Signal processing and computational modeling for interpretation of SEEG-recorded interictal epileptiform discharges in epileptogenic and non-epileptogenic zones.

Objective.In partial epilepsies, interictal epileptiform discharges (IEDs) are paroxysmal events observed in epileptogenic zone (EZ) and non-epileptogenic zone (NEZ). IEDs' generation and recurrence are subject to different hypotheses: they appear through glutamatergic and gamma-aminobutyric acidergic (GABAergic) processes; they may trigger seizures or prevent seizure propagation. This paper focuses on a specific class of IEDs, spike-waves (SWs), characterized by a short-duration spike followed by a longer duration wave, both of the same polarity. Signal analysis and neurophysiological mathematical models are used to interpret puzzling IED generation.Approach.Interictal activity was recorded by intracranial stereo-electroencephalography (SEEG) electrodes in five different patients. SEEG experts identified the epileptic and non-epileptic zones in which IEDs were detected. After quantifying spatial and temporal features of the detected IEDs, the most significant features for classifying epileptic and non-epileptic zones were determined. A neurophysiologically-plausible mathematical model was then introduced to simulate the IEDs and understand the underlying differences observed in epileptic and non-epileptic zone IEDs.Main results.Two classes of SWs were identified according to subtle differences in morphology and timing of the spike and wave component. Results showed that type-1 SWs were generated in epileptogenic regions also involved at seizure onset, while type-2 SWs were produced in the propagation or non-involved areas. The modeling study indicated that synaptic kinetics, cortical organization, and network interactions determined the morphology of the simulated SEEG signals. Modeling results suggested that the IED morphologies were linked to the degree of preserved inhibition.Significance.This work contributes to the understanding of different mechanisms generating IEDs in epileptic networks. The combination of signal analysis and computational models provides an efficient framework for exploring IEDs in partial epilepsies and classifying EZ and NEZ.

Proposal for a Home Sleep Monitoring Platform Employing a Smart Glove.

The present paper proposes the design of a sleep monitoring platform. It consists of an entire sleep monitoring system based on a smart glove sensor called UpNEA worn during the night for signals acquisition, a mobile application, and a remote server called AeneA for cloud computing. UpNEA acquires a 3-axis accelerometer signal, a photoplethysmography (PPG), and a peripheral oxygen saturation (SpO2) signal from the index finger. Overnight recordings are sent from the hardware to a mobile application and then transferred to AeneA. After cloud computing, the results are shown in a web application, accessible for the user and the clinician. The AeneA sleep monitoring activity performs different tasks: sleep stages classification and oxygen desaturation assessment; heart rate and respiration rate estimation; tachycardia, bradycardia, atrial fibrillation, and premature ventricular contraction detection; and apnea and hypopnea identification and classification. The PPG breathing rate estimation algorithm showed an absolute median error of 0.5 breaths per minute for the 32 s window and 0.2 for the 64 s window. The apnea and hypopnea detection algorithm showed an accuracy (Acc) of 75.1%, by windowing the PPG in one-minute segments. The classification task revealed 92.6% Acc in separating central from obstructive apnea, 83.7% in separating central apnea from central hypopnea and 82.7% in separating obstructive apnea from obstructive hypopnea. The novelty of the integrated algorithms and the top-notch cloud computing products deployed, encourage the production of the proposed solution for home sleep monitoring.

Detection and Classification of Sleep Apnea and Hypopnea Using PPG and SpO 2 Signals.

In this work, a detection and classification method for sleep apnea and hypopnea, using photopletysmography (PPG) and peripheral oxygen saturation (SpO 2) signals, is proposed. The detector consists of two parts: one that detects reductions in amplitude fluctuation of PPG (DAP)and one that detects oxygen desaturations. To further differentiate among sleep disordered breathing events (SDBE), the pulse rate variability (PRV) was extracted from the PPG signal, and then used to extract features that enhance the sympatho-vagal arousals during apneas and hypopneas. A classification was performed to discriminate between central and obstructive events, apneas and hypopneas. The algorithms were tested on 96 overnight signals recorded at the UZ Leuven hospital, annotated by clinical experts, and from patients without any kind of co-morbidity. An accuracy of 75.1% for the detection of apneas and hypopneas, in one-minute segments,was reached. The classification of the detected events showed 92.6% accuracy in separating central from obstructive apnea, 83.7% for central apnea and central hypopnea and 82.7% for obstructive apnea and obstructive hypopnea. The low implementation cost showed a potential for the proposed method of being used as screening device, in ambulatory scenarios.

A New Wearable Device for Blood Pressure Estimation Using Photoplethysmogram.

We present a novel smartwatch, CareUp ® , for estimating the Blood Pressure (BP) in real time. It consists of two pulse oximeters: one placed on the back and one on the front of the device. Placing the index finger on the front oximeter starts the acquisition of two photoplethysmograms (PPG); the signals are then filtered and cross-correlated to obtain a Time Delay between them, called Pulse Transit Time (PTT). The Heart Rate (HR) (estimated from the finger PPG) and the PTT are then input in a linear model to give an estimation of the Systolic and Diastolic BP. The performance of the smartwatch in measuring BP have been validated in the Institut Coeur Paris Centre Turin (ICPC), using a sphygmomanometer, on 44 subjects. During the validation, the measures of the CareUp ® were compared to those of two oscillometry-based devices already available on the market: Thuasne ® and Magnien ® . The results showed an accuracy comparable to the oscillometry-based devices and they almost agreed with the American Association for the Advancement of Medical Instrumentation standard for non-automated sphygmomanometers. The integration of the BP estimation algorithm in the smartwatch makes the CareUp ® an easy-to-use, wearable device for monitoring the BP in real time.