Abstract:
Neonatal hypoxic-ischemic encephalopathy (HIE) evolves over different phases of time during recovery. Some neuroprotection treatments are only effective for specific, short windows of time during this evolution of injury. Clinically, we often do not know when an insult may have started, and thus which phase of injury the brain may be experiencing. To improve diagnosis, prognosis and treatment efficacy, we need to establish biomarkers which denote phases of injury. Our pre-clinical research, using preterm fetal sheep, show that micro-scale EEG patterns (e.g. spikes and sharp waves), superimposed on suppressed EEG background, primarily occur during the early recovery from an HI insult (0-6 h), and that numbers of events within the first 2 h are strongly predictive of neural survival. Thus, real-time automated algorithms that could reliably identify EEG patterns in this phase will help clinicians to determine the phases of injury, to help guide treatment options. We have previously developed successful automated machine learning approaches for accurate identification and quantification of HI micro-scale EEG patterns in preterm fetal sheep post-HI. This paper introduces, for the first time, a novel online fusion strategy that employs a high-level wavelet-Fourier (WF) spectral feature extraction method in conjunction with a deep convolutional neural network (CNN) classifier for accurate identification of micro-scale preterm fetal sheep post-HI sharp waves in 1024Hz EEG recordings, along with 256Hz down-sampled data. The classifier was trained and tested over 4120 EEG segments within the first 2 hours latent phase recordings. The WF-CNN classifier can robustly identify sharp waves with considerable high-performance of 99.86% in 1024Hz and 99.5% in 256Hz data. The method is an alternative deep-structure approach with competitive high-accuracy compared to our computationally-intensive WS-CNN sharp wave classifier. Clinical relevance—The suggested classifier could robustly identify EEG patterns of a similar morphology in preterm newborns during recovery from an HI insult.
