The effect of reducing EEG electrode number on the visual interpretation of the human expert for neonatal seizure detection

Publication date: January 2018
Source:Clinical Neurophysiology, Volume 129, Issue 1
Author(s): Nathan J. Stevenson, Leena Lauronen, Sampsa Vanhatalo
ObjectivesTo measure changes in the visual interpretation of the EEG by the human expert for neonatal seizure detection when reducing the number of recording electrodes.MethodsEEGs were recorded from 45 infants admitted to the neonatal intensive care unit (NICU). Three experts annotated seizures in EEG montages derived from 19, 8 and 4 electrodes. Differences between annotations were assessed by comparing intra-montage with inter-montage agreement (K).ResultsThree experts annotated 4464 seizures across all infants and montages. The inter-expert agreement was not significantly altered by the number of electrodes in the montage (p = 0.685, n = 43). Reducing the number of EEG electrodes altered the seizure annotation for all experts. Agreement between the 19-electrode montage (K19,19 = 0.832) was significantly higher than the agreement between 19 and 8-electrode montages (dK = 0.114; p < 0.001, n = 42) or 19 and 4-electrode montages (dK = 0.113, p < 0.001, n = 43). Seizure burden and number were significantly underestimated by the 4 and 8-electrode montage (p < 0.001). No significant difference in agreement was found between 8 and 4-electrode montages (dK = 0.002; p = 0.07, n = 42).ConclusionsReducing the number of EEG electrodes from 19 electrodes resulted in slight but significant changes in seizure detection.SignificanceFour-electrode montages for routine EEG monitoring are comparable to eight electrodes for seizure detection in the NICU.



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