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Published in: Journal of NeuroEngineering and Rehabilitation 1/2010

Open Access 01-12-2010 | Research

A decision support framework for the discrimination of children with controlled epilepsy based on EEG analysis

Authors: Vangelis Sakkalis, Tracey Cassar, Michalis Zervakis, Ciprian D Giurcaneanu, Cristin Bigan, Sifis Micheloyannis, Kenneth P Camilleri, Simon G Fabri, Eleni Karakonstantaki, Kostas Michalopoulos

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2010

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Abstract

Background

In this work we consider hidden signs (biomarkers) in ongoing EEG activity expressing epileptic tendency, for otherwise normal brain operation. More specifically, this study considers children with controlled epilepsy where only a few seizures without complications were noted before starting medication and who showed no clinical or electrophysiological signs of brain dysfunction. We compare EEG recordings from controlled epileptic children with age-matched control children under two different operations, an eyes closed rest condition and a mathematical task. The aim of this study is to develop reliable techniques for the extraction of biomarkers from EEG that indicate the presence of minor neurophysiological signs in cases where no clinical or significant EEG abnormalities are observed.

Methods

We compare two different approaches for localizing activity differences and retrieving relevant information for classifying the two groups. The first approach focuses on power spectrum analysis whereas the second approach analyzes the functional coupling of cortical assemblies using linear synchronization techniques.

Results

Differences could be detected during the control (rest) task, but not on the more demanding mathematical task. The spectral markers provide better diagnostic ability than their synchronization counterparts, even though a combination (or fusion) of both is needed for efficient classification of subjects.

Conclusions

Based on these differences, the study proposes concrete biomarkers that can be used in a decision support system for clinical validation. Fusion of selected biomarkers in the Theta and Alpha bands resulted in an increase of the classification score up to 80% during the rest condition. No significant discrimination was achieved during the performance of a mathematical subtraction task.
Appendix
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Literature
1.
go back to reference Shinnar S, Pellock JM: Update on the Epidemiology and Prognosis of Pediatric Epilepsies. J Child Neurol 2002,17(1):S4-17. 10.1177/08830738020170010201CrossRefPubMed Shinnar S, Pellock JM: Update on the Epidemiology and Prognosis of Pediatric Epilepsies. J Child Neurol 2002,17(1):S4-17. 10.1177/08830738020170010201CrossRefPubMed
2.
go back to reference Cowan LD: The epidemiology of the epilepsies in children. Ment Retard Dev Disabil Res Rev 2002, 8: 171-81. 10.1002/mrdd.10035CrossRefPubMed Cowan LD: The epidemiology of the epilepsies in children. Ment Retard Dev Disabil Res Rev 2002, 8: 171-81. 10.1002/mrdd.10035CrossRefPubMed
3.
go back to reference Ben-Ari Y, Holmes GL: Effects of seizures on developmental processes in the immature brain. The Lancet Neurology 2006, 5: 1055-63. 10.1016/S1474-4422(06)70626-3CrossRefPubMed Ben-Ari Y, Holmes GL: Effects of seizures on developmental processes in the immature brain. The Lancet Neurology 2006, 5: 1055-63. 10.1016/S1474-4422(06)70626-3CrossRefPubMed
4.
go back to reference Salinsky MC, Oken BS, Storzbach D, Dodrill CB: Assessment of CNS effects of antiepileptic drugs by using quantitative EEG measures. Epilepsia 2003,44(8):1042-1050. 10.1046/j.1528-1157.2003.60602.xCrossRefPubMed Salinsky MC, Oken BS, Storzbach D, Dodrill CB: Assessment of CNS effects of antiepileptic drugs by using quantitative EEG measures. Epilepsia 2003,44(8):1042-1050. 10.1046/j.1528-1157.2003.60602.xCrossRefPubMed
5.
go back to reference Tuunainen A, Nousiainen U, Pilke A, Mervaala E, Partanen J, Riekkinen P: Spectral EEG during short term discontinuation of antiepileptic medication in partial epilepsy. Epilepsia 1995,36(8):817-823. 10.1111/j.1528-1157.1995.tb01620.xCrossRefPubMed Tuunainen A, Nousiainen U, Pilke A, Mervaala E, Partanen J, Riekkinen P: Spectral EEG during short term discontinuation of antiepileptic medication in partial epilepsy. Epilepsia 1995,36(8):817-823. 10.1111/j.1528-1157.1995.tb01620.xCrossRefPubMed
6.
go back to reference Cornaggia CM, Beghi M, Provenzi M, Beghi E: Correlation between Cognition and Behavior in Epilepsy. Epilepsia 2006,47(Suppl 2):34-39. 10.1111/j.1528-1167.2006.00685.xCrossRefPubMed Cornaggia CM, Beghi M, Provenzi M, Beghi E: Correlation between Cognition and Behavior in Epilepsy. Epilepsia 2006,47(Suppl 2):34-39. 10.1111/j.1528-1167.2006.00685.xCrossRefPubMed
7.
go back to reference Semrud-Clikeman M, Wical B: Components of attention in children with complex partial seizures with and without ADHD. Epilepsia 1999, 40: 211-215. 10.1111/j.1528-1157.1999.tb02077.xCrossRefPubMed Semrud-Clikeman M, Wical B: Components of attention in children with complex partial seizures with and without ADHD. Epilepsia 1999, 40: 211-215. 10.1111/j.1528-1157.1999.tb02077.xCrossRefPubMed
8.
go back to reference McDermott S, Mani S, Krishnaswami S: A population-based analysis of specific behavior problems associated with childhood seizures. J Epilepsy 1995, 8: 110-118. 10.1016/0896-6974(95)00019-ACrossRef McDermott S, Mani S, Krishnaswami S: A population-based analysis of specific behavior problems associated with childhood seizures. J Epilepsy 1995, 8: 110-118. 10.1016/0896-6974(95)00019-ACrossRef
9.
go back to reference Ettinger AB, Weisbrot DM, Nolan EE, Gadow KD, Vitale SA, Andriola MR, Lenn NJ, Novak GP, Hermann BP: Symptoms of depression and anxiety in pediatric epilepsy patients. Epilepsia 1998, 39: 595-599. 10.1111/j.1528-1157.1998.tb01427.xCrossRefPubMed Ettinger AB, Weisbrot DM, Nolan EE, Gadow KD, Vitale SA, Andriola MR, Lenn NJ, Novak GP, Hermann BP: Symptoms of depression and anxiety in pediatric epilepsy patients. Epilepsia 1998, 39: 595-599. 10.1111/j.1528-1157.1998.tb01427.xCrossRefPubMed
10.
go back to reference Pellock J: Understanding co-morbidities affecting children with epilepsy. Neurology 2004, 62: S17-23.CrossRefPubMed Pellock J: Understanding co-morbidities affecting children with epilepsy. Neurology 2004, 62: S17-23.CrossRefPubMed
11.
go back to reference Dunn DW: Neuropsychiatric aspects of epilepsy in children. Epilepsy & Behavior 2003, 4: 101-106.CrossRef Dunn DW: Neuropsychiatric aspects of epilepsy in children. Epilepsy & Behavior 2003, 4: 101-106.CrossRef
12.
go back to reference Micheloyannis S, Sakkalis V, Vourkas M, Stam CJ, Simos PG: Cortical networks involved in mathematical thinking: Evidence from linear and non-linear cortical synchronization of electrical activity. Neuroscience Letters 2005, 373: 212-217. 10.1016/j.neulet.2004.10.005CrossRefPubMed Micheloyannis S, Sakkalis V, Vourkas M, Stam CJ, Simos PG: Cortical networks involved in mathematical thinking: Evidence from linear and non-linear cortical synchronization of electrical activity. Neuroscience Letters 2005, 373: 212-217. 10.1016/j.neulet.2004.10.005CrossRefPubMed
13.
go back to reference Sakkalis V, Cassar T, Zervakis M, Camilleri KP, Fabri SG, Bigan C, Karakonstantaki E, Micheloyannis S: Time-Frequency Analysis and Modelling of EEGs for the evaluation of EEG activity in Young Children with controlled epilepsy. Comput Intel Neurosc (CIN) 2008. doi: 10.1155/2008/462593 Sakkalis V, Cassar T, Zervakis M, Camilleri KP, Fabri SG, Bigan C, Karakonstantaki E, Micheloyannis S: Time-Frequency Analysis and Modelling of EEGs for the evaluation of EEG activity in Young Children with controlled epilepsy. Comput Intel Neurosc (CIN) 2008. doi: 10.1155/2008/462593
14.
go back to reference Von Aster M, Weinhold M: Neuropsychologische Testbatterie für Zahlenverarbeitung und Rechnen bei Kindern (ZAREKI). Mannedorf: Swets Test Services 2002. Von Aster M, Weinhold M: Neuropsychologische Testbatterie für Zahlenverarbeitung und Rechnen bei Kindern (ZAREKI). Mannedorf: Swets Test Services 2002.
15.
go back to reference Ford M, Goethe J, Dekker D: EEG coherence and power changes during a continuous movement task. Int J Psychophysiol 1986, 4: 99-110. 10.1016/0167-8760(86)90003-6CrossRefPubMed Ford M, Goethe J, Dekker D: EEG coherence and power changes during a continuous movement task. Int J Psychophysiol 1986, 4: 99-110. 10.1016/0167-8760(86)90003-6CrossRefPubMed
16.
go back to reference Sakkalis V, Zervakis M, Micheloyannis S: Significant EEG features involved in mathematical reasoning: evidence from wavelet analysis. Brain Topography 2006, 19: 53-60. 10.1007/s10548-006-0012-zCrossRefPubMed Sakkalis V, Zervakis M, Micheloyannis S: Significant EEG features involved in mathematical reasoning: evidence from wavelet analysis. Brain Topography 2006, 19: 53-60. 10.1007/s10548-006-0012-zCrossRefPubMed
17.
go back to reference Rosso OA, Martin MT, Figliola A, Keller K, Plastino A: EEG analysis using wavelet-based information tools. J Neurosci Methods 2006, 153: 163-182. 10.1016/j.jneumeth.2005.10.009CrossRefPubMed Rosso OA, Martin MT, Figliola A, Keller K, Plastino A: EEG analysis using wavelet-based information tools. J Neurosci Methods 2006, 153: 163-182. 10.1016/j.jneumeth.2005.10.009CrossRefPubMed
18.
go back to reference Torrence C, Compo GP: A practical Guide to Wavelet Analysis. Bull Am Meteorol Soc 1998, 79: 61-78. 10.1175/1520-0477(1998)079<0061:APGTWA>2.0.CO;2CrossRef Torrence C, Compo GP: A practical Guide to Wavelet Analysis. Bull Am Meteorol Soc 1998, 79: 61-78. 10.1175/1520-0477(1998)079<0061:APGTWA>2.0.CO;2CrossRef
19.
go back to reference Willoughby JO, Fitzgibbon SP, Pope KJ, Mackenzie L, Medvedev AV, Clark CR, Davey MP, Wilcox RA: Persistent abnormality detected in the non-ictal electroencephalogram in primary generalised epilepsy. Journal of Neurology, Neurosurgery, and Psychiatry 2003,74(1):51-55. 10.1136/jnnp.74.1.51PubMedCentralCrossRefPubMed Willoughby JO, Fitzgibbon SP, Pope KJ, Mackenzie L, Medvedev AV, Clark CR, Davey MP, Wilcox RA: Persistent abnormality detected in the non-ictal electroencephalogram in primary generalised epilepsy. Journal of Neurology, Neurosurgery, and Psychiatry 2003,74(1):51-55. 10.1136/jnnp.74.1.51PubMedCentralCrossRefPubMed
20.
go back to reference Larsson PG, Kostov H: Lower frequency variability in the alpha activity in EEG among patients with epilepsy. Clinical Neurophysiology 2005, 116: 2701-2706. 10.1016/j.clinph.2005.07.019CrossRefPubMed Larsson PG, Kostov H: Lower frequency variability in the alpha activity in EEG among patients with epilepsy. Clinical Neurophysiology 2005, 116: 2701-2706. 10.1016/j.clinph.2005.07.019CrossRefPubMed
21.
go back to reference Brovelli A, Ding M, Ledberg A, Chen Y, Nakamura R, Bressler SL: Beta oscillations in a large-scale sensorimotor cortical network: directional influences revealed by Granger causality. Proc Natl Acad Sci USA 2004,101(26):9849-9854. 10.1073/pnas.0308538101PubMedCentralCrossRefPubMed Brovelli A, Ding M, Ledberg A, Chen Y, Nakamura R, Bressler SL: Beta oscillations in a large-scale sensorimotor cortical network: directional influences revealed by Granger causality. Proc Natl Acad Sci USA 2004,101(26):9849-9854. 10.1073/pnas.0308538101PubMedCentralCrossRefPubMed
22.
go back to reference Sakkalis V, Giurcăneanu CD, Xanthopoulos P, Zervakis M, Tsiaras V, Yang Y, Micheloyannis S: Assessment of linear and nonlinear synchronization measures for analyzing EEG in a mild epileptic paradigm. IEEE Trans Inf Tech 2009,13(4):433-441. (DOI: 10.1109/TITB.2008.923141) 10.1109/TITB.2008.923141CrossRef Sakkalis V, Giurcăneanu CD, Xanthopoulos P, Zervakis M, Tsiaras V, Yang Y, Micheloyannis S: Assessment of linear and nonlinear synchronization measures for analyzing EEG in a mild epileptic paradigm. IEEE Trans Inf Tech 2009,13(4):433-441. (DOI: 10.1109/TITB.2008.923141) 10.1109/TITB.2008.923141CrossRef
23.
go back to reference Whittle P: On the fitting of multivariate autoregressions and the approximate canonical factorization of a spectral density matrix. Biometrika 1963, 50: 129-134.CrossRef Whittle P: On the fitting of multivariate autoregressions and the approximate canonical factorization of a spectral density matrix. Biometrika 1963, 50: 129-134.CrossRef
24.
go back to reference Wiggins R, Robinson E: Recursive solution to the multichannel filtering problem. J Geophysical Research 1966, 70: 1885-1891. 10.1029/JZ070i008p01885CrossRef Wiggins R, Robinson E: Recursive solution to the multichannel filtering problem. J Geophysical Research 1966, 70: 1885-1891. 10.1029/JZ070i008p01885CrossRef
25.
go back to reference Rissanen J: Modeling by shortest data description. Automatica 1978, 14: 465-471. 10.1016/0005-1098(78)90005-5CrossRef Rissanen J: Modeling by shortest data description. Automatica 1978, 14: 465-471. 10.1016/0005-1098(78)90005-5CrossRef
26.
go back to reference Zar JH: Biostatistical Analysis. New Jersey USA: Prentice-Hall; 1999. Zar JH: Biostatistical Analysis. New Jersey USA: Prentice-Hall; 1999.
27.
go back to reference Lee PL, Wu YT, Chen LF, Chen YS, Cheng CM, Yeh TC, Ho LT, Chang MS, Hsieh JC: ICA-based spatiotemporal approach for single-trial analysis of postmovement MEG beta synchronization. Neuroimage 2003, 20: 2010-1030. 10.1016/j.neuroimage.2003.07.024CrossRefPubMed Lee PL, Wu YT, Chen LF, Chen YS, Cheng CM, Yeh TC, Ho LT, Chang MS, Hsieh JC: ICA-based spatiotemporal approach for single-trial analysis of postmovement MEG beta synchronization. Neuroimage 2003, 20: 2010-1030. 10.1016/j.neuroimage.2003.07.024CrossRefPubMed
28.
go back to reference Krause CM, Boman PA, Sillanmäki L, Varho T, Holopainen IE: Brain Oscillatory EEG event-related desynchronization (ERD) and -synchronization (ERS) responses during an auditory memory task are altered in children with epilepsy. Seizure 2008, 17: 1-10. 10.1016/j.seizure.2007.05.015CrossRefPubMed Krause CM, Boman PA, Sillanmäki L, Varho T, Holopainen IE: Brain Oscillatory EEG event-related desynchronization (ERD) and -synchronization (ERS) responses during an auditory memory task are altered in children with epilepsy. Seizure 2008, 17: 1-10. 10.1016/j.seizure.2007.05.015CrossRefPubMed
29.
go back to reference Fitzgibbon SP, Pope KJ, Mackenzie L, Clark CR, Willoughby JO: Cognitive tasks augment gamma EEG power. Clinical Neurophysiology 2004, 115: 1802-1809. 10.1016/j.clinph.2004.03.009CrossRefPubMed Fitzgibbon SP, Pope KJ, Mackenzie L, Clark CR, Willoughby JO: Cognitive tasks augment gamma EEG power. Clinical Neurophysiology 2004, 115: 1802-1809. 10.1016/j.clinph.2004.03.009CrossRefPubMed
30.
go back to reference Miyauchi T, Endo K, Yamaguchi T, Hagimoto H: Computerized Analysis of EEG Background Activity in Epileptic Patients. Epilepsia 1991,32(6):870-881. 10.1111/j.1528-1157.1991.tb05544.xCrossRefPubMed Miyauchi T, Endo K, Yamaguchi T, Hagimoto H: Computerized Analysis of EEG Background Activity in Epileptic Patients. Epilepsia 1991,32(6):870-881. 10.1111/j.1528-1157.1991.tb05544.xCrossRefPubMed
31.
go back to reference Klimesch W: EEG alpha and theta oscillations reflect cognitive and memory performance: a review and analysis. Brain Research Reviews 1999, 29: 169-195. 10.1016/S0165-0173(98)00056-3CrossRefPubMed Klimesch W: EEG alpha and theta oscillations reflect cognitive and memory performance: a review and analysis. Brain Research Reviews 1999, 29: 169-195. 10.1016/S0165-0173(98)00056-3CrossRefPubMed
33.
go back to reference Keil A, Müller M, Ray WJ, Gruber T, Elbert T: Human Gamma Band Activity and Perception of a Gestalt. The Journal of Neuroscience 1999,19(16):7152-7161.PubMed Keil A, Müller M, Ray WJ, Gruber T, Elbert T: Human Gamma Band Activity and Perception of a Gestalt. The Journal of Neuroscience 1999,19(16):7152-7161.PubMed
34.
go back to reference Olesen J, Baker MG, Freund T, Di Luca M, Mendlewicz J, Ragan I, Westphal M: Consensus document of European brain research. J Neurology, Neurosurgery, Psychiatry 2006, 77: 1-49. 10.1136/jnnp.2005.078287CrossRef Olesen J, Baker MG, Freund T, Di Luca M, Mendlewicz J, Ragan I, Westphal M: Consensus document of European brain research. J Neurology, Neurosurgery, Psychiatry 2006, 77: 1-49. 10.1136/jnnp.2005.078287CrossRef
Metadata
Title
A decision support framework for the discrimination of children with controlled epilepsy based on EEG analysis
Authors
Vangelis Sakkalis
Tracey Cassar
Michalis Zervakis
Ciprian D Giurcaneanu
Cristin Bigan
Sifis Micheloyannis
Kenneth P Camilleri
Simon G Fabri
Eleni Karakonstantaki
Kostas Michalopoulos
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2010
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/1743-0003-7-24

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