Electroencephalogram-Based Complexity Measures as Predictors of Post-operative Neurocognitive Dysfunction.
Electroencephalogram-Based Complexity Measures as Predictors of Post-operative Neurocognitive Dysfunction.
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DOI：
10.3389/fnsys.2021.718769
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发表时间：
2021
影响因子：
3
通讯作者：
Whitson HE
中科院分区：
文献类型：
--
作者：
Acker L;Ha C;Zhou J;Manor B;Giattino CM;Roberts K;Berger M;Wright MC;Colon-Emeric C;Devinney M;Au S;Woldorff MG;Lipsitz LA;Whitson HE
由于多个控制过程在不同时间尺度上的相互作用，生理信号如脑电(EEG)显示出不规则的行为。这种行为的复杂性可以用多尺度熵(MSE)来量化。生理上的高度复杂性意味着健康，复杂性的降低可以预测不良后果。由于术后精神错乱尤其难以预测，我们调查了术前和术中额部脑电信号的复杂性是否可以预测术后精神错乱及其内表型注意力不集中。为了计算均方误差，计算了不同时间尺度下的脑电记录的样本熵，然后将其绘制成尺度图；复杂性是曲线下的总面积。对50例60岁≥患者手术前后额部脑电均方根值进行了计算。术中平均均方根显著高于术前(p=0.0003)。然而，术中脑电均方误差在较小范围内低于术前，但在较大范围内较高(交互作用p<；0.001)，形成了一个交叉点，根据定义，术前和术中均方误差曲线相交。总体而言，脑电复杂性与精神错乱或注意力不相关。在42/50例单交叉点的患者中，术中和术前熵曲线相交的程度与妄想-严重程度评分变化呈负相关(Spearmanρ=−0.31，p=0.054)。因此，老年人手术中的平均脑电复杂性增加，但与规模有关。术前和术中复杂性相等的程度(即交叉点)可能预示着精神错乱。未来的研究应该评估交叉点是否代表神经控制机制的变化，这种变化使患者容易发生术后精神错乱。
Physiologic signals such as the electroencephalogram (EEG) demonstrate irregular behaviors due to the interaction of multiple control processes operating over different time scales. The complexity of this behavior can be quantified using multi-scale entropy (MSE). High physiologic complexity denotes health, and a loss of complexity can predict adverse outcomes. Since postoperative delirium is particularly hard to predict, we investigated whether the complexity of preoperative and intraoperative frontal EEG signals could predict postoperative delirium and its endophenotype, inattention. To calculate MSE, the sample entropy of EEG recordings was computed at different time scales, then plotted against scale; complexity is the total area under the curve. MSE of frontal EEG recordings was computed in 50 patients ≥ age 60 before and during surgery. Average MSE was higher intra-operatively than pre-operatively (p = 0.0003). However, intraoperative EEG MSE was lower than preoperative MSE at smaller scales, but higher at larger scales (interaction p < 0.001), creating a crossover point where, by definition, preoperative, and intraoperative MSE curves met. Overall, EEG complexity was not associated with delirium or attention. In 42/50 patients with single crossover points, the scale at which the intraoperative and preoperative entropy curves crossed showed an inverse relationship with delirium-severity score change (Spearman ρ = −0.31, p = 0.054). Thus, average EEG complexity increases intra-operatively in older adults, but is scale dependent. The scale at which preoperative and intraoperative complexity is equal (i.e., the crossover point) may predict delirium. Future studies should assess whether the crossover point represents changes in neural control mechanisms that predispose patients to postoperative delirium.
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影响因子：
3.3
作者：
Manor, Brad;Costa, Madalena D.;Lipsitz, Lewis A.
通讯作者：
Lipsitz, Lewis A.
影响因子：
1.8
作者：
Costa, M.;Priplata, A. A.;Peng, C. K.
通讯作者：
Peng, C. K.
影响因子：
6.3
作者：
Berger, Miles;Oyeyemi, Deborah;Zani, Sabino
通讯作者：
Zani, Sabino
影响因子：
4.3
作者：
Eagleman SL;Vaughn DA;Drover DR;Drover CM;Cohen MS;Ouellette NT;MacIver MB
通讯作者：
MacIver MB
影响因子：
2.2
作者：
Loponen, Pertti;Luther, Michael;Tarkka, Matti R.
通讯作者：
Tarkka, Matti R.