Nathan J Stevenson1, Leena Lauronen2, Sampsa Vanhatalo2. 1. Clinicum, Faculty of Medicine, University of Helsinki, Finland; BABA Center and Department of Children's Clinical Neurophysiology, HUS Medical Imaging Center, Helsinki University Central Hospital, Finland. Electronic address: nathan.stevenson@helsinki.fi. 2. Clinicum, Faculty of Medicine, University of Helsinki, Finland; BABA Center and Department of Children's Clinical Neurophysiology, HUS Medical Imaging Center, Helsinki University Central Hospital, Finland.
Abstract
OBJECTIVES: To measure changes in the visual interpretation of the EEG by the human expert for neonatal seizure detection when reducing the number of recording electrodes. METHODS: EEGs were recorded from 45 infants admitted to the neonatal intensive care unit (NICU). Three experts annotated seizures in EEG montages derived from 19, 8 and 4 electrodes. Differences between annotations were assessed by comparing intra-montage with inter-montage agreement (K). RESULTS: Three experts annotated 4464 seizures across all infants and montages. The inter-expert agreement was not significantly altered by the number of electrodes in the montage (p = 0.685, n = 43). Reducing the number of EEG electrodes altered the seizure annotation for all experts. Agreement between the 19-electrode montage (K19,19 = 0.832) was significantly higher than the agreement between 19 and 8-electrode montages (dK = 0.114; p < 0.001, n = 42) or 19 and 4-electrode montages (dK = 0.113, p < 0.001, n = 43). Seizure burden and number were significantly underestimated by the 4 and 8-electrode montage (p < 0.001). No significant difference in agreement was found between 8 and 4-electrode montages (dK = 0.002; p = 0.07, n = 42). CONCLUSIONS: Reducing the number of EEG electrodes from 19 electrodes resulted in slight but significant changes in seizure detection. SIGNIFICANCE: Four-electrode montages for routine EEG monitoring are comparable to eight electrodes for seizure detection in the NICU.
OBJECTIVES: To measure changes in the visual interpretation of the EEG by the human expert for neonatal seizure detection when reducing the number of recording electrodes. METHODS: EEGs were recorded from 45 infants admitted to the neonatal intensive care unit (NICU). Three experts annotated seizures in EEG montages derived from 19, 8 and 4 electrodes. Differences between annotations were assessed by comparing intra-montage with inter-montage agreement (K). RESULTS: Three experts annotated 4464 seizures across all infants and montages. The inter-expert agreement was not significantly altered by the number of electrodes in the montage (p = 0.685, n = 43). Reducing the number of EEG electrodes altered the seizure annotation for all experts. Agreement between the 19-electrode montage (K19,19 = 0.832) was significantly higher than the agreement between 19 and 8-electrode montages (dK = 0.114; p < 0.001, n = 42) or 19 and 4-electrode montages (dK = 0.113, p < 0.001, n = 43). Seizure burden and number were significantly underestimated by the 4 and 8-electrode montage (p < 0.001). No significant difference in agreement was found between 8 and 4-electrode montages (dK = 0.002; p = 0.07, n = 42). CONCLUSIONS: Reducing the number of EEG electrodes from 19 electrodes resulted in slight but significant changes in seizure detection. SIGNIFICANCE: Four-electrode montages for routine EEG monitoring are comparable to eight electrodes for seizure detection in the NICU.
Authors: Nathan J Stevenson; Maria-Luisa Tataranno; Anna Kaminska; Elena Pavlidis; Robert R Clancy; Elke Griesmaier; James A Roberts; Katrin Klebermass-Schrehof; Sampsa Vanhatalo Journal: Ann Clin Transl Neurol Date: 2020-08-07 Impact factor: 4.511