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An empirical EEG analysis in brain death diagnosis for adults

Cognitive Neurodynamics volume 2, pages 257–271 (2008)Cite this article

Abstract

Electroencephalogram (EEG) is often used in the confirmatory test for brain death diagnosis in clinical practice. Because EEG recording and monitoring is relatively safe for the patients in deep coma, it is believed to be valuable for either reducing the risk of brain death diagnosis (while comparing other tests such as the apnea) or preventing mistaken diagnosis. The objective of this paper is to study several statistical methods for quantitative EEG analysis in order to help bedside or ambulatory monitoring or diagnosis. We apply signal processing and quantitative statistical analysis for the EEG recordings of 32 adult patients. For EEG signal processing, independent component analysis (ICA) was applied to separate the independent source components, followed by Fourier and time-frequency analysis. For quantitative EEG analysis, we apply several statistical complexity measures to the EEG signals and evaluate the differences between two groups of patients: the subjects in deep coma, and the subjects who were categorized as brain death. We report statistically significant differences of quantitative statistics with real-life EEG recordings in such a clinical study, and we also present interpretation and discussions on the preliminary experimental results.

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Notes

  1. Nevertheless, it was pointed out in Wijdicks (1995) that most patients meeting the clinical criterion for brain death might still have isoelectric EEGs (≤2 μV at a sensitivity of 2 μV/mm).

  2. The CBF test involves the injection of a mild radioactive isotope into the blood stream. By placing a radioactivity counter over the head, one can measure the amount of blood flow into the brain. The cerebral blood flow study takes 20–30 min to perform. If there is no blood flow to the brain as demonstrated by this study, the brain is dead. A negative cerebral flow study is indisputable evidence of a dead brain.

  3. The layout of the electrodes on the frontal regions of the brain is simply for the technical convenience without interfering with other medical treatment or moving the patient’s body. However, the EEG confirmatory test conducted at later stage (see the flowchart of Fig. 1) will require the electrodes cover the whole scalp.

  4. Indeed, the presence of the slow activity (< 4 Hz) was always found in all measurements, which created a difficulty for discrimination.

  5. All of quantitative analysis softwares were written in MATLAB© (MathWorks, Natick, MA) and are available from the authors upon request.

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Acknowledgements

This work was supported in part by the Japan Society for the Promotion Science (JSPS) and the National Natural Science Foundation of China (NSFC) in the Japan-China Research Cooperative Program. We thank two anonymous reviewers for many valuable comments.

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Author notes

  1. Zhe Chen

    Present address: Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA

Authors and Affiliations

  1. Laboratory for Advanced Brain Signal Processing, RIKEN Brain Science Institute, Wako-shi, Saitama, 351-0198, Japan

    Zhe Chen, Jianting Cao & Andrzej Cichocki

  2. Neuroscience Statistics Research Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA

    Zhe Chen

  3. Department of Human Robotics, Saitama Institute of Technology, Fukaya-shi, Saitama, 369-0293, Japan

    Jianting Cao

  4. Brain Science Research Center, Institute of Brain Science, Fudan University, Shanghai, 200433, China

    Yang Cao & Fanji Gu

  5. Huashan Hospital, Fudan University, Shanghai, 200433, China

    Yue Zhang, Guoxian Zhu & Zhen Hong

  6. Department of Electrical Engineering, Fudan University, Shanghai, 200433, China

    Bin Wang

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  1. Zhe Chen
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Chen, Z., Cao, J., Cao, Y. et al. An empirical EEG analysis in brain death diagnosis for adults. Cogn Neurodyn 2, 257–271 (2008). https://doi.org/10.1007/s11571-008-9047-z

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