AUTOMATED ANALYSIS OF THE ELECTRICAL ACTIVITY OF THE HUMAN BRAIN (EEG): A PROGRESS REPORT ‘Alan 8. Gevins, Charles L. Yeager, Stephen L. Diamond, Jean-Paul Spire, Gerry M. Zeitlin, and Adria H. Gevins (Copyright ©1975 by The Institute of Electrical and Electronica Bagineet, ne. Printed in US.A. Annals No, SIOPROOLsea, PROCEEDINGS OF THE IEEE, VOL. 63, NO. 10, OCTOBER 1975 Automated Analysis of the Electrical Activity of the Human Brain (EEG): A Progress Report ALAN S, GEVINS, CHARLES L. YEAGER, STEPHEN L. DIAMOND, JEAN-PAUL SPIRE, GERRY M. ZEITLIN, ano ADRIA H. GEVINS| Abstract—Clnical evaluation of electroencephalographic (EEG) re- cording is based on complex subjective process of data reduction and feature extraction. The high dimensionality of the EEG signal, its ‘varlablity, and the lack of standard population values have retarded de- ‘velopment of auiomied systems. An interactive, seal-time analy 57- {em (ADIEEG) has been implemented to develop features to simplify visual interpretation and facilitate automated claification. Tt uses 2 40-000 word PDPIS-PDFI1 dual processor computer. Resident code ‘ecupies approximately 31,000 locations, while maximum ef 12 000 locations aze used for buffers. ‘The syttem performs 1) continuots spectral analysis wing te fast Fourier transform to produce estimates (of power and coherence, 2) parallel time domain analysis to detect ‘sharp teansients significant to diagnosis, 3) several forms of gaphics, ‘4 simple algoriums 10 reject noncortical and instrumental artifact, 5) interactive parameter alteration and ondine feedback to adjust decision ‘thresholds when neces, and 6) extraction of diagnostically elpful ‘eatues using heuristics based on clinical EEG. "The ADIEEG eyrtom reside in the University of California, San Fran- sco Medical Center, and Langey Porter Neuropsychiatric Insitute. 1. IntRopucrion A. History and Current Application of EEG eee EEG is a research tool in neurophysiology [11], psychophys- B. Origination of EEG Intracellular recordings have established that the scalp BEG derives from graded synaptic potentials generated by pyramidal cells in the cerebral cortex, which are triggered by rhythmic discharges from thalamic nuclei. A pacemaker system situated {in the thalamus and in the reticular formation probably regu- lates the synchrony of cortical signals (7], (111, [17]. The potentials are diffused and attenuated as they are conducted ‘through the cerebrospinal fluid, the skull, and the scalp [18]~ [22]. As recorded from electrodes attached to the surface of the scalp, the EEG normally ranges from 10 to 200 pV, but ‘may rise to S mV during epileptic seizures. Manuscript received January 6, 1975: revised May 5, 1975. This work wat fupported in part by National Inter of Heath under Geant NS 1047 ‘The authors are with the EEG Systems Group, Universit of Clif nia Medical Center, San Francisco, Calf 94143. C. The Traditional Method of EEG Recording The 2-stage’ dc-coupled differential amplifiers most com- monly used for EEG recording have input impedances of 1-10 ‘MQ and common mode rejections exceeding 500: 1 [23] ‘The 3-4B bandpass points are typically set to 1 and 70 Hz. Between I and 22 electrodes are applied to the subject’s scalp in a stereotyped symmetrical pattem [24]. Standard pattems ‘of connection between electrodes (montage) are selected, and amplifier exins and passbands afe adjusted by the attending ERG technician t6 hest reveal the distinguishing character of the patient’s EEG. A typical recording session lasts about 30 ‘min, generates approximately 55 meters of paper tracings, and. includes periods of recording the eyes-closed and eyes-open states, as well as several activating procedures such as hyper~ ventilation, photic stimulation, and natural or induced sleep. D. The Traditional Method of BEG Interpretation Electrooncephalographers employ complex subjective pattern recognition techniques to reduce the polygraph recording to a few interpretive statements (51-171, [25], [26]. Keeping in ‘mind what is known about the patient, the clinician categorizes the tracings on the basis of frequency, amplitude, and spatial and temporal distributions. Patterns of activity are considered to either constitate a background continuum, for example the 4 continuous rhythms labeled delta through beta in Fig. 1(a)~ (@), oF to be transients, as are the paroxysmal waveforms of Figs. 1(f)-G) and 2 which are often astociatea with epilepsy [9]. Interchannel comparisons are made to reveal major dis: crepancies in amplitude and wave shape such’ as hemispheric asymmetry or focal activity. In complex records, the analysis and identification of individual components are often s0 diffi- cult that specific analysis must be deemphasized in favor of a general interpretation of the overall pattern. Few of these methods are directly amenable to quantification or to precise definition, ‘The few studies which have examined the reliability of EEG. Interpretation {27]-[29] have shown high agreement among. electroencephalographers in making overall classifications of records as normal or abnormal. Houfek and Ellingson [27] found that many more differences occurred when borderline ‘cases displaying minimal abnormal activity were iudged. Gose, Werner, and Bickford [29] found frequent disagreement on classification of individual sharp transient waveforms, but high ‘agreement on overall classification E. The History of Automated EBG Systems Reviews of the special-purpose devices and computer tech- ‘niques applied to EEG analysis [30]-[371 reveal the EEG to bbe one of the last of the standard clinical tests to be automated. Factors contributing to this delay include the comparatively ‘small number of EEG recordings made, the complexity of the Copyright ©1975 by The Institute of Electrics and Electronics Engineers, Inc. Printed in US.A. Annals No, SLOPROLGEVINS etal: AUTOMATED EEG ANALYSIS pe — neem iq MO espa ma nmi ARH) ban ees at oa yt =A NWN TR Anan arniten + To = Arne tra te ast etch eens” Syn ces” crs PRE HY Post—Hy Bn carina Mell AIL tit encom Al Ney ad hh wht HAL Nero Ce Agen Onl etna TeAg rete On Men Phage Fig. 1. Components of KEG. Traditional EEG bands extend from 1-30 ‘pe. Note falloff of amplltode with frequency. Distinctions are drawn, ‘ewen (huh (whlch ay be hia a form a (of alpha tytn and appearance af low-voltage theta activity as Aah NR oI ue ie 2 6s of poleranh acing Gom un epic ptt snp. Scalp (bipolar) channels aye arranged from (EIFS) 10 pos {erlor (25-01) scalp placements, Electrode placements corrersond to Shatomical locations as follows! FPI-left superior frontal gyrus, 3-teft middle frontal gyrus, C3—teft central sulcus: P3~leftangulr eft lateral occipital ye, Homologour placements. on ad are annotated ap FP2, F4, C424, 02. Waveforms by majority of 9 human scores have been indicated with dot.” ‘Computer detections ae indiated on ‘bottom marker channel by $ fuzzy bipy. The system scores as sngle vent all significant sharp teazslontsznat occur within epprosimately ‘0109 sof each other on same or anatomical adjeceat chennels: signal, the subjective method of interpretation, and the cor roborative rather than independently diggnostic nature of the EEG test. In their 1972 review of the literature, Cox, Nolle, and Arthur [35] concluded that only in the limited area of sleep research have automatic techniques of EEG analysis been sufficiently developed for performance evaluation to take place. Although, with the possible exception of rudimentary screening proce dures, the human interpreter will not be eliminated from the analytic process in the immediate future, current automated systems can simplify the process of interpretation and develop, the data bases necessary for automated classification. The de velopment of automated systems has focused on 6 areas: 1) establishment of data bases and determination of standard values, 2) analysis of background shythms, 3) detection of in- frequent but clinicaly significant transient activity, 4) simplifi cation of displays, 5) classification of patterns, and 6) extrac- tion of features 1) Data Bases and Standard Values: A major obstacle to the automation of clinical EEG has been the lack of widely available standardized data bases upon which to perform ‘quantitative studies. The best of the few existing ERG data bases, “The normative EEG reference library,” [38] consists of I-h recordings from 200 normal subjects. It is over 11 years ald, Several quantitative studies have been undertaken to specify the range of EEG variation [39]-[46]. Significant differences ‘were found between individuals in the 7-13-Hz range when compared with intra-individual variation [42]. Studies of de+ velopmental changes of the EEG [44], [45] have shown that the ratio of theta to alpha activity, corrected with an empitical factor, is highly correlated with age; other studies [45] have reported that the average variation of mean dominant fres. ‘quency over successive days was + 0.5 Hz, but that frequency id not vary as a function of adult age or sex. Interindividual variability seemed to increase with age, while intra-individual variability of amplitude remained the same across age groups. 2) Analysis of Background Activity: In 1938, Grass and Gibbs [47] applied the Fourier transform to the EEG, demon- strating the technique fo be a useful way to characterize back-