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Urdanibia-Centelles O, Nielsen RM, Rostrup E, Vedel-Larsen E, Thomsen K, Nikolic M, Johnsen B, Møller K, Lauritzen M, Benedek K. Automatic continuous EEG signal analysis for diagnosis of delirium in patients with sepsis. Clin Neurophysiol 2021; 132:2075-2082. [PMID: 34284242 DOI: 10.1016/j.clinph.2021.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 04/12/2021] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE In critical care, continuous EEG (cEEG) monitoring is useful for delirium diagnosis. Although visual cEEG analysis is most commonly used, automatic cEEG analysis has shown promising results in small samples. Here we aimed to compare visual versus automatic cEEG analysis for delirium diagnosis in septic patients. METHODS We obtained cEEG recordings from 102 septic patients who were scored for delirium six times daily. A total of 1252 cEEG blocks were visually analyzed, of which 805 blocks were also automatically analyzed. RESULTS Automatic cEEG analyses revealed that delirium was associated with 1) high mean global field power (p < 0.005), mainly driven by delta activity; 2) low average coherence across all electrode pairs and all frequencies (p < 0.01); 3) lack of intrahemispheric (fronto-temporal and temporo-occipital regions) and interhemispheric coherence (p < 0.05); and 4) lack of cEEG reactivity (p < 0.005). Classification accuracy was assessed by receiver operating characteristic (ROC) curve analysis, revealing a slightly higher area under the curve for visual analysis (0.88) than automatic analysis (0.74) (p < 0.05). CONCLUSIONS Automatic cEEG analysis is a useful supplement to visual analysis, and provides additional cEEG diagnostic classifiers. SIGNIFICANCE Automatic cEEG analysis provides useful information in septic patients.
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Affiliation(s)
- Olalla Urdanibia-Centelles
- Department of Clinical Neurophysiology, The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Valdemar Hansens Vej 1-23, Glostrup, Denmark; Center for Healthy Aging and Department of Neuroscience, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
| | - Rikke M Nielsen
- Department of Neuroanesthesiology, The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Egill Rostrup
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen University Hospital, Valdemar Hansens Vej 1-23, Glostrup, Denmark.
| | - Esben Vedel-Larsen
- Department of Clinical Neurophysiology, The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Valdemar Hansens Vej 1-23, Glostrup, Denmark.
| | - Kirsten Thomsen
- Center for Healthy Aging and Department of Neuroscience, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
| | - Miki Nikolic
- Department of Clinical Neurophysiology, The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Valdemar Hansens Vej 1-23, Glostrup, Denmark.
| | - Birger Johnsen
- Department of Clinical Neurophysiology, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark.
| | - Kirsten Møller
- Department of Neuroanesthesiology, The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Denmark.
| | - Martin Lauritzen
- Department of Clinical Neurophysiology, The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Valdemar Hansens Vej 1-23, Glostrup, Denmark; Center for Healthy Aging and Department of Neuroscience, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
| | - Krisztina Benedek
- Department of Clinical Neurophysiology, The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Valdemar Hansens Vej 1-23, Glostrup, Denmark.
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