Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Division of Neurology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Sci Rep. 2017 Apr 3;7:45567. doi: 10.1038/srep45567.
Our objective was to assess the ability of a smartphone-based electroencephalography (EEG) application, the Smartphone Brain Scanner-2 (SBS2), to detect epileptiform abnormalities compared to standard clinical EEG. The SBS2 system consists of an Android tablet wirelessly connected to a 14-electrode EasyCap headset (cost ~ 300 USD). SBS2 and standard EEG were performed in people with suspected epilepsy in Bhutan (2014-2015), and recordings were interpreted by neurologists. Among 205 participants (54% female, median age 24 years), epileptiform discharges were detected on 14% of SBS2 and 25% of standard EEGs. The SBS2 had 39.2% sensitivity (95% confidence interval (CI) 25.8%, 53.9%) and 94.8% specificity (95% CI 90.0%, 97.7%) for epileptiform discharges with positive and negative predictive values of 0.71 (95% CI 0.51, 0.87) and 0.82 (95% CI 0.76, 0.89) respectively. 31% of focal and 82% of generalized abnormalities were identified on SBS2 recordings. Cohen's kappa (κ) for the SBS2 EEG and standard EEG for the epileptiform versus non-epileptiform outcome was κ = 0.40 (95% CI 0.25, 0.55). No safety or tolerability concerns were reported. Despite limitations in sensitivity, the SBS2 may become a viable supportive test for the capture of epileptiform abnormalities, and extend EEG access to new, especially resource-limited, populations at a reduced cost.
我们的目标是评估基于智能手机的脑电图 (EEG) 应用程序 Smartphone Brain Scanner-2 (SBS2) 检测癫痫样异常的能力，并与标准临床 EEG 进行比较。SBS2 系统由一个无线连接到 14 电极 EasyCap 耳机的 Android 平板电脑组成（成本约为 300 美元）。SBS2 和标准 EEG 在不丹进行了疑似癫痫患者的检查（2014-2015 年），并由神经科医生进行了记录解读。在 205 名参与者中（54%为女性，中位年龄 24 岁），SBS2 上检测到癫痫样放电的比例为 14%，标准 EEG 上为 25%。SBS2 对癫痫样放电的敏感度为 39.2%（95%置信区间 (CI) 25.8%，53.9%），特异性为 94.8%（95%CI 90.0%，97.7%），阳性预测值为 0.71（95%CI 0.51，0.87），阴性预测值为 0.82（95%CI 0.76，0.89）。SBS2 记录中 31%的局灶性和 82%的全面性异常得到识别。SBS2 EEG 和标准 EEG 对癫痫样与非癫痫样结果的 Cohen's kappa（κ）值为 κ=0.40（95%CI 0.25，0.55）。没有报告安全性或耐受性问题。尽管敏感度有限，但 SBS2 可能成为捕捉癫痫样异常的一种可行辅助测试，并以较低的成本将 EEG 技术扩展到新的、特别是资源有限的人群。
