Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health, Department of Medicine, University of British Columbia, Vancouver, BC V6T 2B5, Canada
Dr. Maryam Mirian
Pacific Parkinson's Research Centre, Djavad Mowafaghian Centre for Brain Health, Department of Medicine, University of British Columbia, Vancouver, BC V6T 2B5, Canada
Sleep disturbances are common in Alzheimer’s disease and other neurodegenerative disorders, and together represent a potential therapeutic target for disease modification. A major barrier for studying sleep in patients with dementia is the requirement for overnight polysomnography (PSG) to achieve formal sleep staging. This is not only costly, but also spending a night in a hospital setting is not always advisable in this patient group. As an alternative to PSG, portable electroencephalography (EEG) headbands (HB) have been developed, which reduce cost, increase patient comfort, and allow sleep recordings in a person’s home environment. However, naïve applications of current automated sleep staging systems tend to perform inadequately with HB data, due to their relatively lower quality. Here we present a deep learning (DL) model for automated sleep staging of HB EEG data to overcome these critical limitations. The solution includes a simple band-pass filtering, a data augmentation step, and a model using convolutional (CNN) and long short-term memory (LSTM) layers. With this model, we have achieved 74% (±10%) validation accuracy on low-quality two-channel EEG headband data and 77% (±10%) on gold-standard PSG. Our results suggest that DL approaches achieve robust sleep staging of both portable and in-hospital EEG recordings, and may allow for more widespread use of ambulatory sleep assessments across clinical conditions, including neurodegenerative disorders.
Parkinson’s disease (PD) is characterized by abnormal brain oscillations that can change rapidly. Tracking neural alternations with high temporal resolution electrophysiological monitoring methods such as EEG can lead to valuable information about alterations observed in PD. Concomitantly, there have been advances in the high-accuracy performance of deep neural networks (DNNs) using few-patient data. In this study, we propose a method to transform resting-state EEG data into a deep latent space to classify PD subjects from healthy cases. We first used a general orthogonalized directed coherence (gOPDC) method to compute directional connectivity (DC) between all pairwise EEG channels in four frequency bands (Theta, Alpha, Beta, and Gamma) and then converted the DC maps into 2D images. We then used the VGG-16 architecture (trained on the ImageNet dataset) as our pre-trained model, enlisted weights of convolutional layers as initial weights, and fine-tuned all layer weights with our data. After training, the classification achieved 99.62% accuracy, 100% precision, 99.17% recall, 0.9958 F1 score, and 0.9958 AUC averaged for 10 random repetitions of training/evaluating on the proposed deep transfer learning (DTL) network. Using the latent features learned by the network and employing LASSO regression, we found that latent features (as opposed to the raw DC values) were significantly correlated with five clinical indices routinely measured: left and right finger tapping, left and right tremor, and body bradykinesia. Our results demonstrate the power of transfer learning and latent space derivation for the development of oscillatory biomarkers in PD.
The primary treatment for Parkinson’s disease (PD) is supplementation of levodopa (L-dopa). With disease progression, people may experience motor and non-motor fluctuations, whereby the PD symptoms return before the next dose of medication. Paradoxically, in order to prevent wearing-off, one must take the next dose while still feeling well, as the upcoming off episodes can be unpredictable. Waiting until feeling wearing-off and then taking the next dose of medication is a sub-optimal strategy, as the medication can take up to an hour to be absorbed. Ultimately, early detection of wearing-off before people are consciously aware would be ideal. Towards this goal, we examined whether or not a wearable sensor recording autonomic nervous system (ANS) activity could be used to predict wearing-off in people on L-dopa. We had PD subjects on L-dopa record a diary of their on/off status over 24 hours while wearing a wearable sensor (E4 wristband®) that recorded ANS dynamics, including electrodermal activity (EDA), heart rate (HR), blood volume pulse (BVP), and skin temperature (TEMP). A joint empirical mode decomposition (EMD) / regression analysis was used to predict wearing-off (WO) time. When we used individually specific models assessed with cross-validation, we obtained > 90% correlation between the original OFF state logged by the patients and the reconstructed signal. However, a pooled model using the same combination of ASR measures across subjects was not statistically significant. This proof-of-principle study suggests that ANS dynamics can be used to assess the on/off phenomenon in people with PD taking L-dopa, but must be individually calibrated. More work is required to determine if individual wearing-off detection can take place before people become consciously aware of it.
3 September 2024 in Clinical Neurology and Neurosurgery
Objective: Sport-related concussion presents significant diagnostic and monitoring challenges, especially in youth populations. This study investigates the potential of EEG microstate analysis as a tool for assessing acute-phase brain activity changes in adolescent male athletes following a concussion. We analyzed resting-state EEG data from 32 participants in a between-subjects design, comparing participants with acute concussion (within two weeks of injury) to an age- and sex- matched sample with no reported history of concussion. Methodology: We applied a modified k-means clustering algorithm to group resting-state EEG topographical maps into seven clusters, with each cluster represented by one of the canonical microstate classes (A-G). Average duration, occurrence rate, and time coverage for each microstate were extracted. Results: Statistically significant differences in mean duration, occurrence rate, and time coverage of microstates B and E were observed. Specifically, the mean duration, occurrence and time coverage of microstate E showed a significant decrease in the concussed cohort in comparision to the controls (p < 0.001). In addition, the mean duration, occurrence rate and time coverage was higher in the concussed cohort in comparision with the healthy cohort (p = 0.003). A significant negative linear relationship was found between microstate E and symptom severity (p = 0.006, F = 15.72). Discussion: These results suggest that mild traumatic brain injury may disrupt the dynamic interaction of large-scale brain networks, hinting at potential biomarkers of injury. This study may help to inform future work on objective, brain-based tools for diagnosis and recovery assessment in concussed adolescents. Further research in larger, more diverse populations is necessary to validate these potential biomarkers.