K. Narayanan

Long-term prospective on-line real-time seizure prediction

OBJECTIVE Epilepsy, one of the most common neurological disorders, constitutes a unique opportunity to study the dynamics of spatiotemporal state transitions in real, complex, nonlinear dynamical systems. In this study, we evaluate the performance of a prospective on-line real-time seizure prediction algorithm in two patients from a common database. METHODS We previously demonstrated that measures of chaos and angular frequency, estimated from electroencephalographic (EEG) signals recorded at critical sites in the cerebral cortex, progressively converge (i.e. become dynamically entrained) as the epileptic brain transits from the asymptomatic interictal state to the ictal state (seizure) (Iasemidis et al., 2001, 2002a, 2003a). This observation suggested the possibility of developing algorithms to predict seizures well ahead of their occurrences. One of the central points in those investigations was the application of optimization theory, specifically quadratic zero-one programming, for the selection of the critical cortical sites. This current study combines that observation with a dynamical entrainment detection method to prospectively predict epileptic seizures. The algorithm was tested in two patients with long-term (107.54h) and multi-seizure EEG data B and C (Lehnertz and Litt, 2004). RESULTS Analysis from the 2 test patients resulted in the prediction of up to 91.3% of the impending 23 seizures, about 89+/-15min prior to seizure onset, with an average false warning rate of one every 8.27h and an allowable prediction horizon of 3h. CONCLUSIONS The algorithm provides warning of impending seizures prospectively and in real time, that is, it constitutes an on-line and real-time seizure prediction scheme. SIGNIFICANCE These results suggest that the proposed seizure prediction algorithm could be used in novel diagnostic and therapeutic applications in epileptic patients.

On the evidence of deterministic chaos in ECG: Surrogate and predictability analysis

The question whether the human cardiac system is chaotic or not has been an open one. Recent results in chaos theory have shown that the usual methods, such as saturation of correlation dimension D(2) or the existence of positive Lyapunov exponent, alone do not provide sufficient evidence to confirm the presence of deterministic chaos in an experimental system. The results of surrogate data analysis together with the short-term prediction analysis can be used to check whether a given time series is consistent with the hypothesis of deterministic chaos. In this work nonlinear dynamical tools such as surrogate data analysis, short-term prediction, saturation of D(2) and positive Lyapunov exponent have been applied to measured ECG data for several normal and pathological cases. The pathology presently studied are PVC (Premature Ventricular Contraction), VTA (Ventricular Tachy Arrhythmia), AV (Atrio-Ventricular) block and VF (Ventricular Fibrillation). While these results do not prove that ECG time series is definitely chaotic, they are found to be consistent with the hypothesis of chaotic dynamics. (c) 1998 American Institute of Physics.

Prediction of Human Epileptic Seizures based on Optimization and Phase Changes of Brain Electrical Activity

The phenomenon of epilepsy, one of the most common neurological disorders, constitutes a unique opportunity to study the dynamics of spatiotemporal state transitions in real, complex, nonlinear dynamical systems. We previously demonstrated that measures of chaos and angular frequency obtained from electroencephalographic (EEG) signals generated by critical sites in the cerebral cortex converge progressively (dynamical entrainment) from the asymptomatic interictal state to the ictal state (seizure) [L.D. Iasemidis, P. Pardalos, J.C. Sackellares and D.-S. Shiau (2001). Quadratic binary programming and dynamical system approach to determine the predictability of epileptic seizures. J. Combinatorial Optimization, 5, 9–26; L.D. Iasemidis, D.-S. Shiau, P.M. Pardalos and J.C. Sackellares (2002). Phase entrainment and predictability of epileptic seizures. In: P.M. Pardalos and J. Principe (Eds.), Biocomputing, pp. 59–84. Kluwer Academic Publishers]. This observation suggests the possibility of developing algorithms to predict seizures. One of the central points of those investigations was the application of optimization theory, specifically quadratic zero-one programming, for the selection of the cortical sites that exhibit preictal dynamical entrainment. In this study we present results from the application of this methodology to the prediction of epileptic seizures. Analysis of continuous, long-term (18–140 h), multielectrode EEG recordings from 5 patients resulted in the prediction of 88% of the impending 50 seizures, on average about 83 min prior to seizure onset, with an average false warning rate of one every 5.26 h. These results suggest that this seizure prediction algorithm performs well enough to be used in diagnostic and therapeutic applications in epileptic patients. Similar algorithms may be useful for certain spatiotemporal state transitions in other physical and biological systems.

Information Flow in Coupled Nonlinear Systems: Application to the Epileptic Human Brain

A recently proposed measure, namely Transfer Entropy (TE), is used to estimate the direction of information flow between coupled linear and nonlinear systems. In this study, we suggest improvements in the selection of parameters for the estimation of TE that significantly enhance its accuracy and robustness in identifying the direction of information flow and quantifying the level of interaction between observed data series from coupled systems. We demonstrate the potential usefulness of the improved method through simulation examples with coupled nonlinear chaotic systems. The statistical significance of the results is shown through the use of surrogate data. The improved TE method is then used for the study of information flow in the epileptic human brain. We illustrate the application of TE to electroencephalographic (EEG) signals for the study of localization of the epileptogenic focus and the dynamics of its interaction with other brain sites in two patients with Temporal Lobe Epilepsy (TLE).

Measuring the direction and the strength of coupling in nonlinear Systems-a modeling approach in the State space

We present a novel signal processing methodology to determine the direction and the strength of coupling between coupled nonlinear systems. The methodology is based on multivariate local linear prediction in the reconstructed state spaces of the observed variables from each multivariable nonlinear system. Application of the method is illustrated with systems of coupled Rossler and Lorenz oscillators in various coupling configurations. The obtained results are compared with ones produced by the use of the directed transfer function, a model-based method in the time domain. Through a surrogate analysis, it is shown that the proposed method is more reliable than the directed transfer function in identifying the direction and strength of the involved interactions.

Effects of Deep Brain Stimulation on dynamic posture shifts in Parkinson's disease

Deep Brain Stimulation (DBS) of the subthalamic nucleus (STN) is now widely used to alleviate symptoms of Parkinsons disease (PD). The long-term goal is to develop a quantitative tool to facilitate selection of DBS settings in the clinic since the typical parameter selection process may not adequately consider the effects of DBS on posture control. The aim of this study was to characterize the effects of changing the stimulation amplitude of DBS on posture control in PD. A dynamic posture shift paradigm involving target acquisition was used to assess posture control in 4 PD STN-DBS subjects. Each subject was tested at 4 stimulation amplitude settings: Clinically-determined (CD) settings, moderate (approx. 70% CD), low (approx. 30% CD), and off (no stimulation). Movements of the center of pressure and the position of the pelvis were monitored and several quantitative indices were calculated. The most substantial change was reductions in the peak velocity and the average movement velocity during the initial and mid phases of movement towards the target posture. These results may be explained in terms of increased akinesia and bradykinesia in the altered stimulation conditions. Thus, the dynamic posture shift paradigm can reveal changes in posture control capabilities, as evidenced by changes in movement velocity, due to alterations in DBS stimulation settings.

Dynamics of cardiac system through unstable periodic orbits

For the first time unstable periodic orbits (UPOs) are extracted from experimental human ECG signals for the quantitative classification of normal and abnormal cases. The normal cardiac system is characterized by three or four UPOs whereas pathological conditions such as premature ventricular contraction, ventricular fibrillation, and atrioventricular block shows different trends in the number and distribution of the UPOs.