CN112022155A - Brain-computer interface system capable of evaluating auditory behaviors of patient with disturbance of consciousness - Google Patents
Brain-computer interface system capable of evaluating auditory behaviors of patient with disturbance of consciousness Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7203—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7225—Details of analog processing, e.g. isolation amplifier, gain or sensitivity adjustment, filtering, baseline or drift compensation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7235—Details of waveform analysis
Abstract
The invention discloses a brain-computer interface system capable of evaluating auditory behaviors of a patient with disturbance of consciousness, which comprises: an auditory stimulus module for providing an auditory startle stimulus to the subject; the electroencephalogram acquisition module is used for acquiring an electroencephalogram of a subject; an evaluation module for evaluating whether an auditory response is present in the subject based on the electroencephalogram. The invention solves the problem of auditory behavior evaluation of DOC patients who hear but cannot generate auditory startle response, can directly detect brain activity without any behavior expression, provides a more objective and more sensitive mode for the auditory behavior evaluation of the DOC patients, and can be used for assisting CRS-R behavior evaluation.
Description
Technical Field
The invention belongs to the technical field of auditory behavior assessment of patients with disturbance of consciousness.
Background
The behavioral assessment method is used for assessing brain-injured patients suffering from disturbance of consciousness (DOC). Patients with brain damage typically include coma (Comma), Vegetative State (VS), minimal state of consciousness (MCS) and state of loss of microcosmic state (EMCS). Accurate assessment of the level of consciousness of DOC patients is important for their diagnosis and monitoring of their therapeutic and rehabilitative effects. Auditory behavior assessment of the coma recovery scale revision (CRS-R) is a consistent and sensitive behavior assessment standard for patients with disturbance of consciousness (DOC), which is also the most widely used assessment method in the clinic. However, CRS-R depends on behavior markers, and the dysconsciousness patients have motor behavior impairment, so that the behavior markers are difficult to detect, the CRS-R has large limitation, and the misdiagnosis rate is high. The main reasons are as follows: first, DOC patients have difficulty maintaining long-term stability for evaluation due to fluctuations in wakefulness, fatigue, pain, and other factors. Second, the presence of dyskinesias and tracheotomies may affect behavioral responses, leading to inaccurate assessments. For example, several items of CRS-R rely on head nodding/shaking (e.g., a communication sub-table) or repeated word-like sounds (e.g., a motion/language function sub-table) for scoring. This task is not easy or even possible for most tracheotomy patients. In addition, there are inter-evaluator reliability (reproducibility of CRS-R scores between different evaluators) and test-retest reliability issues that relate to the status of the evaluators and patients, respectively. As reported in recent studies, these limitations of CRS-R behavioral assessment can lead to high rates of misdiagnosis in DOC patients. It was observed that 37% to 43% of patients diagnosed with VS actually showed signs of consciousness.
In recent years, there has been BCI combining vision P300 and Steady State Visual Evoked Potential (SSVEP) instructing patients to view a picture of themselves or another unfamiliar picture displayed on a computer screen to check DOC patient consciousness. There is also proposed a BCI using congruent audiovisual numbers to stimulate, and DOC patients are required to find target numbers for instruction prompt in experiments to detect DOC patient consciousness. Even with the use of a BCI system based on Motor Imagery (MI), DOC patients are instructed to imagine squeezing their right hand, or moving all of their toes. Some DOC patients may lose the ability to gaze and fail the BCI assessment described above. To overcome the evaluation limitations of DOC patients with loss of gaze ability, auditory BCI was beginning to be applied to DOC patients. These auditory BCIs typically require the DOC patient to respond in response to the test person issuing yes, no, stop, and go passwords during the evaluation. Because of the order-based tracking approach, some patients do not exhibit any response to the order and are unable to communicate via BCI.
Disclosure of Invention
The invention aims to provide a more objective and sensitive brain-computer interface system for evaluating the auditory behavior of a patient with disturbance of consciousness.
The invention aims to be realized by the following technical scheme: a brain-computer interface system for enabling assessment of auditory behavior in a patient with impaired consciousness, comprising:
an auditory stimulus module for providing an auditory startle stimulus to the subject;
the electroencephalogram acquisition module is used for acquiring an electroencephalogram of a subject;
an evaluation module for evaluating whether an auditory response is present in the subject based on the electroencephalogram.
The invention can directly detect brain activity without any behavior expression, provides a more objective and sensitive way to evaluate auditory behaviors, and can be used for evaluating an auditory function scale, namely auditory startle, in CRS-R.
The auditory startle stimuli include abnormal auditory stimuli and normal auditory stimuli, and the abnormal auditory stimuli are randomly arranged among the normal auditory stimuli to induce the event-related potentials MMN and P300.
The stimulation cycles are performed, and each cycle comprises one abnormal auditory stimulation and a plurality of conventional auditory stimulations. The stimulation is carried out periodically, so that the calculation process can be effectively simplified.
The electroencephalogram signals acquired by the electroencephalogram acquisition module comprise scalp signals recorded on 4 lead channels of Fz, FCz, Cz and CPz. The signals are processed by a band-pass filter with the filtering frequency range of 0.05Hz to 100Hz and then input.
The evaluation module determines whether the subject has an auditory response by detecting whether the electroencephalogram exhibits MMN and P300 potentials elicited by the abnormal auditory stimulus.
When the MMN and P300 potentials induced by the abnormal auditory stimulus are detected for more than two times, the evaluation module judges whether the auditory reaction exists in the subject or not, and avoids misjudgment caused by accidental events.
The evaluation module detects MMN and P300 potentials elicited by the abnormal auditory stimulus by:
in each period, calculating the absolute value of the difference value of the MMN and P300 potentials corresponding to each stimulus, and judging whether the value corresponding to the abnormal auditory stimulus is the maximum value or not; in the period, if the value corresponding to the abnormal auditory stimulation on most channels in all the concerned lead channels is the maximum value, the MMN and P300 electric potentials led out by the abnormal auditory stimulation in the period are judged.
Compared with the prior art, the invention has the following beneficial effects:
1) the invention solves the problem of auditory behavior evaluation of DOC patients who hear but cannot generate auditory startle reaction, can directly detect brain activity without any behavior expression, provides a more objective and more sensitive mode for the auditory behavior evaluation of the DOC patients, and can be used for assisting CRS-R behavior evaluation;
2) conventional BCI systems are designed in a training manner, i.e., a mathematical model is first constructed based on a data set collected during training, and then used to classify input signals and provide online feedback. The model training process may increase the difficulty of applying the BCI approach to DOC patients because the DOC patients' wake periods are typically too short to obtain a reliable mathematical model. The brain-computer interface system of the invention randomly presents the conventional and abnormal auditory stimuli to the testee, leads out the event-related potentials MMN and P300, and then judges whether the event-related potentials MMN and P300 are led out or not without initial training by detecting a new peak value detection algorithm of a maximum difference value, thereby judging whether the testee has auditory reaction or not.
Detailed Description
In the BCI system capable of evaluating auditory behaviors of patients with disturbance of consciousness, loud clapping sound (about 90dB and 200ms in duration) is used as abnormal auditory stimuli, environmental background noise (about 40dB and 200ms in duration) is used as conventional auditory stimuli, 1 abnormal auditory stimulus and 4 conventional auditory stimuli randomly form 1 auditory stimulus period, each auditory stimulus interval is 600ms, and 10 stimulation periods form 1 auditory behavior evaluation test. The BCI system uses amplifiers and electroencephalographic caps to record EEG signals on the 4 lead conductions Fz, FCz, Cz, CPz. The EEG signal is amplified and the scalp EEG signal is recorded at a sampling rate of 250Hz and the band is filtered by a band pass filter between 0.05Hz and 100 Hz. The impedance of all lead channels is kept below 5K omega.
After sampling the EEG signal, the procedure for assessing the auditory behavior of a patient with a meaning disorder is as follows:
firstly, carrying out band-pass filtering on an EEG signal of an original test sample to obtain filtering data of 10 times of stimulation periods
EEG signals on the 4 lead channels Fz, FCz, Cz and CPz are selected to carry out six-order minimum phase FIR band-pass filtering in the range of 0.05Hz to 100 Hz. After band-pass filtering, EEG data corresponding to event-related potentials consisting of a random combination of 1 abnormal stimulus and 4 conventional stimuli was extracted for 10 stimulation sessions per channel.
Secondly, selecting and establishing a test sample vector of 1 abnormal stimulus in the ith stimulus period
Ai＝(ai，Fz，250，ai，FCz，250，ai，Cz，250，ai，CPz，250)
ai，Fz，250，ai，FCz，250，ai，Cz，250，ai，CPz，250The time range of the onset of 1 abnormal stimulation is-200 ms to 800ms (in the invention, the initiation time of stimulation is taken as a time point 0), and the Fz, FCz, Cz and CPz channels correspond to a sample vector component with the dimension of 250. Constructing abnormal stimulation test sample vector A by the four sample vector componentsi。
Thirdly, selecting and establishing 4 conventional stimulation test sample vectors in the ith stimulation period
Bi＝(bi，Fz，250，bi，FCz，250，bi，Cz，250，bi，CPz，250)
Ci＝(Ci，Fz，250，Ci，FCz，250，Ci，Cz，250，Ci，CPz，250)
Di＝(di，Fz，250，di，FCz，250，di，Cz，250，di，CPz，250)
Ei＝(ei，Fz，250，ei，FCz，250，ei，Cz，250，ei，CPz，250)
Bi、Ci、Di、Ei4 conventional stimulus test sample vectors consisting of sample vector components of four channels Fz, FCz, Cz and CPz, dimension 250, with attack times ranging from-200 ms to 800ms, respectively.
Fourthly, establishing 1 abnormal stimulation test sample differential vector in the ith stimulation period
Solving the difference vector component of the Fz channel of the abnormal stimulation test sample in the ith stimulation period:
dai，Fz，250＝Max(ai，Fz，250)-Min(ai，Fz，250)
wherein Min (a)i，Fz，250) Is the minimum value in the range of 250ms to 40ms of abnormal stimulation in the ith stimulation period, Max (a)i，Fz，250) Is Min (a)i，Fz，250) The maximum value is found in the latter 100ms range.
Similarly, the abnormal stimulation test samples FCz in the ith stimulation period, the Cz and CPz channel differential vector components are respectively obtained:
dai，FCz，250＝Max(ai，FCz，250)-Min(ai，FCz，250)
dai，Cz，250＝Max(ai，Cz，250)-Min(ai，Cz，250)
dai，CPz，250＝Max(ai，CPz，250)-Min(ai，CPz，250)
constructing an abnormal stimulation test sample differential vector in the ith stimulation period:
dAi＝(dai，Fz，250，dai，FCz，250，dai，Cz，250，dai，CPz，250)
fifthly, establishing four normal stimulation test sample differential vectors in the ith stimulation period
According to the fourth step, four conventional stimulation test sample differential vectors in the ith stimulation period are established:
dBi＝(dbi，Fz，250，dbi，FCz，250，dbi，Cz，250，dbi，CPz，250)
dCi＝(dCi，Fz，250，dCi，FCz，250，dci，Cz，250，dci，CPz，250)
dDi＝(ddi，Fz，250，ddi，FCz，250，ddi，Cz，250，ddi，CPz，250)
dEi＝(dei，Fz，250，dei，FCz，250，dei，Cz，250，dei，CPz，250)
sixthly, establishing a test sample differential vector formed by 1 abnormal stimulus and 4 conventional stimulus tests in the ith stimulus period
di＝(dAi，dBi，dCi，dDi，dEi)
Seventhly, judging whether the abnormal stimulation in the ith stimulation period belongs to the target stimulation
According to diAnd testing the sample difference vector to judge whether the following 4 equations are true:
dai，Fz，250＝Max(dai，Fz，250，dbi，Fz，250，dCi，Fz，250，ddi，Fz，250，dei，Fz，250)
dai，FCz，250＝Max(dai，FCz，250，dbi，FCz，250，dCi，FCz，250，ddi，FCz，250，dei，FCz，250)
dai，Cz，250＝Max(dai，Cz，250，dbi，Cz，250，dci，Cz，250，ddi，Cz，250，dei，Cz，250)
dai，CPz，250＝Max(dai，CPz，250，dbi，CPz，250，dci，CPz，250，ddi，CPz，250，dei，CPz，250)
if at least 3 of the above 4 equations hold, the abnormal stimulus belongs to the target stimulus in the ith stimulation period.
Eighthly, carrying out statistical analysis on abnormal stimulation to judge whether DOC patients respond to auditory startle
In the 10 stimulation periods, the number of the abnormal stimulation belonging to the target stimulation is n, if the following formula is established, the DOC patient is judged to be responded to the auditory startle, otherwise, the DOC patient is not responded.
In the present invention, 19 patients with disturbance of consciousness participated in the CRS-R assessment by clinicians and the assessment of the present invention, 3 of which showed no auditory startle behavioral response in the CRS-R assessment by clinicians, but showed such behavior in the assessment of the present invention. These results show that a subset of DOC patients who do not have an auditory behavioral response in the CRS-R assessment of the clinician can produce a neurological response, which can be detected by the present invention. Therefore, the present invention provides results that are more sensitive than the clinician's CRS-R, thereby facilitating the clinician's assessment of auditory behavior in patients with impaired consciousness.
The embodiments of the present invention are not limited thereto, and various other modifications, substitutions or alterations can be made to the present invention in light of the above basic technical ideas of the present invention and the common technical knowledge and conventional means in the field of the present invention, and are within the scope of the present invention.
Claims (8)
1. A brain-computer interface system for enabling assessment of auditory behavior in a patient with impaired consciousness, comprising:
an auditory stimulus module for providing an auditory startle stimulus to the subject;
the electroencephalogram acquisition module is used for acquiring an electroencephalogram of a subject;
an evaluation module for evaluating whether an auditory response is present in the subject based on the electroencephalogram.
2. The brain-computer interface system according to claim 1, wherein the auditory startle stimuli include abnormal auditory stimuli and normal auditory stimuli, the abnormal auditory stimuli being randomly arranged between the normal auditory stimuli to elicit event-related potentials MMN and P300.
3. The brain-computer interface system according to claim 2, wherein the stimulation cycles are performed, and each cycle comprises an abnormal auditory stimulation and a plurality of regular auditory stimulations.
4. The brain-computer interface system according to claim 3, wherein the electroencephalogram signals acquired by the electroencephalogram acquisition module include scalp signals recorded on 4 lead channels Fz, FCz, Cz, CPz.
5. The brain-computer interface system according to claim 4, wherein the scalp signal is input after being processed by a band pass filter with a filtering frequency range of 0.05Hz to 100 Hz.
6. The brain-computer interface system according to claim 3 or 4, wherein the assessment module determines whether the subject has an auditory response by detecting whether the electroencephalogram exhibits MMN and P300 potentials elicited by the abnormal auditory stimulus.
7. The brain-computer interface system according to claim 6, wherein the assessment module determines whether the subject has an auditory response when more than two MMN and P300 potentials elicited by the abnormal auditory stimulus are detected.
8. The brain-computer interface system according to claim 6, wherein the evaluation module detects MMN and P300 potentials elicited by the abnormal auditory stimulus by:
in each period, calculating the absolute value of the difference value of the MMN and P300 potentials corresponding to each stimulus, and judging whether the value corresponding to the abnormal auditory stimulus is the maximum value or not; in the period, if the value corresponding to the abnormal auditory stimulation on most channels in all the concerned lead channels is the maximum value, the MMN and P300 electric potentials led out by the abnormal auditory stimulation in the period are judged.
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| CN113576496A (en) * | 2021-07-08 | 2021-11-02 | 华南理工大学 | Vision tracking brain-computer interface detection system |
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