Epilepsy is one of the most common neurological diseases that manifests in repetitive epileptic seizures as a result of an abnormal, synchronous activity of a large group of neurons. Depending on the affected brain regions, seizures produce various severe clinical symptoms. There is no cure for epilepsy and sometimes even medication and other therapies, like surgery, vagus nerve stimulation or ketogenic diet, do not control the number of seizures. In that case, long-term (home) monitoring and automatic seizure detection would enable the tracking of the evolution of the disease and improve objective insight in any responses to medical interventions or changes in medical treatment. Especially during the night, supervision is reduced; hence a large number of seizures is missed. In addition, an alarm should be integrated into the automated seizure detection algorithm for severe seizures in order to help the ...

Advances in wearable electrocardiogram (ECG) monitoring devices have allowed for new cardiovascular applications to emerge beyond diagnostics, such as stress and fatigue detection, athletic performance assessment, sleep disorder characterization, mood recognition, activity surveillance, biometrics, and fitness tracking, to name a few. Such devices, however, are prone to artifacts, particularly due to movement, thus hampering heart rate and heart rate variability measurement and posing a serious threat to cardiac monitoring applications. To address these issues, this thesis proposes the use of a spectro-temporal signal representation called “modulation spectrum”, which is shown to accurately separate cardiac and noise components from the ECG signals, thus opening doors for noise-robust ECG signal processing tools and applications. First, an innovative ECG quality index based on the modulation spectral signal representation is proposed. The representation quantifies the rate-of-change of ECG spectral components, which are shown to ...

Epilepsy is a neurological condition that manifests in epileptic seizures as a result of an abnormal, synchronous activity of a large group of neurons. Depending on the affected brain regions, seizures produce various severe clinical symptoms. Epilepsy cannot be cured and in many cases is not controlled by medication either. Surgical resection of the region responsible for generating the epileptic seizures might offer remedy for these patients. Electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) measure the changes of brain activity in time over different locations of the brain. As such, they provide valuable information on the nature, the timing and the spatial origin of the epileptic activity. Unfortunately, both techniques record activity of different brain and artefact sources as well. Hence, EEG and fMRI signals are characterised by low signal to noise ratio. Data quality and the vast amount ...

Brain function requires a continuous flow of oxygen and glucose. An insufficient supply for a few minutes during the first period of life may have severe consequences or even result in death. This happens in one to six infants per 1000 live term births. Therefore, there is a high need for a method which can enable bedside brain monitoring to identify those neonates at risk and be able to start the treatment in time. The most important currently available technology to continuously monitor brain function is electroEncephaloGraphy (or EEG). Unfortunately, visual EEG analysis requires particular skills which are not always present round the clock in the Neonatal Intensive Care Unit (NICU). Even if those skills are available it is laborsome to manually analyse many hours of EEG. The lack of time and skill are the main reasons why EEG is ...

A complex physical system like the human brain can only be comprehended by the use of a combination of various medical imaging techniques, each of which shed light on only a specific aspect of the neural processes that take place beneath the skull. Electroencephalography (EEG) and functional magnetic resonance (fMRI) are two such modalities, which enable the study of brain (dys)function. While the EEG is measured with a limited set of scalp electrodes which record rapid electrical changes resulting from neural activity, fMRI offers a superior spatial resolution at the expense of only picking up slow fluctuations of oxygen concentration that takes place near active brain cells. Hence, combining these very complementary modalities is an appealing, but complicated task due to their heterogeneous nature. In this thesis, we devise advanced signal processing techniques which integrate the multimodal data stemming from ...

Epilepsy is one of the most common neurological diseases, especially in children. And although the majority of patients can be treated through medication or surgery (70%-75%), a significant group of patients cannot be treated. For this latter group of patients it is advisable to follow the evolution of the disease. This can be done through a long-term automatic monitoring, which gives an objective measure of the number of seizures that the patient has, for example during the night. On the other hand, there is a reduced social control overnight and the parents or caregivers can miss some seizures. In severe seizures, it is sometimes necessary, however, to avoid dangerous situations during or after the seizure (e.g. the danger of suffocation caused by vomiting or a position that obstructs breathing, or the risk of injury during violent movements), and to comfort ...

Electrocardiography (ECG) is the standard method for assessing the state of the cardiovascular system non-invasively. In the context of magnetic resonance imaging (MRI) the ECG signal is used for cardiac monitoring and triggering, i.e., the acquisition of images synchronized to the cardiac cycle. However, ECG acquisition is impeded by the static and dynamic magnetic fields which alter the measured voltages and may reduce signal-to-noise ratio (SNR), leading to false alarms during cardiac monitoring or to image artifacts during cardiac triggering. A major source of noise is the magnetohydrodynamic (MHD) effect as it is proportional to field strength and represents a key challenge in application of ultra-high-field (UHF) MRI >=7 T. In this work, two approaches for overcoming these limitations are proposed: i) Development of a hardware and software system based on the principal of photoplethysmography imaging (PPGi) as an optical ...

Obstructive sleep apnea (OSA) is among the most prevalent sleep disorders, which is estimated to affect 6 %−19 % of women and 13 %−33 % of men. Besides daytime sleepiness, impaired cognitive functioning and an increased risk for accidents, OSA may lead to obesity, diabetes and cardiovascular diseases (CVD) on the long term. Its prevalence is only expected to rise, as it is linked to aging and excessive body fat. Nevertheless, many patients remain undiagnosed and untreated due to the cumbersome clinical diagnostic procedures. For this, the patient is required to sleep with an extensive set of body attached sensors. In addition, the recordings only provide a single night perspective on the patient in an uncomfortable, and often unknown, environment. Thus, large scale monitoring at home is desired with comfortable sensors, which can stay in place for several nights. To ...

Obstructive sleep apnea (OSA) is the most prevalent sleep related breathing disorder, nevertheless subjects suffering from it often remain undiagnosed due to the cumbersome diagnosis procedure. Moreover, the prevalence of OSA is increasing and a better phenotyping of patients is needed in order to prioritize treatment. The goal of this thesis was to tackle those challenges in OSA diagnosis. Additionally, two main algorithmic contributions which are generally applicable were proposed within this thesis. The binary interval coded scoring algorithm was extended to multilevel problems and novel monotonicity constraints were introduced. Moreover, improvements to the random-forest based feature selection were proposed including the use of the Cohen’s kappa value, patient independent validation, and further feature pruning steered by the correlation between features. These novel methods were applied together with classification and feature selection methods from the literature to improve the OSA ...

Acutely-ill hospitalised patients are at risk of clinical deteriorations in health leading to adverse events such as cardiac arrests. Deteriorations are currently detected by manually measuring physiological parameters every 4-6 hours. Consequently, deteriorations can remain unrecognised between assessments, delaying clinical intervention. It may be possible to provide earlier detection of deteriorations by using wearable sensors for continuous physiological monitoring. Respiratory rate (RR) is not commonly monitored by wearable sensors, despite being a sensitive marker of deteriorations. This thesis presents investigations to identify an algorithm suitable for estimating RR from two signals commonly acquired by wearable sensors: the electrocardiogram (ECG) and photoplethysmogram (PPG). A suitable algorithm was then used to estimate RRs retrospectively from a physiological dataset acquired from acutely-ill patients to assess the potential utility of wearable sensors for detecting deteriorations. Existing RR algorithms were identi ed through a systematic ...

This research focuses on the development of algorithms to extract diagnostic information from the ECG signal, which can be used to improve automatic detection systems and home monitoring solutions. In the first part of this work, a generically applicable algorithm for model selection in kernel principal component analysis is presented, which was inspired by the derivation of respiratory information from the ECG signal. This method not only solves a problem in biomedical signal processing, but more importantly offers a solution to a long-standing problem in the field of machine learning. Next, a methodology to quantify the level of contamination in a segment of ECG is proposed. This level is used to detect artifacts, and to improve the performance of different classifiers, by removing these artifacts from the training set. Furthermore, an evaluation of three different methodologies to compute the ECG-derived ...

This work has, as its objective, the development of non-invasive and low-cost systems for monitoring and automatic diagnosing specific neonatal diseases by means of the analysis of suitable video signals. We focus on monitoring infants potentially at risk of diseases characterized by the presence or absence of rhythmic movements of one or more body parts. Seizures and respiratory diseases are specifically considered, but the approach is general. Seizures are defined as sudden neurological and behavioural alterations. They are age-dependent phenomena and the most common sign of central nervous system dysfunction. Neonatal seizures have onset within the 28th day of life in newborns at term and within the 44th week of conceptional age in preterm infants. Their main causes are hypoxic-ischaemic encephalopathy, intracranial haemorrhage, and sepsis. Studies indicate an incidence rate of neonatal seizures of 2‰ live births, 11‰ for preterm ...

Localizing the bioelectric phenomena originating from the cerebral cortex and evoked by auditory and somatosensory stimuli are clear objectives to both understand how the brain works and to recognize different pathologies. Diseases such as Parkinson's, Alzheimer's, schizophrenia and epilepsy are intensively studied to find a cure or accurate diagnosis. Epilepsy is considered the disease with major prevalence within disorders with neurological origin. The recurrent and sudden incidence of seizures can lead to dangerous and possibly life-threatening situations. Since disturbance of consciousness and sudden loss of motor control often occur without any warning, the ability to predict epileptic seizures would reduce patients' anxiety, thus considerably improving quality of life and safety. The common procedure for epilepsy seizure detection is based on brain activity monitorization via electroencephalogram (EEG) data. This process consumes a lot of time, especially in the case of long ...

Objective diagnosis and therapy evaluation are still challenging tasks for many neurological disorders. This is highly related to the diversity of cases and the variety of treatment modalities available. Especially in the case of epilepsy, which is a complex disorder not well-explained at the biochemical and physiological levels, there is the need for investigations for novel features, which can be extracted and quantified from electrophysiological signals in clinical practice. Neurotherapy is a complementary treatment applied in various disorders of the central nervous system, including epilepsy. The method is subsumed under behavioral medicine and is considered an operant conditioning in psychological terms. Although the application areas of this promising unconventional approach are rapidly increasing, the method is strongly debated, since the neurophysiological underpinnings of the process are not yet well understood. Therefore, verification of the efficacy of the treatment is one ...

The brain is the most important signal processing unit in the human body. It is responsible for receiving, processing and storing information. One of the possibilities to study brain functioning is by placing electrodes on the scalp and recording the synchronous neuronal activity of the brain. Such a recording measures a combination of active processes in the whole brain. Unfortunately, it is also contaminated by artifacts. By extracting the artifacts and removing them, cleaned recordings can be investigated. Furthermore, it is easier to look at specific brain activities, like an epileptic seizure, than at a combination. In this thesis, we present different mathematical techniques that can be used to extract individual contributing sources from the measured signals for this purpose. We focused on Canonical Correlation Analysis (CCA), Independent Component Analysis (ICA) and Canonical/ Parallel Factor Analysis (CPA). We show that ...