Document Detail


The EEG assessment of low-grade hepatic encephalopathy: comparison of an artificial neural network-expert system (ANNES) based evaluation with visual EEG readings and EEG spectral analysis.
MedLine Citation:
PMID:  16931145     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The EEG provides an objective staging of hepatic encephalopathy (HE), but its interpretation may be biased by inter-observer variability. This study aims at comparing an entirely automatic EEG classification of HE based on an artificial neural network-expert system procedure (ANNES) with visual and spectral analysis based EEG classifications. METHODS: Two hundred and thirty-eight consecutive cirrhotic patients underwent closed-eye EEG. They were followed up for up to one-year to detect bouts of overt HE and death. The EEG was classified by ANNES, qualitative visual reading, main basic rhythm frequency and spectral analysis. The classifications were assessed on the basis of: (i) match with liver function, (ii) prognostic value and (iii) repeatability. RESULTS: All classifications were found to be related to the severity of liver failure, with cognitive findings and a history of previous bouts of HE. All of them had prognostic value on the occurrence of overt HE and on survival. The ANNES based classification was more repeatable than the qualitative visual one, and had the advantage of detecting low power EEG, but its efficiency in analyzing low-grade alterations was questionable. CONCLUSIONS: An entirely automatic - ANNES based - EEG classification of HE can improve the repeatability of EEG assessment, but further improvement of the device is required to classify mild alterations. SIGNIFICANCE: The ANNES based EEG grading of HE needs further improvements to be recommended in clinical practice, but it is already sufficient for detecting normal and clearly altered EEG tracings.
Authors:
P Amodio; A Pellegrini; E Ubiali; I Mathy; F Del Piccolo; R Orsato; A Gatta; J M Guerit
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2006-08-22
Journal Detail:
Title:  Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology     Volume:  117     ISSN:  1388-2457     ISO Abbreviation:  Clin Neurophysiol     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-14     Completed Date:  2006-12-15     Revised Date:  2008-09-10    
Medline Journal Info:
Nlm Unique ID:  100883319     Medline TA:  Clin Neurophysiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  2243-51     Citation Subset:  IM    
Affiliation:
Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy. piero.amodio@unipd.it
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MeSH Terms
Descriptor/Qualifier:
Electroencephalography
Expert Systems*
Female
Hepatic Encephalopathy / classification*,  mortality,  physiopathology
Humans
Male
Middle Aged
Neural Networks (Computer)*
Prognosis
Reproducibility of Results
Sensitivity and Specificity
Spectrum Analysis / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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