Artifact removal in magnetoencephalogram background activity with independent component analysis

The aim of this study was to assess whether independent component analysis (ICA) could be valuable to remove power line noise, cardiac, and ocular artifacts from magnetoencephalogram (MEG) background activity. The MEGs were recorded from 11 subjects with a 148-channel whole-head magnetometer. We used a statistical criterion to estimate the number of independent components. Then, a robust ICA algorithm decomposed the MEG epochs and several methods were applied to detect those artifacts. The whole process had been previously tested on synthetic data. We found that the line noise components could be easily detected by their frequency spectrum. In addition, the ocular artifacts could be identified by their frequency characteristics and scalp topography. Moreover, the cardiac artifact was better recognized by its skewness value than by its kurtosis one. Finally, the MEG signals were compared before and after artifact rejection to evaluate our method.     

Interpretation of the Lempel-Ziv complexity measure in the context of biomedical signal analysis

Lempel-Ziv complexity (LZ) and derived LZ algorithms have been extensively used to solve information theoretic problems such as coding and lossless data compression. In recent years, LZ has been widely used in biomedical applications to estimate the complexity of discrete-time signals. Despite its popularity as a complexity measure for biosignal analysis, the question of LZ interpretability and its relationship to other signal parameters and to other metrics has not been previously addressed. We have carried out an investigation aimed at gaining a better understanding of the LZ complexity itself, especially regarding its interpretability as a biomedical signal analysis technique. Our results indicate that LZ is particularly useful as a scalar metric to estimate the bandwidth of random processes and the harmonic variability in quasi-periodic signals.     

Interpretation of approximate entropy: analysis of intracranial pressure approximate entropy during acute intracranial hypertension

We studied changes in intracranial pressure (ICP) complexity, estimated by the approximate entropy (ApEn) of the ICP signal, as subjects progressed from a state of normal ICP (< 20-25 mmHg) to acutely elevated ICP (an ICP "spike" defined as ICP > 25 mmHg for < or = 5 min). We hypothesized that the measures of intracranial pressure (ICP) complexity and irregularity would decrease during acute elevations in ICP. To test this hypothesis we studied ICP spikes in pediatric subjects with severe traumatic brain injury (TBI). We conclude that decreased complexity of ICP coincides with episodes of intracranial hypertension (ICH) in TBI. This suggests that the complex regulatory mechanisms that govern intracranial pressure are disrupted during acute rises in ICP. Furthermore, we carried out a series of experiments where ApEn was used to analyze synthetic signals of different characteristics with the objective of gaining a better understanding of ApEn itself, especially its interpretation in biomedical signal analysis.     

Usefulness of preoperative location studies in the initial surgical intervention in primary hyperparathyroidism

BACKGROUND: The aim of the study was to assess whether preoperative localization is helpful in improving the outcome of initial surgery of primary hyperparathyroidism (PHPT). PATIENTS AND METHODS: Retrospective review of 100 patients treated surgically for PHPT. In 30 cases (group I) 3 or 4 localization studies were performed from the following: ultrasonography (US), computed tomography (CT), thallium-technetium substraction scintigraphy (TTS), and technetium 99m-sestamibi scanning (MIBI). Thirty one patients (group II) were operated without previous localization. Sensitivity and false localization rate of image studies were calculated, and cure and surgical complication rates were compared in both groups. RESULTS: Both groups were similar in mean age (56.2 vs 52.2 years), serum calcium (12.3 vs 12.1 mg/dl), intact PTH levels (304 vs 254 pg/ml), pathology (26 adenomas, 3 hyperplasias and 1 carcinoma vs 27 adenomas, 3 hyperplasias and 1 carcinoma) and additional clinical and biochemical data. The highest sensitivity technique was for MIBI (62.5%). The highest false localization rate was for CT (27.6%). No significative differences were found between groups I and II for the cure rate (90% vs 87.1%) or surgical complications (3.3% vs 3.2%). CONCLUSIONS: In our series of patients with primary hyperparathyroidism preoperative localization studies display low sensitivity and estimable false localization rate. These techniques increment cost and don't improve success rate of initial surgery in PHPT. Therefore, we believe its performance controversial.     

Utility of approximate entropy from overnight pulse oximetry data in the diagnosis of the obstructive sleep apnea syndrome

Approximate entropy (ApEn) is a family of statistics introduced as a quantification of regularity in time series without any a priori knowledge about the system generating them. The aim of this preliminary study was to assess whether a time series analysis of arterial oxygen saturation (SaO2) signals from overnight pulse oximetry by means of ApEn could yield essential information on the diagnosis of obstructive sleep apnea (OSA) syndrome. We analyzed SaO2 signals from 187 subjects: 111 with a positive diagnosis of OSA and 76 with a negative diagnosis of OSA. We divided our data in a training set (44 patients with OSA Positive and 30 patients with OSA Negative) and a test set (67 patients with OSA Positive and 46 patients with OSA Negative). The training set was used for algorithm development and optimum threshold selection. Results showed that recurrence of apnea events in patients with OSA determined a significant increase in ApEn values. This method was assessed prospectively using the test dataset, where we obtained 82.09% sensitivity and 86.96% specificity. We conclude that ApEn analysis of SaO2 from pulse oximetric recording could be useful in the study of OSA.     

Variability, regularity, and complexity of time series generated by schizophrenic patients and control subjects

We analyzed time series generated by 20 schizophrenic patients and 20 sex- and age-matched control subjects using three nonlinear methods of time series analysis as test statistics: central tendency measure (CTM) from the scatter plots of first differences of data, approximate entropy (ApEn), and Lempel-Ziv (LZ) complexity. We divided our data into a training set (10 patients and 10 control subjects) and a test set (10 patients and 10 control subjects). The training set was used for algorithm development and optimum threshold selection. Each method was assessed prospectively using the test dataset. We obtained 80% sensitivity and 90% specificity with LZ complexity, 90% sensitivity, and 60% specificity with ApEn, and 70% sensitivity and 70% specificity with CTM. Our results indicate that there exist differences in the ability to generate random time series between schizophrenic subjects and controls, as estimated by the CTM, ApEn, and LZ. This finding agrees with most previous results showing that schizophrenic patients are characterized by less complex neurobehavioral and neuropsychologic measurements.     

Neural network based detection of hard exudates in retinal images

Diabetic retinopathy (DR) is an important cause of visual impairment in developed countries. Automatic recognition of DR lesions in fundus images can contribute to the diagnosis of the disease. The aim of this study is to automatically detect one of these lesions, hard exudates (EXs), in order to help ophthalmologists in the diagnosis and follow-up of the disease. We propose an algorithm which includes a neural network (NN) classifier for this task. Three NN classifiers were investigated: multilayer perceptron (MLP), radial basis function (RBF) and support vector machine (SVM). Our database was composed of 117 images with variable colour, brightness, and quality. 50 of them (from DR patients) were used to train the NN classifiers and 67 (40 from DR patients and 27 from healthy retinas) to test the method. Using a lesion-based criterion, we achieved a mean sensitivity (SE(l)) of 88.14% and a mean positive predictive value (PPV(l)) of 80.72% for MLP. With RBF we obtained SE(l)=88.49% and PPV(l)=77.41%, while we reached SE(l)=87.61% and PPV(l)=83.51% using SVM. With an image-based criterion, a mean sensitivity (SE(i)) of 100%, a mean specificity (SP(i)) of 92.59% and a mean accuracy (AC(i)) of 97.01% were obtained with MLP. Using RBF we achieved SE(i)=100%, SP(i)=81.48% and AC(i)=92.54%. With SVM the image-based results were SE(i)=100%, SP(i)=77.78% and AC(i)=91.04%.     

Analysis of the magnetoencephalogram background activity in Alzheimer's disease patients with auto-mutual information

The aim of the present study was to analyse the magnetoencephalogram (MEG) background activity in patients with Alzheimer's disease (AD), one of the most frequent disorders among elderly population. For this pilot study, we recorded the MEGs with a 148-channel whole-head magnetometer in 20 patients with probable AD and 21 age-matched control subjects. Artefact-free epochs of 3392 samples were analysed with auto-mutual information (AMI). Average AMI decline rates were lower for the AD patients' recordings than for control subjects' ones. Statistically significant differences were found using a Student's t-test (p<0.01) in 144 channels. Mean AMI values were analysed with a receiver operating characteristic curve. Sensitivity, specificity and accuracy values of 75%, 90.5% and 82.9% were obtained. Our results show that AMI estimations of the magnetic brain activity are different in both groups, hence indicating an abnormal type of dynamics associated with AD. This study suggests that AMI might help medical doctors in the diagnosis of the disease.     

Nonlinear analysis of electroencephalogram and magnetoencephalogram recordings in patients with Alzheimer's disease

The aim of the present study is to show the usefulness of nonlinear methods to analyse the electroencephalogram (EEG) and magnetoencephalogram (MEG) in patients with Alzheimer's disease (AD). The following nonlinear methods have been applied to study the EEG and MEG background activity in AD patients and control subjects: approximate entropy, sample entropy, multiscale entropy, auto-mutual information and Lempel-Ziv complexity. We discuss why these nonlinear methods are appropriate to analyse the EEG and MEG. Furthermore, the performance of all these methods has been compared when applied to the same databases of EEG and MEG recordings. Our results show that EEG and MEG background activities in AD patients are less complex and more regular than in healthy control subjects. In line with previous studies, our work suggests that nonlinear analysis techniques could be useful in AD diagnosis.