Kamousi Baharan, Grant Alexander M, Bachelder Brad, Yi Jianchun, Hajinoroozi Mehdi, Woo Raymond
Ceribell Inc., 2483 Old Middlefield Way, Suite 120, Mountain View, CA 94043, USA.
Clin Neurophysiol Pract. 2019 Mar 13;4:69-75. doi: 10.1016/j.cnp.2019.02.002. eCollection 2019.
To compare the quality of electroencephalography (EEG) signals recorded with a rapid response EEG system and the signals recorded with conventional clinical EEG recordings.
We studied the differences between EEG recordings taken with a rapid response EEG system (Ceribell) compared to conventional EEG through two separate set of studies. First, we conducted simultaneous recording on a healthy subject in an experimental laboratory setting where the rapid response EEG and two conventional EEG recording systems (Nihon Kohden and Natus) were used at the same time on the same subject using separate but adjacently placed electrodes. The rapid response EEG was applied by a user without prior training in EEG set up while two separate sets of conventional EEG electrodes were placed by a trained EEG technologist. The correlation between each of the recordings was calculated and quantitatively compared. In the second study, we performed a set of consecutive recordings on 22 patients in an ICU environment. The rapid response EEG system was applied by clinical ICU fellows without prior training in EEG set up while waiting for the conventional EEG system to arrive, after which the rapid response EEG was stopped and the conventional EEG was applied by a trained EEG technologist. We measured and compared several metrics of EEG quality using comparative metrics.
For the simultaneous recording performed in a laboratory environment, the tested rapid response EEG and conventional EEG recordings showed agreement when aligned and visually compared in the time domain, all EEG waveform features were distinguishable in both recordings. The correlation between each pair of recordings also showed that the correlation between the rapid response EEG recording and each of the two conventional recordings was statistically the same as the correlation between the two conventional recordings. For the consecutive recordings performed in real life clinical ICU environment, Hjorth parameters, spike count, baseline wander, and kurtosis measures were statistically similar (p > 0.05, Wilcoxon signed rank test) for the rapid response EEG and conventional clinical EEG recordings. The rapid response EEG data had significantly lower 60 Hz noise compared to recordings made with the conventional systems both in laboratory and ICU settings. Lastly, the clinical information obtained with the rapid response EEG system was concordant with the diagnostic information obtained with the conventional EEG recordings in the ICU setting.
Our findings show that the tested rapid response EEG system provides EEG recording quality that is equivalent to conventional EEG systems and even better when it comes to 60 Hz noise level. The concordance between the rapid response EEG and conventional EEG systems was demonstrated both in a controlled laboratory environment as well as in the noisy environment of a hospital ICU on patients with altered mental status.
Our findings clearly confirm that the tested rapid response EEG system provides EEG data that is equivalent in quality to the recordings made using conventional EEG systems despite the fact that the rapid response system can be applied within few minutes and with no reliance on specialized technologists. This can be important for urgent situations where the use of conventional EEG systems is hindered by the lengthy setup time and limited availability of EEG technologists.
比较使用快速响应脑电图（EEG）系统记录的EEG信号质量与传统临床EEG记录的信号质量。
我们通过两组独立的研究，研究了快速响应EEG系统（Ceribell）与传统EEG记录之间的差异。首先，我们在实验室内对一名健康受试者进行同步记录，在同一受试者身上同时使用快速响应EEG和两个传统EEG记录系统（日本光电和Natus），电极分别放置但相邻。快速响应EEG由未经EEG设置培训的用户应用，而两组独立的传统EEG电极由经过培训的EEG技术人员放置。计算并定量比较每次记录之间的相关性。在第二项研究中，我们在重症监护病房（ICU）环境中对22名患者进行了一系列连续记录。在等待传统EEG系统到达时，由临床ICU住院医师应用快速响应EEG系统，他们未经EEG设置培训，之后停止快速响应EEG，由经过培训的EEG技术人员应用传统EEG。我们使用比较指标测量并比较了EEG质量的几个指标。
对于在实验室环境中进行的同步记录，经测试的快速响应EEG和传统EEG记录在时域中对齐并进行视觉比较时显示出一致性，两种记录中所有EEG波形特征均可区分。每对记录之间的相关性还表明，快速响应EEG记录与两个传统记录中每一个之间的相关性在统计学上与两个传统记录之间的相关性相同。对于在现实生活临床ICU环境中进行的连续记录，快速响应EEG和传统临床EEG记录的 Hjorth参数、尖峰计数、基线漂移和峰度测量在统计学上相似（p>0.05，Wilcoxon符号秩检验）。与传统系统在实验室和ICU设置中进行的记录相比，快速响应EEG数据的60Hz噪声明显更低。最后，在ICU设置中，使用快速响应EEG系统获得的临床信息与使用传统EEG记录获得的诊断信息一致。
我们的研究结果表明，经测试的快速响应EEG系统提供的EEG记录质量与传统EEG系统相当，在60Hz噪声水平方面甚至更好。在受控实验室环境以及医院ICU嘈杂环境中，对精神状态改变的患者进行测试时，快速响应EEG和传统EEG系统之间表现出一致性。
我们的研究结果明确证实，经测试的快速响应EEG系统提供的EEG数据质量与使用传统EEG系统进行的记录相当，尽管快速响应系统可在几分钟内应用，且无需依赖专业技术人员。这对于紧急情况可能很重要，因为在紧急情况下，传统EEG系统的设置时间长且EEG技术人员可用性有限会阻碍其使用。
