Gen Shinozaki1, Aubrey C Chan1,2, Nicholas A Sparr1, Kasra Zarei1, Lindsey N Gaul1, Jonathan T Heinzman1, Julian Robles1, Kumi Yuki1,3, Theodosis J Chronis1, Timothy Ando4, Terrence Wong5, Sayeh Sabbagh1, Michelle T Weckmann1,3, Sangil Lee6, Thoru Yamada7, Matthew D Karam8, Nicolas O Noiseux8, Eri Shinozaki2, John W Cromwell9. 1. Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, USA. 2. Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, USA. 3. Department of Family Medicine, University of Iowa Carver College of Medicine, Iowa City, USA. 4. Department of Psychiatry, Stanford University School of Medicine, Stanford, USA. 5. Department of Internal Medicine, Highland Hospital, Alameda Health System, Oakland, USA. 6. Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, USA. 7. Department of Neurology, University of Iowa Carver College of Medicine, Iowa City, USA. 8. Department of Orthopedics and Rehabilitation, University of Iowa Carver College of Medicine, Iowa City, USA. 9. Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, USA.
Abstract
AIM: Delirium is common and dangerous among elderly inpatients; yet, it is underdiagnosed and thus undertreated. This study aimed to test the diagnostic characteristics of a noninvasive point-of-care device with two-channel (bispectral) electroencephalography (EEG) for the screening of delirium in the hospital. METHODS: Patients admitted to the University of Iowa Hospitals and Clinics were assessed for the presence of delirium with a clinical assessment, the Confusion Assessment Method for Intensive Care Unit and Delirium Rating Scale. Subsequently, we obtained a 10-min bispectral EEG (BSEEG) recording from a hand-held electroencephalogram device during hospitalization. We performed power spectral density analysis to differentiate between those patients with and without delirium. RESULTS: Initially 45 subjects were used as a test dataset to establish a cut-off. The BSEEG index was determined to be a significant indicator of delirium, with sensitivity 80% and specificity 87.7%. An additional independent validation dataset with 24 patients confirmed the validity of the approach, with a sensitivity of 83.3% and specificity of 83.3%. CONCLUSION: In this pilot study, the BSEEG method was able to distinguish delirious patients from non-delirious patients. Our data showed the feasibility of this technology for mass screening of delirium in the hospital.
AIM: Delirium is common and dangerous among elderly inpatients; yet, it is underdiagnosed and thus undertreated. This study aimed to test the diagnostic characteristics of a noninvasive point-of-care device with two-channel (bispectral) electroencephalography (EEG) for the screening of delirium in the hospital. METHODS:Patients admitted to the University of Iowa Hospitals and Clinics were assessed for the presence of delirium with a clinical assessment, the Confusion Assessment Method for Intensive Care Unit and Delirium Rating Scale. Subsequently, we obtained a 10-min bispectral EEG (BSEEG) recording from a hand-held electroencephalogram device during hospitalization. We performed power spectral density analysis to differentiate between those patients with and without delirium. RESULTS: Initially 45 subjects were used as a test dataset to establish a cut-off. The BSEEG index was determined to be a significant indicator of delirium, with sensitivity 80% and specificity 87.7%. An additional independent validation dataset with 24 patients confirmed the validity of the approach, with a sensitivity of 83.3% and specificity of 83.3%. CONCLUSION: In this pilot study, the BSEEG method was able to distinguish delirious patients from non-deliriouspatients. Our data showed the feasibility of this technology for mass screening of delirium in the hospital.
Authors: Gen Shinozaki; Nicholas L Bormann; Aubrey C Chan; Kasra Zarei; Nicholas A Sparr; Mason J Klisares; Sydney S Jellison; Jonathan T Heinzman; Elijah B Dahlstrom; Gabrielle N Duncan; Lindsey N Gaul; Robert J Wanzek; Ellyn M Cramer; Charlotte G Wimmel; Sayeh Sabbagh; Kumi Yuki; Michelle T Weckmann; Thoru Yamada; Matthew D Karam; Nicolas O Noiseux; Eri Shinozaki; Hyunkeun R Cho; Sangil Lee; John W Cromwell Journal: J Clin Psychiatry Date: 2019-09-03 Impact factor: 4.384
Authors: Kasra Zarei; Nicholas A Sparr; Nicholas T Trapp; Elena D Neuhaus; John W Cromwell; Aaron D Boes; Gen Shinozaki Journal: Psychiatry Res Date: 2020-01-25 Impact factor: 3.222
Authors: Takehiko Yamanashi; Pedro S Marra; Kaitlyn J Crutchley; Nadia E Wahba; Johnny R Malicoat; Eleanor J Sullivan; Cade C Akers; Catherine A Nicholson; Felipe M Herrmann; Matthew D Karam; Nicolas O Noiseux; Koichi Kaneko; Eri Shinozaki; Masaaki Iwata; Hyunkeun Ryan Cho; Sangil Lee; Gen Shinozaki Journal: Sci Rep Date: 2021-07-09 Impact factor: 4.996