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Biopotentials and

Electrophysiology
Measurement
Agenda
Introduction to biopotentials
Measurement methods
Traditional: ECG, EEG, EMG, EOG
Novell: VCG
Measurement considerations
Electronics
Electrodes
Practices
What are biopotentials
Biopotential: An electric potential that is measured between points in
living cells, tissues, and organisms, and which accompanies all
biochemical processes.
Also describes the transfer of information between and within cells
Mechanism behind biopotentials 1/2
Concentration of potassium (K+) ions
is 30-50 times higher inside as
compared to outside
Sodium ion (Na+) concentration is 10
times higher outside the membrane Vm 70... 100 mV
than inside
In resting state the member is
permeable only for potassium ions
Potassium flows outwards leaving an
equal number of negative ions inside
Electrostatic attraction pulls
potassium and chloride ions close to
the membrane
Electric field directed inward forms
Electrostatic force vs.RT ci ,k force
diffusional
Nernst equation:Vk ln
zk F co ,k

Goldman-Hodgkin-Katz equation:
RT PK ci , K PNa ci , Na PCl ci ,Cl
Vm ln Vm 70... 100 mV
z k F PK ci , K PNa ci , Na PCl ci ,Cl
Mechanism behind biopotentials 2/2
When membrane stimulation exceeds a
threshold level of about 20 mV, so called
action potential occurs:
1. Sodium and potassium ionic permeabilities
of the membrane change
2. Sodium ion permeability increases very
rapidly at first, allowing sodium ions to
flow from outside to inside, making the
inside more positive
3. The more slowly increasing potassium ion
permeability allows potassium ions to flow
from inside to outside, thus returning
membrane potential to its resting value
4. While at rest, the Na-K pump restores the
ion concentrations to their original values
The number of ions flowing through an
open channel >106/sec
Body is an inhomogeneous volume
conductor and these ion fluxes create
measurable potentials on body surface
Electrocardiography (ECG)
Measures galvanically the electric activity of the heart
Well known and traditional, first measurements by
Augustus Waller using capillary electrometer (year 1887)
Very widely used method in clinical environment
Very high diagnostic value

2. Ventricular 3. Ventricular repolarization


depolarization

1. Atrial
depolarization
ECG basics
Amplitude: 1-5 mV
Bandwidth: 0.05-100 Hz

Largest measurement error sources:


Motion artifacts
50/60 Hz powerline interference

Typical applications:
Diagnosis of ischemia
Arrhythmia
Conduction defects
12-Lead ECG measurement
Most widely used ECG measurement setup in clinical environment
Signal is measured non-invasively with 9 electrodes
Lots of measurement data and international reference databases
Well-known measurement and diagnosis practices
This particular method was adopted due to historical reasons, now it is
already rather obsolete

Einthoven leads: I, II & III Goldberger augmented leads: VR, VL & VF Precordial leads: V1-V6
Why is 12-lead system obsolete?
Over 90% of the hearts electric activity can be explained
with a dipole source model
Only 3 orthogonal components need to be measured,
which makes 9 of the leads redundant
The remaining percentage, i.e. nondipolar components,
may have some clinical value
This makes 8 truly independent and 4 redundant leads
12-lead system does, to some extend, enhance pattern
recognition and gives the clinician a few more projections
to choose from
but.
If there was no legacy problem with current
systems, 12-lead system wouldve been
discarded ages ago
Electroencephalography (EEG)
Measures the brains electric
activity from the scalp
Measured signal results from
the activity of billions of neurons

Amplitude: 0.001-0.01 mV
Bandwidth: 0.5-40 Hz

Errors:
Thermal RF noise
50/60 Hz power lines
Blink artifacts and similar

Typical applications:
Sleep studies
Seizure detection
Cortical mapping
EEG measurement setup
10-20 Lead system is most

widely clinically accepted


Certain physiological
features
are used as reference
points
Allow localization of
diagnostic features in the
vicinity of the electrode
Often a readily available
wire or rubber mesh is
used
Brain research utilizes
even 256 or 512 channel
EEG hats
Electromyography (EMG)
Measures the electric activity of active muscle fibers
Electrodes are always connected very close to the muscle
group being measured
Rectified and integrated EMG signal gives rough indication
of the muscle activity
Needle electrodes can be used to measure individual muscle
fibers

Amplitude: 1-10 mV
Bandwidth: 20-2000 Hz

Main sources of errors are 50/60 Hz and RF interference

Applications: muscle function, neuromuscular disease, prosthesis


Electrooculography (EOG)
Electric potentials are created as a result of the movement of the
eyeballs
Potential varies in proportion to the amplitude of the movement
In many ways a challenging measurement with some clinical
value

Amplitude: 0.01-0.1 mV
Bandwidth: DC-10 Hz

Primary sources of error include skin potential and motion

Applications: eye position, sleep state, vestibulo-ocular reflex


Vectorcardiogram (VCG or EVCG)
Instead of displaying the scalar amplitude
(ECG curve) the electric activation front is
measured and displayed as a vector
(dipole model, remember?)
It has amplitude and direction
Diagnosis is based on the curve that the
point of this vector draws in 2 or 3
dimensions
The information content of the VCG signal
is roughly the same as 12-lead ECG
system. The advantage comes from the
way how this information is displayed
A normal, scalar ECG curve can be formed
from this vectro representation, although
(for practical reasons) transformation can
be quite complicated
Plenty of different types of VCG systems
are in use
The biopotential amplifier
Small amplitudes, low frequencies, environmental and biological
sources of interference etc.
Essential requirements for measurement equipment:
High amplification
High differential gain, low common mode gain high CMRR
High input impedance
Low Noise
Stability against temperature and voltage fluctuations
Electrical safety, isolation and defibrillation protection
The Instrumentation Amplifier
Potentially combines the best features desirable for biopotential
measurements
High differential gain, low common mode gain, high CMRR, high input
resistance
A key design component to almost all biopotential measurements!
Simple and cheap, although high-quality OpAmps with high CMRR
R R
should be used G1 1 2 2 G2 4
R1 R3

CMRR fine tuning


Application-specific requirements
ECG amplifier
Lower corner frequency 0.05 Hz, upper 100Hz
Safety and protection: leakage current below safety standard limit of 10 uA
Electrical isolation from the power line and the earth ground
Protection against high defibrillation voltages
EEG amplifier
Gain must deal with microvolt or lower levels of signals
Components must have low thermal and electronic noise @ the front end
Otherwise similar to ECG
EMG amplifier
Slightly enhanced amplifier BW suffices
Post-processing circuits are almost always needed (e.g. rectifier + integrator)
EOG amplifier
High gain with very good low frequency (or even DC) response
DC-drifting electrodes should be selected with great care
Often active DC or drift cancellation or correction circuit may be necessary
Electrical Interference Reduction
Power line interference (50 or 60 Hz) is always around us
Connects capacitively and causes common mode interference
The common mode interference would be completely rejected by the
instrumentation amplifier if the matching would be ideal
Often a clever driven right leg circuit is used to further enhance CMRR
Average of the VCM is inverted and driven back to the body via reference
electrode

iD R0
VCM iD R0 VCM
R
1 2 2
R1
Filtering
Filtering should be included in the front end of the InstrAmp
Transmitters, motors etc. cause also RF interference

Small inductors Low-pass filtering


or ferritefilter
High-pass beads at several stages
RFthe
filtering with
toin
reject
smallHF
lead
DC wires
drifting
capacitors
is recommended to
block frequency attenuate residual
EM interference RF interference
50 or 60 Hz notch filter
Sometimes it may be desirable to remove the power line
interference
Overlaps with the measurement bandwidth
May distort the measurement result and have an affect on the
diagnosis!
Option often available with EEG & EOG measuring instruments
Determines
notch
frequency

Twin T
Notch
notch tuning
filter
Artifact reduction
Electrode-skin interface is a major source of artifact
Changes in the junction potential causes slow changes in the
baseline
Movement artifacts cause more sudden changes and artifacts
Drifting in the baseline can be detected by discharging the high-
pass capacitor in the amplifier to restore the baseline
Electrical isolation
Electrical isolation limits the possibility of passage of any leakage
current from the instrument in use to the patient
Such passage would be harmful if not fatal!

1. Transformer
Transformers are inherently high
frequency AC devices
Modulation and demodulation
needed

2. Optical isolation
Optical signal is modulated in
proportion to the electric signal
and transmitted to the detector
Typically pulse code modulated to
circumvent the inherent
nonlinearity of the LED-
phototransistor combination
Defibrillation Protection
Measuring instruments can encounter very high voltages
E.g. 15005000V shocks from defibrillator
Front-end must be designed to withstand these high voltages

1. Resistors in the input


leads limit the current
3. Protection against
much higher
2. Diodes or Zener diodes voltages
protect against high is achieved with
voltages low-pressure gas
discharge tubes
Discharge @ 0.7-15V (e.g. neon lamps)
(note: even isolation
components such as
transformers and
optical isolators need
these spark gaps)
Discharge @ ~100V
Electrodes Basics
High-quality biopotential measurements require
Good amplifier design
Use of good electrodes and their proper placement on the patient
Good laboratory and clinical practices
Electrodes should be chosen according to the application
Basic electrode structure includes:
The body and casing
Electrode made of high-conductivity material
Wire connector
Cavity or similar for electrolytic gel
Adhesive rim
The complexity of electrode design often neglected
Electrodes - Basics
Skin preparation by abrasion or cleansing
Placement close to the source being measured
Placement above bony structures where there is less muscle mass
Distinguishing features of different electrodes:
How secure? The structure and the use of strong but less irritant adhesives
How conductive? Use of noble metals vs. cheaper materials
How prone to artifact? Use of low-junction-potential materials such as Ag-AgCl
If electrolytic gel is used, how is it applied? High conductivity gels can help
reduce the junction potentials and resistance but tend to be more allergenic
or irritating

Baseline drift due to the


changes in junction
potential or motion artifacts
Choice of electrodes Muscle signal
interference
Placement
Electromagnetic
interference
Shielding
Ag-AgCl, Silver-Silver Chloride Electrodes
The most commonly used electrode type
Silver is interfaced with its salt silver-chloride
Choice of materials helps to reduce junction
potentials
Junction potentials are the result of the dissimilar
electrolytic interfaces
Electrolytic gel enhances conductivity and also
reduces junction potentials
Typically based on sodium or potassium chloride,
concentration in the order of 0.1 M weak enough to
not irritate the skin
The gel is typically soaked into a foam pad or
applied directly in a pocket produced by electrode
housing
Relatively low-cost and general purpose electrode
Particularly suited for ambulatory or long term use
Gold Electrodes
Very high conductivity suitable for low-noise meas.
Inertness suitable for reusable electrodes
Body forms cavity which is filled with electrolytic gel
Compared to Ag-AgCL: greater expense, higher
junction potentials and motion artifacts
Often used in EEG, sometimes in EMG

Conductive polymer electrodes


Made out of material that is simultaneously conductive and
adhesive
Polymer is made conductive by adding monovalent metallic ions
Aluminum foil allows contact to external instrumentation
No need for gel or other adhesive substance
High resistivity makes unsuitable for low-noise meas.
Not as good connection as with traditional electrodes
Metal or carbon electrodes
Other metals are seldom used as high-quality noble
metal electrodes or low-cost carbon or polymeric
electrodes are so readily available
Historical value. Bulky and awkward to use
Carbon electrodes have high resistivity and are noisier
but they are also flexibleand reusable
Applications in electrical stimulation and impedance
plethysmography
Needle electrodes
Obviously invasive electrodes
Used when measurements have to be taken from the organ itself
Small signals such as motor unit potentials can be measured
Needle is often a steel wire with hooked tip
Biopotentials
ECG electrocardiogram
abnormal heart beats or arrhythmias
can be readily diagnosed from an ECG
EEG electroencephalogram
Neurologists interpret EEG signals to
identify epileptic seizure events
Biopotentials
EMG electrotromyogram
EMG signals can be helpful in assessing muscle
function as well as neuromuscular disorders
EOG electrooculogram
EOG signals are used in the diagnosis of disorders
of eye movement and balance disorders

These biopotentials represent the activity of the


respective organs: the heart, brain, muscle,
and eyes.
The Origins of
Biopotentials
The origins of these biopotentials can be traced to
the electric activity at the cellular level. The electric
potential across a cell membrane is the result of
different ionic concentrations that exist inside and
outside the cell. The electrochemical concentration
gradient across a semipermeable membrane results
in the Nernst potential. The cell membrane
separates high concentrations of potassium ion and
low concentrations of sodium ions (along with other
ions such as calcium in less significant proportions)
inside a cell and just the opposite outside a cell.
The Origins of
Biopotentials
This difference in ionic concentration across the
cell membrane produces the resting potential.
Some of the cells in the body are excitable and
produce what is called an action potential,
which results from a rapid flux of ions across
the cell membrane in response to an electric
stimulation or transient change in the electric
gradient of the cell. The electric excitation of
cells generates currents in the surrounding
volume conductor manifesting itself as
potentials on the body.
Schematic showing origins of biopotentials: (a) an
action potential from a heart cell (recorded using a
microelectrode); (b) the electrogram from the heart
surface (recorded using an endocardial catheter); and
electrodes
help acquire the biopotentials
interface to the organ or the body and
transduce low-noise, artifact-free signals

biopotential amplifier
Chracteristics needed for the
measurement of biopotentials
high amplification
input impedance
and the ability to reject electrical
Practical considerations in
biopotential measurement

electrode placement and skin


preparation
shielding from interference, and
other good measurement practices.
Biopotentials, Specifications, and
Applications

all acquisitions are made with the aid of


specialized electrodes in which actual design
The most noteworthy features of
biopotentials
Small amplitudes (10V to 10 mV)
Low frequency range of signals (dc to
several hundred hertz)

The most noteworthy problems of such


acquisitions
Presence of biological interference (from skin,
electrodes, motion, etc.),
Noise from environmental sources (power line,
radio frequency, electromagnetic, etc.).
ECG signals are acquired by
placing electrodes directly on the
torso, arms, and legs. The
activity on the body surface is
known to reflect the activity of the
heart muscle underneath and in its
proximity

A clinically accepted lead system


has been devised and is called
the 12-lead system. It comprises
a combination of electrodes
taking measurements from
different regions designated limb
leads, the precordial leads,
and the chest leads.
Limb leads derive signals
from electrodes on the
limbs, and are designated
as leads I, II, and III.
Precordial leads are
designated aVR, aVL, and
aVF, and are derived by
combining signals from
the limb leads.
Chest leads - the
remaining six leads, V1,
V2, V6.
The ECG signals at the surface of the body are small
in amplitude, which make the measurements
susceptible to artifacts, generated by the relative
motion of the electrode and the skin as well as by
the activity of the nearby muscles. An important
consideration in good ECG signal acquisition is the
use of high-quality electrodes . Electrodes made out
of silver coated with silver chloride or of
sintered AgAgCl material, are recommended.
An electrolytic gel is used to enhance conduction
between the skin and the electrode metal. Artifacts
at the electrodeskin contact as well as
electromagnetic interference from all sources must
be minimized. Since ECG instruments are often used
in critical-care environments, they must be
electrically isolated for safety and protected from
the high voltages generated by defibrillators.
ECG bio-potential amplifiers find use in
many monitoring instruments,
pacemakers, and defibrillators
ECG signal acquisition is also useful in
many clinical applications including
diagnosis of arrhythmias, ischemia, or
heart failure.
EEG signals are characterized
by their extremely small
amplitudes (in the microvolt
range). Gold-plated electrodes are
placed very securely on the scalp
to make a very low resistance
contact. A clinically accepted lead
system, which includes several
electrodes placed uniformly
around the head, is called the 10-
20 lead system. This
comprehensive lead system
allows localization of diagnostic
features, such as seizure spikes,
in the vicinity of the electrode.
EEG signals are difficult to
interpret since they represent the
comprehensive activity of billions of
neurons transmitted via the brain
tissues, fluids, and scalp .
Nevertheless, certain features can be
interpreted.
In the waveform itself, it is possible
to see interictal seizure spikes or a
full seizure (such as petit mal and
grand mal epilepsy).
Analysis of the frequency spectrum
of the EEG can reveal changes in the
signal power at different frequencies
being produced during various stages
of sleep, as a result of anesthetic
effects, and sometimes as a result of
brain injury.
Practical problems and challenges
associated with EEG signal recordings
Physiological i.e. motion artifact, muscle
noise, eye motion or blink artifact, and
sometimes even heartbeat signals
environmental
electronic noise sources i.e. 60 Hz power
lines, radio frequencies (RF), and
electrically or magnetically induced
interference
Moreover, the electronic components in the
amplifier also contribute noise
EMG signals are recorded
by placing electrodes close
to the muscle group. For
example, a pair of electrodes
placed on the biceps and
another pair placed on the
triceps can capture the EMG
signals generated when
these muscles contract. EMG
signals recorded in this
manner have been shown to
give a rough indication of the
force generated by the
muscle group.
EMG electrodes
Electrodes used for such applications
should be small, securely attached
and should provide recordings free of
artifacts. Either silversilver chloride
or gold-plated electrodes perform
quite well, although inexpensive
stainless steel electrodes may also
suffice.
EMG (cont.)
Since the frequency range of EMG signals is
higher than that of ECG and EEG signals, and
since the signals are of comparable or larger
amplitudes, the problem of motion artifact
and other interference is relatively less
severe.
Filtering can reduce the artifact and
interference: for example, setting the
bandwidth to above 20 Hz can greatly reduce
the skin potentials and motion artifacts.
EMG (cont.)
Recording activity directly from the
muscle fibers themselves can be
clinically valuable in identifying
neuromuscular disorders . Therefore,
invasive electrodes are needed to access
the muscle fibers or the neuromuscular
junction. Fine-needle electrodes or thin
stainless steel wires are inserted or
implanted to obtain local recording from
the fibers or neuromuscular junctions.
EOG Electric potentials are
generated as a result of
movement of the eyeballs
within the conductive
environment of the skull. The
generation of EOG signals can
be understood by envisaging
dipoles (indicating separated
positive and negative potential
sources) located in the
eyeballs. Electrodes placed on
either side of the eyes or
above and below them pick up
the potentials generated by
the motion of the eyeball
EOG (cont.)
This potential varies approximately in
proportion to the movement of the
eyeballs, and hence EOG is sometimes
used to study eye positions or disorders
of eye movement and balance (a reflex
called vestibulo-ocular reflex affects the
nystagmus of the eye). Similarly,
saccades inherent in eye motion as well
as blinking of the eyelids can produce
changes in the EOG signal.
EOG (cont.)
This signal is small (10 to 100mV) and
has low frequencies (dc to 10 Hz).
Hence, an amplifier with a high gain
and good low frequency response and
dc stability is desirable.
the electrodegel combination should
be such that it produces low levels of
junction potential, motion artifacts,
and drift in the dc signal.
Practical problems and challenges
associated with EOG signal recordings
dc drift

motion artifacts

Securing electrodes in the vicinity of


the eyes
The Principles of Biopotential
Measurements
Electrode design and its attachment
suited to the application;
Amplifier circuit design for suitable
amplification of the signal and
rejection of noise and interference;
Good measurement practices to
mitigate artifacts, noise, and
interference.
Electrodes for Biopotential
Recordings
Electrodes for bio-potential recordings are
designed to obtain the signal of interest
selectively while reducing the potential to
pick up artifact. The design should be
pragmatic to reduce cost and allow for
good manufacturing and reliable long-term
use. These practical considerations
determine whether high quality but
reusable electrodes made of silver or gold
or cheaper disposable electrodes are used.
SilverSilver Chloride
Electrodes
The classic, high-quality electrode
design consists of a highly
conductive metal, silver, interfaced
to its salt, silver chloride, and
connected via an electrolytic gel to
the human body. Silversilver
chloridebased electrode design is
known to produce the lowest and
most stable junction potentials.
SilverSilver Chloride
Electrodes
Junction potentials are the result of the
dissimilar electrolytic interfaces, and
are a serious source of electrode-
based motion artifacts. Therefore,
additionally, an electrolytic gel typically
based on sodium or potassium
chloride is applied to the electrode. A
gel concentration in the order of 0.1M
(molar concentration) results in a
good conductivity and low junction
potential without causing skin irritation.
reusable AgAg Cl electrode
Reusable silversilver chloride
electrodes are made of silver disks
coated electrolytically by silver
chloride, or, alternatively, particles of
silver and silver chloride are sintered
together to form the metallic
structure of the electrode. The gel is
typically soaked into a foam pad or is
applied directly in a pocket produced
by the electrode housing. The
electrode is secured to the skin by
means of nonallergenic adhesive
tape. The electrode is connected to
the external instrumentation
Disposable electrodes
Disposable electrodes are made
similarly, although the use of silver
may be minimized (for
example,the snap-on button itself
may be silver coated and
chlorided). To allow for a secure
attachment, a large foam pad
attaches the electrode body with
adhesive coating on one side. Such
electrodes are particularly suited
for ambulatory or long term use.
Gold Electrodes
Gold-plated electrodes (Figure 74.4c), which
have the advantages of high conductivity and
inertness desirable in reusable electrodes, are
commonly used in EEG recordings. Small reusable
electrodes are designed so that they can be securely
attached to the scalp. The electrode body is also shaped
to make a recessed space for electrolytic gel, which can
be applied through a hole in the electrode body. The
electrodes are attached in hair-free areas by use of a
strong adhesive such as colloidon or securely attached
with elastic bandages or wire mesh. Similar electrodes
may also be used for recording EMG, especially when a
great deal of motion is expected
Disadvantages of using gold electrodes over silver
silver chloride

electrodes include greater


expense
higher junction potentials
and greater susceptibility to
motion artifacts
advantages of using gold electrodes
over silversilver chloride
gold electrodes maintain low
impedance
inert and reusable
good for short-term recordings as
long as a highly conductive gel is
applied and they are attached
securely.
Conductive Polymer
Electrodes
It is often convenient to construct
an electrode out of a material that
is simultaneously conductive and
adhesive .
Certain polymeric materials have
adhesive properties and by
attaching monovalent metal ions
can be made conductive. The
polymer is attached to a metallic
backing made of silver or
aluminum foil, which allows
electric contact to external
instrumentation.
The conductive polymeric
electrode performs adequately as
Advantages of Conductive
Polymer Electrodes
This electrode does not need additional
adhesive or electrolytic gel and hence
can be immediately and conveniently
used.
when the signal level is high and when
restricting the subject movement
minimizes artifact, the polymeric
electrode offers a relatively inexpensive
solution to biopotential recording.
disadvantages of Conductive
Polymer Electrodes
The higher resistivity of the polymer makes
these electrodes unsuitable for low-noise
measurement
The polymer does not attach as effectively
to the skin as does the conventional
adhesive on disposable ECG electrodes
built with a foam base
the potentials generated at the electrode
skin interface are more readily disturbed
by motion
Metal or Carbon
Electrodes
Although other metals such as stainless steel or brass
electrodes are used rather infrequently now because high-
quality noble metal electrodes or low-cost carbon or
polymeric electrodes are so readilyavailable.

historically these metallic electrodes were used in


laboratory or clinical settings because of their sturdy
construction and reusability.
Electrode gel is applied to the metal electrode which is
fastened to the body by means of a rubber band.
These electrodes have the potential for producing very
high levels of artifact and are bulky and awkward to use
reusable and inexpensive
Metal or Carbon
Electrodes
Carbon or carbon-impregnated polymer
electrodes are also used occasionally (although
they are mainly used as electrical stimulation
electrodes)
These electrodes have a much higher resistivity and
are noisier and more susceptible to artifacts
inexpensive, flexible, and reusable
chosen for applications such as electric stimulation
or impedance plethysmography. For these
applications, gel is usually not applied and the
electrodes are used in dry form for easy
attachment and removal.
Needle Electrodes
Needle electrodes comprise a
small class of invasive
electrodes, used when it is
absolutely essential to record
from the organ itself. The most
common application is in
recording
A metallic, typically fromismuscles
steel, wire orvia a
delivered
needle inserted atmuscle fibers.
the site of the muscle fiber. The
wire is hooked and hence fastens to the muscle
fiber, even as the needle is removed. Small signals
such as motor unit potentials can be recorded in
this manner.
For research applications, similar needle or wire
electrodes are sometimes connected directly to the
heart muscle. Since such electrodes are
The Biopotential
Amplifier
design considerations
proper amplification
bandwidth
high input impedance
low noise
stability against temperature and voltage
fluctuations.

The key design component of all biopotential


amplifiers is the instrumentation amplifier
The Instrumentation
Amplifier
The instrumentation amplifier is a
circuit configuration that potentially
combines the best features desirable
for biopotential measurements,
namely, high differential gain, low
common mode gain, high common
mode rejection ratio (CMRR), and high
input resistance
Design of the basic
instrumentation amplifier