, D'Arcy RC. Brain vital signs as a quantitative measure of cognition: Methodological implementation in a care home environment. Heliyon 2024; 10:e28982. [PMID: 38576563 PMCID: PMC10990968 DOI: 10.1016/j.heliyon.2024.e28982] [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: 09/13/2023] [Revised: 03/14/2024] [Accepted: 03/27/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Managing cognitive function in care homes is a significant challenge. Individuals in care have a variety of scores across standard clinical assessments, such as the Mini-Mental Status Exam (MMSE), and many of them have scores that fall within the range associated with dementia. A recent methodological advance, brain vital sign monitoring through auditory event-related potentials, provides an objective and sensitive physiological measurement to track abnormalities, differences, or changes in cognitive function. Taking advantage of point-of-care accessibility, the current study evaluated the methodological feasibility, the assessment of whether a particular research method can be successfully implemented, of quantitatively measuring cognition of care home residents using brain vital signs. Secondarily, the current study examined the relationship between brain vital signs, specifically the cognitive processing associated N400 component, and MMSE scores in care home residents. Materials and methods Brain vital signs used the established N100 (auditory sensation), P300 (basic attention), and N400 (cognitive processing) event-related potential (ERP) components. A total of 52 residents were enrolled, with all participants evaluated using the MMSE. Participants were assigned into homogeneous groups based on their MMSE scores, and were categorized into low (n = 14), medium (n = 17), and high (n = 13) MMSE groups. Both brain vital sign measures and underlying ERP waveforms were examined. Statistical analyses used partial least squares correlation (PLS) analyses in which both MMSE and age were included as factors, as well as jackknife approaches, to test for significant brain vital sign changes. Results The current study successfully measured and analyzed standardized, quantifiable brain vital signs in a care home setting. ERP waveform data showed specific N400 changes between MMSE groups as a function of MMSE score. PLS analyses confirmed significant MMSE-related and age-related differences in the N400 amplitude (p < 0.05, corrected). Similarly, the jackknife approach emphasized the N400 latency difference between the low and high MMSE groups. Discussion and conclusion It was possible to acquire brain vital signs measures in care home residents. Additionally, the current study evaluated brain vital signs relative to MMSE in this group. The comparison revealed significant decreasing in N400 response amplitude (cognitive processing) as a function of both MMSE score and age, as well as a slowing of N400 latency. The findings indicate that objective neurophysiological measures of impairment are detectable in care home residents across the span of MMSE scores. Direct comparison to MMSE- and age-related variables represents a critical initial step ahead of future studies that will investigate relative improvements in sensitivity, validity, reliability and related advantages of brain vital sign monitoring.
Collapse
Affiliation(s)
- Joshua Ighalo
- Simon Fraser University, Faculty of Sciences and Applied Sciences, Metro-Vancouver, Canada
- Health and Technology District, BrainNET, Metro-Vancouver, Canada
| | - Eric D. Kirby
- Simon Fraser University, Faculty of Sciences and Applied Sciences, Metro-Vancouver, Canada
- Health and Technology District, BrainNET, Metro-Vancouver, Canada
| | - Xiaowei Song
- Simon Fraser University, Faculty of Sciences and Applied Sciences, Metro-Vancouver, Canada
- Fraser Health, Surrey Memorial Hospital and Royal Columbian Hospital, Metro-Vancouver, Canada
| | - Shaun D. Fickling
- HealthTech Connex, Centre for Neurology Studies, Metro-Vancouver, Canada
| | - Gabriela Pawlowski
- Simon Fraser University, Faculty of Sciences and Applied Sciences, Metro-Vancouver, Canada
- Health and Technology District, BrainNET, Metro-Vancouver, Canada
| | - Sujoy Ghosh Hajra
- Simon Fraser University, Faculty of Sciences and Applied Sciences, Metro-Vancouver, Canada
- Florida Institute of Technology, College of Engineering and Sciences, Melbourne, FL, USA
| | - Careesa C. Liu
- Simon Fraser University, Faculty of Sciences and Applied Sciences, Metro-Vancouver, Canada
- Florida Institute of Technology, College of Engineering and Sciences, Melbourne, FL, USA
| | - Carlo Menon
- Simon Fraser University, Faculty of Sciences and Applied Sciences, Metro-Vancouver, Canada
- ETH Zurich, Department of Health Sciences and Technology, Zurich, Switzerland
| | - Sudhin A. Shah
- Department of Radiology, Weill Cornell Medicine, New York, USA
| | - Frank Knoefel
- Bruyere Research Institute, Bruyere Memory Program, Ottawa, Canada
- University of Ottawa, Faculty of Medicine, Ottawa, Canada
- Carleton University, Faculty of Engineering and Design, Ottawa, Canada
| | - Ryan C.N. D'Arcy
- Simon Fraser University, Faculty of Sciences and Applied Sciences, Metro-Vancouver, Canada
- Health and Technology District, BrainNET, Metro-Vancouver, Canada
- Fraser Health, Surrey Memorial Hospital and Royal Columbian Hospital, Metro-Vancouver, Canada
- University of British Columbia, DM Centre for Brain Health, Metro-Vancouver, Canada
| |
Collapse
|
2
|
Page C, Liu CC, Meltzer J, Ghosh Hajra S. Blink-Related Oscillations Provide Naturalistic Assessments of Brain Function and Cognitive Workload within Complex Real-World Multitasking Environments. SENSORS (BASEL, SWITZERLAND) 2024; 24:1082. [PMID: 38400241 PMCID: PMC10892680 DOI: 10.3390/s24041082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/14/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND There is a significant need to monitor human cognitive performance in complex environments, with one example being pilot performance. However, existing assessments largely focus on subjective experiences (e.g., questionnaires) and the evaluation of behavior (e.g., aircraft handling) as surrogates for cognition or utilize brainwave measures which require artificial setups (e.g., simultaneous auditory stimuli) that intrude on the primary tasks. Blink-related oscillations (BROs) are a recently discovered neural phenomenon associated with spontaneous blinking that can be captured without artificial setups and are also modulated by cognitive loading and the external sensory environment-making them ideal for brain function assessment within complex operational settings. METHODS Electroencephalography (EEG) data were recorded from eight adult participants (five F, M = 21.1 years) while they completed the Multi-Attribute Task Battery under three different cognitive loading conditions. BRO responses in time and frequency domains were derived from the EEG data, and comparisons of BRO responses across cognitive loading conditions were undertaken. Simultaneously, assessments of blink behavior were also undertaken. RESULTS Blink behavior assessments revealed decreasing blink rate with increasing cognitive load (p < 0.001). Prototypical BRO responses were successfully captured in all participants (p < 0.001). BRO responses reflected differences in task-induced cognitive loading in both time and frequency domains (p < 0.05). Additionally, reduced pre-blink theta band desynchronization with increasing cognitive load was also observed (p < 0.05). CONCLUSION This study confirms the ability of BRO responses to capture cognitive loading effects as well as preparatory pre-blink cognitive processes in anticipation of the upcoming blink during a complex multitasking situation. These successful results suggest that blink-related neural processing could be a potential avenue for cognitive state evaluation in operational settings-both specialized environments such as cockpits, space exploration, military units, etc. and everyday situations such as driving, athletics, human-machine interactions, etc.-where human cognition needs to be seamlessly monitored and optimized.
Collapse
Affiliation(s)
- Cleo Page
- Division of Engineering Science, University of Toronto, Toronto, ON M5S 2E4, Canada
| | - Careesa Chang Liu
- Department of Biomedical Engineering and Science, Florida Institute of Technology, 150 W University Boulevard, Melbourne, FL 32901, USA;
| | - Jed Meltzer
- Baycrest Health Sciences, Toronto, ON M6A 2E1, Canada
| | - Sujoy Ghosh Hajra
- Department of Biomedical Engineering and Science, Florida Institute of Technology, 150 W University Boulevard, Melbourne, FL 32901, USA;
| |
Collapse
|
3
|
Ziccardi A, Van Benthem K, Liu CC, Herdman CM, Ghosh Hajra S. Towards ubiquitous and nonintrusive measurements of brain function in the real world: assessing blink-related oscillations during simulated flight using portable low-cost EEG. Front Neurosci 2024; 17:1286854. [PMID: 38260016 PMCID: PMC10801007 DOI: 10.3389/fnins.2023.1286854] [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: 08/31/2023] [Accepted: 12/06/2023] [Indexed: 01/24/2024] Open
Abstract
Blink-related oscillations (BRO) are newly discovered neurophysiological phenomena associated with spontaneous blinking and represent cascading neural mechanisms including visual sensory, episodic memory, and information processing responses. These phenomena have been shown to be present at rest and during tasks and are modulated by cognitive load, creating the possibility for brain function assessments that can be integrated seamlessly into real-world settings. Prior works have largely examined the BRO phenomenon within controlled laboratory environments using magnetoencephalography and high-density electroencephalography (EEG) that are ill-suited for real-world deployment. Investigating BROs using low-density EEG within complex environments reflective of the real-world would further our understanding of how BRO responses can be utilized in real-world settings. We evaluated whether the BRO response could be captured in a high-fidelity flight simulation environment using a portable, low-density wireless EEG system. The effects of age and task demands on BRO responses were also examined. EEG data from 30 licensed pilots (age 43.37 +/- 17.86, 2 females) were collected during simulated flights at two cognitive workload levels. Comparisons of signal amplitudes were undertaken to confirm the presence of BRO responses and mixed model ANOVAs quantified the effects of workload and age group on BRO amplitudes. Significant increases in neural activity were observed post-blink compared to the baseline period (p < 0.05), confirming the presence of BRO responses. In line with prior studies, results showed BRO time-domain responses from the delta band (0.5-4 Hz) consisting of an early negative peak followed by a positive peak post-blink in temporal and parietal electrodes. Additionally, task workload and age-related effects were also found, with observations of the enhancement of BRO amplitudes with older age and attenuation of BRO responses in high workloads (p < 0.05). These findings demonstrate that it is possible to capture BRO responses within simulated flight environments using portable, low-cost, easy-to-use EEG systems. Furthermore, biological and task salience were reflected in these BRO responses. The successful detection and demonstration of both task-and age-related modulation of BRO responses in this study open the possibility of assessing human brain function across the lifespan with BRO responses in complex and realistic environments.
Collapse
Affiliation(s)
- Alexia Ziccardi
- Department of Cognitive Science, Carleton University, Ottawa, ON, Canada
| | | | - Careesa Chang Liu
- Department of Biomedical Engineering and Science, Florida Institute of Technology, Melbourne, FL, United States
| | - Chris M. Herdman
- Department of Cognitive Science, Carleton University, Ottawa, ON, Canada
| | - Sujoy Ghosh Hajra
- Department of Biomedical Engineering and Science, Florida Institute of Technology, Melbourne, FL, United States
- Aerospace Research Centre, National Research Council Canada, Ottawa, ON, Canada
| |
Collapse
|
4
|
Vlieger R, Suominen H, Apthorp D, Lueck CJ, Daskalaki E. Evaluating methods of oversampling and averaging resting-state electroencephalography data in classifying Parkinson's disease . ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-5. [PMID: 38082678 DOI: 10.1109/embc40787.2023.10340819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Collecting resting-state electroencephalography (RSEEG) data is time-consuming and data sets are therefore often small. Because many machine learning (ML) algorithms work better with ample data, researchers looking to use RSEEG and ML to develop diagnostic models have used oversampling methods that may seem to contradict averaging methods used in conventional electroencephalography (EEG) research to improve the signal-to-noise ratio. Using eyes open (EO) and eyes closed (EC) recordings from 3 different research groups, we investigated the effect of different averaging and oversampling methods on classification metrics when classifying people with Parkinson's disease (PD) and controls. Both EC and EO recordings were used due to differences found between these methods. Our results indicated that grouping 58 electrodes into regions-of-interest (ROI) based on anatomical location is preferable to using single electrodes. Furthermore, although recording EO data led to slightly better classification, the number of data points for each participant was reduced and recordings for three participants entirely lost during pre-processing due to a higher level of artefacts than in the EC data.Clinical relevance- RSEEG is a potential biomarker for the diagnosis and prognostication of PD, but for RSEEG to have clinical relevance, it is necessary to establish which averaging and oversampling of data most reliably segregates the classes for people with PD and controls. We found that using of ROIs and EC data performed the best, as EO data was often contaminated with artefacts.
Collapse
|