Abstract:
Neonatal seizures after birth may contribute to brain injury after an hypoxic-ischemic (HI) event, impaired brain development and a later life risk for epilepsy. Despite neural immaturity, seizures can also occur in preterm infants. However, surprisingly little is known about their evolution after an HI insult or patterns of expression. An improved understanding of preterm seizures will help facilitate diagnosis and prognosis and the implementation of treatments. This requires improved detection of seizures, including electrographic seizures. We have established a stable preterm fetal sheep model of HI that results in different types of post-HI seizures. These including the expression of epileptiform transients during the latent phase (0-6 h) of cerebral energy recovery, and bursts of high amplitude stereotypic evolving seizures (HAS) during the secondary phase of cerebral energy failure (~6-72 h). We have previously developed successful automated machine-learning strategies for accurate identification and quantification of the evolving micro-scale EEG patterns (e.g. gamma spikes and sharp waves), during the latent phase. The current paper introduces, for the first time, a real-time approach that employs a 15-layer deep convolutional neural network (CNN) classifier, directly fed with the raw EEG timeseries, to identify HAS in the 1024Hz and 256Hz down-sampled data in our preterm fetuses post-HI. The classifier was trained and tested using EEG segments during ~6 to 48 hours post-HI recordings. The classifier accurately identified HAS with 98.52% accuracy in the 1024Hz and 97.78% in the 256Hz data. Clinical relevance—Results highlight the promising ability of the proposed CNN classifier for accurate identification of HI related seizures in the neonatal preterm brain, if further applied to the current 256Hz clinical recordings, in real-world.
