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. 2022 Mar 17;12(1):4621.
doi: 10.1038/s41598-022-08628-9.

Effects of a reduction of the number of electrodes in the EEG montage on the number of identified seizure patterns

Moritz Tacke  1   2 , Katharina Janson  3 , Katharina Vill  3 , Florian Heinen  3 , Lucia Gerstl  3   4 , Karl Reiter  5 , Ingo Borggraefe  3   4
Affiliations

Effects of a reduction of the number of electrodes in the EEG montage on the number of identified seizure patterns

Moritz Tacke et al. Sci Rep. .

Abstract

Continuous EEG monitoring (cEEG) is frequently used in neurocritical care. The detection of seizures is one of the main objectives. The placement of the EEG electrodes is time consuming, therefore a reduced montage might lead to an increased availability in the ICU setting. It is unknown whether such a reduction of electrodes reduces the number of seizure patterns that are detected. A total of 95 seizure and 95 control EEG sequences from a pediatric epilepsy monitoring unit (EMU) were anonymized and reduced to an eight-lead montage. Two experts evaluated the recordings and the seizure detection rates using the reduced and the full montage were compared. Sensitivity and specificity for the seizure detection were calculated using the original EMU findings as gold standard. The sensitivity to detect seizures was 0.65 for the reduced montage compared to 0.76 for the full montage (p = 0.031). The specificities (0.97 and 0.96) were comparable (p = 1). A total of 4/9 (44%) of the generalized, 12/44 (27%) of the frontal, 6/14 (43%) of the central, 0/1 (0%) of the occipital, 6/20 (30%) of the temporal, and 5/7 (71%) of the parietal seizure patterns were not detected using the reduced montage. The median time difference between the onset of the seizure pattern in the full and reduced montage was 0.026s (IQR 5.651s). In this study the reduction of the EEG montage from 21 to eight electrodes reduced the sensitivity to detect seizure patterns from 0.76 to 0.65. The specificity remained virtually unchanged.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
The electrodes used in the reduced montage.
Figure 2
Figure 2
Posterior distributions for the sensitivity and the specificity of both EEG montages. Similar to the use of confidence intervals this plot shows the estimations for the sensitivities and specificities. The lower, and wider, curves for the sensitivities signify that, given the observed data (i.e. the EEG classifications), there is still a relevant degree of uncertainty regarding the true sensitivities.
Figure 3
Figure 3
Sankey diagram depicting differences between the localizations and lateralizations of the epileptic seizure patterns between the original EMU classifications (left), the assessment of the full EEG montage (middle), and the reduced EEG montage (right).
See this image and copyright information in PMC

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