Automated Pain Assessment in Children Using Electrodermal Activity and Video Data Fusion via Machine Learning.

OBJECTIVE: Pain assessment in children continues to challenge clinicians and researchers, as subjective experiences of pain require inference through observable behaviors, both involuntary and deliberate. The presented approach supplements the subjective self-report-based method by fusing electrodermal activity (EDA) recordings with video facial expressions to develop an objective pain assessment metric. Such an approach is specifically important for assessing pain in children who are not capable of providing accurate self-pain reports, requiring nonverbal pain assessment. We demonstrate the performance of our approach using data recorded from children in post-operative recovery following laparoscopic appendectomy. We examined separately and combined the usefulness of EDA and video facial expression data as predictors of children's self-reports of pain following surgery through recovery. Findings indicate that EDA and facial expression data independently provide above chance sensitivities and specificities, but their fusion for classifying clinically significant pain vs. clinically nonsignificant pain achieved substantial improvement, yielding 90.91% accuracy, with 100% sensitivity and 81.82% specificity. The multimodal measures capitalize upon different features of the complex pain response. Thus, this paper presents both evidence for the utility of a weighted maximum likelihood algorithm as a novel feature selection method for EDA and video facial expression data and an accurate and objective automated classification algorithm capable ofdiscriminating clinically significant pain from clinically nonsignificant pain in children.

Automated Pain Assessment using Electrodermal Activity Data and Machine Learning.

Objective pain assessment is required for appropriate pain management in the clinical setting. However, clinical gold standard pain assessment is based on subjective methods. Automated pain detection from physiological data may provide important objective information to better standardize pain assessment. Specifically, electrodermal activity (EDA) can identify features of stress and anxiety induced by varying pain levels. However, notable variability in EDA measurement exists and research to date has demonstrated sensitivity but lack of specificity in pain assessment. In this paper, we use timescale decomposition (TSD) to extract salient features from EDA signals to identify an accurate and automated EDA pain detection algorithm to sensitively and specifically distinguish pain from no-pain conditions.

Code-VEP vs. Eye Tracking: A Comparison Study.

Even with state-of-the-art techniques there are individuals whose paralysis prevents them from communicating with others. Brain⁻Computer-Interfaces (BCI) aim to utilize brain waves to construct a voice for those whose needs remain unmet. In this paper we compare the efficacy of a BCI input signal, code-VEP via Electroencephalography, against eye gaze tracking, among the most popular modalities used. These results, on healthy individuals without paralysis, suggest that while eye tracking works well for some, it does not work well or at all for others; the latter group includes individuals with corrected vision or those who squint their eyes unintentionally while focusing on a task. It is also evident that the performance of the interface is more sensitive to head/body movements when eye tracking is used as the input modality, compared to using c-VEP. Sensitivity to head/body movement could be better in eye tracking systems which are tracking the head or mounted on the face and are designed specifically as assistive devices. The sample interface developed for this assessment has the same reaction time when driven with c-VEP or with eye tracking; approximately 0.5⁻1 second is needed to make a selection among the four options simultaneously presented. Factors, such as system reaction time and robustness play a crucial role in participant preferences.

Towards Automated Pain Detection in Children using Facial and Electrodermal Activity.

Accurately determining pain levels in children is difficult, even for trained professionals and parents. Facial activity and electro- dermal activity (EDA) provide rich information about pain, and both have been used in automated pain detection. In this paper, we discuss preliminary steps towards fusing models trained on video and EDA features respectively. We compare fusion models using original video features and those using transferred video features which are less sensitive to environmental changes. We demonstrate the benefit of the fusion and the transferred video features with a special test case involving domain adaptation and improved performance relative to using EDA and video features alone.

Decoding complex imagery hand gestures.

Brain computer interfaces (BCIs) offer individuals suffering from major disabilities an alternative method to interact with their environment. Sensorimotor rhythm (SMRs) based BCIs can successfully perform control tasks; however, the traditional SMR paradigms intuitively disconnect the control and real task, making them non-ideal for complex control scenarios. In this study we design a new, intuitively connected motor imagery (MI) paradigm using hierarchical common spatial patterns (HCSP) and context information to effectively predict intended hand grasps from electroencephalogram (EEG) data. Experiments with 5 participants yielded an aggregate classification accuracy-intended grasp prediction probability-of 64.5% for 8 different hand gestures, more than 5 times the chance level.

Context-aware recursive bayesian graph traversal in BCIs.

Noninvasive brain computer interfaces (BCI), and more specifically Electroencephalography (EEG) based systems for intent detection need to compensate for the low signal to noise ratio of EEG signals. In many applications, the temporal dependency information from consecutive decisions and contextual data can be used to provide a prior probability for the upcoming decision. In this study we proposed two probabilistic graphical models (PGMs), using context information and previously observed EEG evidences to estimate a probability distribution over the decision space in graph based decision-making mechanism. In this approach, user moves a pointer to the desired vertex in the graph in which each vertex represents an action. To select a vertex, a "Select" command, or a proposed probabilistic Selection criterion (PSC) can be used to automatically detect the user intended vertex. Performance of different PGMs and Selection criteria combinations are compared over a keyboard based on a graph layout. Based on the simulation results, probabilistic Selection criterion along with the probabilistic graphical model provides the highest performance boost for individuals with pour calibration performance and achieving the same performance for individuals with high calibration performance.

An Active RBSE Framework to Generate Optimal Stimulus Sequences in a BCI for Spelling.

A class of brain computer interfaces (BCIs) employs noninvasive recordings of electroencephalography (EEG) signals to enable users with severe speech and motor impairments to interact with their environment and social network. For example, EEG based BCIs for typing popularly utilize event related potentials (ERPs) for inference. Presentation paradigm design in current ERP-based letter by letter typing BCIs typically query the user with an arbitrary subset characters. However, the typing accuracy and also typing speed can potentially be enhanced with more informed subset selection and flash assignment. In this manuscript, we introduce the active recursive Bayesian state estimation (active-RBSE) framework for inference and sequence optimization. Prior to presentation in each iteration, rather than showing a subset of randomly selected characters, the developed framework optimally selects a subset based on a query function. Selected queries are made adaptively specialized for users during each intent detection. Through a simulation-based study, we assess the effect of active-RBSE on the performance of a language-model assisted typing BCI in terms of typing speed and accuracy. To provide a baseline for comparison, we also utilize standard presentation paradigms namely, row and column matrix presentation paradigm and also random rapid serial visual presentation paradigms. The results show that utilization of active-RBSE can enhance the online performance of the system, both in terms of typing accuracy and speed. Moreover, we conduct real time experiments with human participants to study the human-in-the-loop effect on the performance of the proposed active-RBSE framework and consistent with the simulation results, the results of these experiments show improvement both in typing speed and accuracy.

Recursive Bayesian Coding for BCIs.

Brain-Computer Interfaces (BCIs) seek to infer some task symbol, a task relevant instruction, from brain symbols, classifiable physiological states. For example, in a motor imagery robot control task a user would indicate their choice from a dictionary of task symbols (rotate arm left, grasp, etc.) by selecting from a smaller dictionary of brain symbols (imagined left or right hand movements). We examine how a BCI infers a task symbol using selections of brain symbols. We offer a recursive Bayesian decision framework which incorporates context prior distributions (e.g., language model priors in spelling applications), accounts for varying brain symbol accuracy and is robust to single brain symbol query errors. This framework is paired with Maximum Mutual Information (MMI) coding which maximizes a generalization of ITR. Both are applicable to any discrete task and brain phenomena (e.g., P300, SSVEP, MI). To demonstrate the efficacy of our approach we perform SSVEP "Shuffle" Speller experiments and compare our recursive coding scheme with traditional decision tree methods including Huffman coding. MMI coding leverages the asymmetry of the classifier's mistakes across a particular user's SSVEP responses; in doing so it offers a 33% increase in letter accuracy though it is 13% slower in our experiment.

Probabilistic Simulation Framework for EEG-Based BCI Design.

A simulation framework could decrease the burden of attending long and tiring experimental sessions on the potential users of brain computer interface (BCI) systems. Specifically during the initial design of a BCI, a simulation framework that could replicate the operational performance of the system would be a useful tool for designers to make design choices. In this manuscript, we develop a Monte Carlo based probabilistic simulation framework for electroencephalography (EEG) based BCI design. We employ one event related potential (ERP) based typing and one steady state evoked potential (SSVEP) based control interface as testbeds. We compare the results of simulations with real time experiments. Even though over and under estimation of the performance is possible, the statistical results over the Monte Carlo simulations show that the developed framework generally provides a good approximation of the real time system performance.

Language-Model Assisted Brain Computer Interface for Typing: A Comparison of Matrix and Rapid Serial Visual Presentation.

Noninvasive electroencephalography (EEG)-based brain-computer interfaces (BCIs) popularly utilize event-related potential (ERP) for intent detection. Specifically, for EEG-based BCI typing systems, different symbol presentation paradigms have been utilized to induce ERPs. In this manuscript, through an experimental study, we assess the speed, recorded signal quality, and system accuracy of a language-model-assisted BCI typing system using three different presentation paradigms: a 4 × 7 matrix paradigm of a 28-character alphabet with row-column presentation (RCP) and single-character presentation (SCP), and rapid serial visual presentation (RSVP) of the same. Our analyses show that signal quality and classification accuracy are comparable between the two visual stimulus presentation paradigms. In addition, we observe that while the matrix-based paradigm can be generally employed with lower inter-trial-interval (ITI) values, the best presentation paradigm and ITI value configuration is user dependent. This potentially warrants offering both presentation paradigms and variable ITI options to users of BCI typing systems.

Quantitative change of EEG and respiration signals during mindfulness meditation.

BACKGROUND: This study investigates measures of mindfulness meditation (MM) as a mental practice, in which a resting but alert state of mind is maintained. A population of older people with high stress level participated in this study, while electroencephalographic (EEG) and respiration signals were recorded during a MM intervention. The physiological signals during meditation and control conditions were analyzed with signal processing. METHODS: EEG and respiration data were collected and analyzed on 34 novice meditators after a 6-week meditation intervention. Collected data were analyzed with spectral analysis, phase analysis and classification to evaluate an objective marker for meditation. RESULTS: Different frequency bands showed differences in meditation and control conditions. Furthermore, we established a classifier using EEG and respiration signals with a higher accuracy (85%) at discriminating between meditation and control conditions than a classifier using the EEG signal only (78%). CONCLUSION: Support vector machine (SVM) classifier with EEG and respiration feature vector is a viable objective marker for meditation ability. This classifier should be able to quantify different levels of meditation depth and meditation experience in future studies.

Change in physiological signals during mindfulness meditation.

Mindfulness meditation (MM) is an inward mental practice, in which a resting but alert state of mind is maintained. MM intervention was performed for a population of older people with high stress levels. This study assessed signal processing methodologies of electroencephalographic (EEG) and respiration signals during meditation and control condition to aid in quantification of the meditative state. EEG and respiration data were collected and analyzed on 34 novice meditators after a 6-week meditation intervention. Collected data were analyzed with spectral analysis and support vector machine classification to evaluate an objective marker for meditation. We observed meditation and control condition differences in the alpha, beta and theta frequency bands. Furthermore, we established a classifier using EEG and respiration signals with a higher accuracy at discriminating between meditation and control conditions than one using the EEG signal only. EEG and respiration based classifier is a viable objective marker for meditation ability. Future studies should quantify different levels of meditation depth and meditation experience using this classifier. Development of an objective physiological meditation marker will allow the mind-body medicine field to advance by strengthening rigor of methods.

Fusion with language models improves spelling accuracy for ERP-based brain computer interface spellers.

Event related potentials (ERP) corresponding to a stimulus in electroencephalography (EEG) can be used to detect the intent of a person for brain computer interfaces (BCI). This paradigm is widely utilized to build letter-by-letter text input systems using BCI. Nevertheless using a BCI-typewriter depending only on EEG responses will not be sufficiently accurate for single-trial operation in general, and existing systems utilize many-trial schemes to achieve accuracy at the cost of speed. Hence incorporation of a language model based prior or additional evidence is vital to improve accuracy and speed. In this paper, we study the effects of Bayesian fusion of an n-gram language model with a regularized discriminant analysis ERP detector for EEG-based BCIs. The letter classification accuracies are rigorously evaluated for varying language model orders as well as number of ERP-inducing trials. The results demonstrate that the language models contribute significantly to letter classification accuracy. Specifically, we find that a BCI-speller supported by a 4-gram language model may achieve the same performance using 3-trial ERP classification for the initial letters of the words and using single trial ERP classification for the subsequent ones. Overall, fusion of evidence from EEG and language models yields a significant opportunity to increase the word rate of a BCI based typing system.