Biomedical Engineering - Research Publications

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    Non-Invasive Measurement of Intracranial Pressure Through Application of Venous Ophthalmodynamometry.
    Lo, L ; Zhao, D ; Ayton, L ; Grayden, D ; Bui, B ; Morokoff, A ; John, S (IEEE, 2021-11)
    Non-invasive intracranial pressure (ICP) monitoring is possible using venous ophthalmodynamometry to observe a pulsation in retinal blood vessels when intraocular pressure (IOP) exceeds ICP. Here, we identify features in the eye - optic disc and retinal blood vessel locations - and identify pulsation in large retinal blood vessels. The relationship between force and the magnitude of pulsation is used to estimate ICP when force is applied to the eye to gradually increase IOP over time. This approach yields 77% accuracy in automatically observing vessel pulsation.Clinical Relevance - Non-invasive ICP monitoring is desirable to improve patient outcome by reducing potential trauma and complications associated with invasive assessment with intracranial sensors or lumbar puncture.
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    State transitions through inhibitory interneurons in a cortical network model
    Bryson, A ; Berkovic, SF ; Petrou, S ; Grayden, DB ; Graham, LJ (PUBLIC LIBRARY SCIENCE, 2021-10)
    Inhibitory interneurons shape the spiking characteristics and computational properties of cortical networks. Interneuron subtypes can precisely regulate cortical function but the roles of interneuron subtypes for promoting different regimes of cortical activity remains unclear. Therefore, we investigated the impact of fast spiking and non-fast spiking interneuron subtypes on cortical activity using a network model with connectivity and synaptic properties constrained by experimental data. We found that network properties were more sensitive to modulation of the fast spiking population, with reductions of fast spiking excitability generating strong spike correlations and network oscillations. Paradoxically, reduced fast spiking excitability produced a reduction of global excitation-inhibition balance and features of an inhibition stabilised network, in which firing rates were driven by the activity of excitatory neurons within the network. Further analysis revealed that the synaptic interactions and biophysical features associated with fast spiking interneurons, in particular their rapid intrinsic response properties and short synaptic latency, enabled this state transition by enhancing gain within the excitatory population. Therefore, fast spiking interneurons may be uniquely positioned to control the strength of recurrent excitatory connectivity and the transition to an inhibition stabilised regime. Overall, our results suggest that interneuron subtypes can exert selective control over excitatory gain allowing for differential modulation of global network state.
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    Multiday cycles of heart rate are associated with seizure likelihood: An observational cohort study
    Karoly, PJ ; Stirling, RE ; Freestone, DR ; Nurse, ES ; Maturana, M ; Halliday, AJ ; Neal, A ; Gregg, NM ; Brinkmann, BH ; Richardson, MP ; La Gerche, A ; Grayden, DB ; D'Souza, W ; Cook, MJ (ELSEVIER, 2021-10)
    BACKGROUND: Circadian and multiday rhythms are found across many biological systems, including cardiology, endocrinology, neurology, and immunology. In people with epilepsy, epileptic brain activity and seizure occurrence have been found to follow circadian, weekly, and monthly rhythms. Understanding the relationship between these cycles of brain excitability and other physiological systems can provide new insight into the causes of multiday cycles. The brain-heart link has previously been considered in epilepsy research, with potential implications for seizure forecasting, therapy, and mortality (i.e., sudden unexpected death in epilepsy). METHODS: We report the results from a non-interventional, observational cohort study, Tracking Seizure Cycles. This study sought to examine multiday cycles of heart rate and seizures in adults with diagnosed uncontrolled epilepsy (N=31) and healthy adult controls (N=15) using wearable smartwatches and mobile seizure diaries over at least four months (M=12.0, SD=5.9; control M=10.6, SD=6.4). Cycles in heart rate were detected using a continuous wavelet transform. Relationships between heart rate cycles and seizure occurrence were measured from the distributions of seizure likelihood with respect to underlying cycle phase. FINDINGS: Heart rate cycles were found in all 46 participants (people with epilepsy and healthy controls), with circadian (N=46), about-weekly (N=25) and about-monthly (N=13) rhythms being the most prevalent. Of the participants with epilepsy, 19 people had at least 20 reported seizures, and 10 of these had seizures significantly phase locked to their multiday heart rate cycles. INTERPRETATION: Heart rate cycles showed similarities to multiday epileptic rhythms and may be comodulated with seizure likelihood. The relationship between heart rate and seizures is relevant for epilepsy therapy, including seizure forecasting, and may also have implications for cardiovascular disease. More broadly, understanding the link between multiday cycles in the heart and brain can shed new light on endogenous physiological rhythms in humans. FUNDING: This research received funding from the Australian Government National Health and Medical Research Council (investigator grant 1178220), the Australian Government BioMedTech Horizons program, and the Epilepsy Foundation of America's 'My Seizure Gauge' grant.
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    Neural activity shaping utilizing a partitioned target pattern
    Spencer, MJ ; Kameneva, T ; Grayden, DB ; Burkitt, AN ; Meffin, H (IOP PUBLISHING LTD, 2021-08)
    Electrical stimulation of neural tissue is used in both clinical and experimental devices to evoke a desired spatiotemporal pattern of neural activity. These devices induce a local field that drives neural activation, referred to as an activating function or generator signal. In visual prostheses, the spread of generator signal from each electrode within the neural tissue results in a spread of visual perception, referred to as a phosphene.Objective.In cases where neighbouring phosphenes overlap, it is desirable to use current steering or neural activity shaping strategies to manipulate the generator signal between the electrodes to provide greater control over the total pattern of neural activity. Applying opposite generator signal polarities in neighbouring regions of the retina forces the generator signal to pass through zero at an intermediate point, thus inducing low neural activity that may be perceived as a high-contrast line. This approach provides a form of high contrast visual perception, but it requires partitioning of the target pattern into those regions that use positive or negative generator signals. This discrete optimization is an NP-hard problem that is subject to being trapped in detrimental local minima.Approach.This investigation proposes a new partitioning method using image segmentation to determine the most beneficial positive and negative generator signal regions. Utilizing a database of 1000 natural images, the method is compared to alternative approaches based upon the mean squared error of the outcome.Main results.Under nominal conditions and with a set computation limit, partitioning provided improvement for 32% of these images. This percentage increased to 89% when utilizing image pre-processing to emphasize perceptual features of the images. The percentage of images that were dealt with most effectively with image segmentation increased as lower computation limits were imposed on the algorithms.Significance.These results provide a new method to increase the resolution of neural stimulating arrays and thus improve the experience of visual prosthesis users.
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    Unifying information theory and machine learning in a model of electrode discrimination in cochlear implants
    Gao, X ; Grayden, D ; McDonnell, M ; Buechner, A (PUBLIC LIBRARY SCIENCE, 2021-09-20)
    Despite the development and success of cochlear implants over several decades, wide inter-subject variability in speech perception is reported. This suggests that cochlear implant user-dependent factors limit speech perception at the individual level. Clinical studies have demonstrated the importance of the number, placement, and insertion depths of electrodes on speech recognition abilities. However, these do not account for all inter-subject variability and to what extent these factors affect speech recognition abilities has not been studied. In this paper, an information theoretic method and machine learning technique are unified in a model to investigate the extent to which key factors limit cochlear implant electrode discrimination. The framework uses a neural network classifier to predict which electrode is stimulated for a given simulated activation pattern of the auditory nerve, and mutual information is then estimated between the actual stimulated electrode and predicted ones. We also investigate how and to what extent the choices of parameters affect the performance of the model. The advantages of this framework include i) electrode discrimination ability is quantified using information theory, ii) it provides a flexible framework that may be used to investigate the key factors that limit the performance of cochlear implant users, and iii) it provides insights for future modeling studies of other types of neural prostheses.
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    Seizure Forecasting Using a Novel Sub-Scalp Ultra-Long Term EEG Monitoring System
    Stirling, RE ; Maturana, M ; Karoly, PJ ; Nurse, ES ; McCutcheon, K ; Grayden, DB ; Ringo, SG ; Heasman, JM ; Hoare, RJ ; Lai, A ; D'Souza, W ; Seneviratne, U ; Seiderer, L ; McLean, KJ ; Bulluss, KJ ; Murphy, M ; Brinkmann, BH ; Richardson, MP ; Freestone, DR ; Cook, MJ (FRONTIERS MEDIA SA, 2021-08-23)
    Accurate identification of seizure activity, both clinical and subclinical, has important implications in the management of epilepsy. Accurate recognition of seizure activity is essential for diagnostic, management and forecasting purposes, but patient-reported seizures have been shown to be unreliable. Earlier work has revealed accurate capture of electrographic seizures and forecasting is possible with an implantable intracranial device, but less invasive electroencephalography (EEG) recording systems would be optimal. Here, we present preliminary results of seizure detection and forecasting with a minimally invasive sub-scalp device that continuously records EEG. Five participants with refractory epilepsy who experience at least two clinically identifiable seizures monthly have been implanted with sub-scalp devices (Minder®), providing two channels of data from both hemispheres of the brain. Data is continuously captured via a behind-the-ear system, which also powers the device, and transferred wirelessly to a mobile phone, from where it is accessible remotely via cloud storage. EEG recordings from the sub-scalp device were compared to data recorded from a conventional system during a 1-week ambulatory video-EEG monitoring session. Suspect epileptiform activity (EA) was detected using machine learning algorithms and reviewed by trained neurophysiologists. Seizure forecasting was demonstrated retrospectively by utilizing cycles in EA and previous seizure times. The procedures and devices were well-tolerated and no significant complications have been reported. Seizures were accurately identified on the sub-scalp system, as visually confirmed by periods of concurrent conventional scalp EEG recordings. The data acquired also allowed seizure forecasting to be successfully undertaken. The area under the receiver operating characteristic curve (AUC score) achieved (0.88), which is comparable to the best score in recent, state-of-the-art forecasting work using intracranial EEG.
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    Forecasting Seizure Likelihood With Wearable Technology
    Stirling, RE ; Grayden, DB ; D'Souza, W ; Cook, MJ ; Nurse, E ; Freestone, DR ; Payne, DE ; Brinkmann, BH ; Pal Attia, T ; Viana, PF ; Richardson, MP ; Karoly, PJ (FRONTIERS MEDIA SA, 2021-07-15)
    The unpredictability of epileptic seizures exposes people with epilepsy to potential physical harm, restricts day-to-day activities, and impacts mental well-being. Accurate seizure forecasters would reduce the uncertainty associated with seizures but need to be feasible and accessible in the long-term. Wearable devices are perfect candidates to develop non-invasive, accessible forecasts but are yet to be investigated in long-term studies. We hypothesized that machine learning models could utilize heart rate as a biomarker for well-established cycles of seizures and epileptic activity, in addition to other wearable signals, to forecast high and low risk seizure periods. This feasibility study tracked participants' (n = 11) heart rates, sleep, and step counts using wearable smartwatches and seizure occurrence using smartphone seizure diaries for at least 6 months (mean = 14.6 months, SD = 3.8 months). Eligible participants had a diagnosis of refractory epilepsy and reported at least 20 seizures (mean = 135, SD = 123) during the recording period. An ensembled machine learning and neural network model estimated seizure risk either daily or hourly, with retraining occurring on a weekly basis as additional data was collected. Performance was evaluated retrospectively against a rate-matched random forecast using the area under the receiver operating curve. A pseudo-prospective evaluation was also conducted on a held-out dataset. Of the 11 participants, seizures were predicted above chance in all (100%) participants using an hourly forecast and in ten (91%) participants using a daily forecast. The average time spent in high risk (prediction time) before a seizure occurred was 37 min in the hourly forecast and 3 days in the daily forecast. Cyclic features added the most predictive value to the forecasts, particularly circadian and multiday heart rate cycles. Wearable devices can be used to produce patient-specific seizure forecasts, particularly when biomarkers of seizure and epileptic activity cycles are utilized.
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    Seizure likelihood varies with day-to-day variations in sleep duration in patients with refractory focal epilepsy: A longitudinal electroencephalography investigation
    Dell, KL ; Payne, DE ; Kremen, V ; Maturana, MI ; Gerla, V ; Nejedly, P ; Worrell, GA ; Lenka, L ; Mivalt, F ; Boston, RC ; Brinkmann, BH ; D'Souza, W ; Burkitt, AN ; Grayden, DB ; Kuhlmann, L ; Freestone, DR ; Cook, MJ (ELSEVIER, 2021-07)
    BACKGROUND: While the effects of prolonged sleep deprivation (≥24 h) on seizure occurrence has been thoroughly explored, little is known about the effects of day-to-day variations in the duration and quality of sleep on seizure probability. A better understanding of the interaction between sleep and seizures may help to improve seizure management. METHODS: To explore how sleep and epileptic seizures are associated, we analysed continuous intracranial electroencephalography (EEG) recordings collected from 10 patients with refractory focal epilepsy undergoing ordinary life activities between 2010 and 2012 from three clinical centres (Austin Health, The Royal Melbourne Hospital, and St Vincent's Hospital of the Melbourne University Epilepsy Group). A total of 4340 days of sleep-wake data were analysed (average 434 days per patient). EEG data were sleep scored using a semi-automated machine learning approach into wake, stages one, two, and three non-rapid eye movement sleep, and rapid eye movement sleep categories. FINDINGS: Seizure probability changes with day-to-day variations in sleep duration. Logistic regression models revealed that an increase in sleep duration, by 1·66 ± 0·52 h, lowered the odds of seizure by 27% in the following 48 h. Following a seizure, patients slept for longer durations and if a seizure occurred during sleep, then sleep quality was also reduced with increased time spent aroused from sleep and reduced rapid eye movement sleep. INTERPRETATION: Our results suggest that day-to-day deviations from regular sleep duration correlates with changes in seizure probability. Sleeping longer, by 1·66 ± 0·52 h, may offer protective effects for patients with refractory focal epilepsy, reducing seizure risk. Furthermore, the occurrence of a seizure may disrupt sleep patterns by elongating sleep and, if the seizure occurs during sleep, reducing its quality.
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    Automatic speech recognition in neurodegenerative disease
    Schultz, BG ; Tarigoppula, VSA ; Noffs, G ; Rojas, S ; van der Walt, A ; Grayden, DB ; Vogel, AP (SPRINGER, 2021-09)
    Abstract Automatic speech recognition (ASR) could potentially improve communication by providing transcriptions of speech in real time. ASR is particularly useful for people with progressive disorders that lead to reduced speech intelligibility or difficulties performing motor tasks. ASR services are usually trained on healthy speech and may not be optimized for impaired speech, creating a barrier for accessing augmented assistance devices. We tested the performance of three state-of-the-art ASR platforms on two groups of people with neurodegenerative disease and healthy controls. We further examined individual differences that may explain errors in ASR services within groups, such as age and sex. Speakers were recorded while reading a standard text. Speech was elicited from individuals with multiple sclerosis, Friedreich’s ataxia, and healthy controls. Recordings were manually transcribed and compared to ASR transcriptions using Amazon Web Services, Google Cloud, and IBM Watson. Accuracy was measured as the proportion of words that were correctly classified. ASR accuracy was higher for controls than clinical groups, and higher for multiple sclerosis compared to Friedreich’s ataxia for all ASR services. Amazon Web Services and Google Cloud yielded higher accuracy than IBM Watson. ASR accuracy decreased with increased disease duration. Age and sex did not significantly affect ASR accuracy. ASR faces challenges for people with neuromuscular disorders. Until improvements are made in recognizing less intelligible speech, the true value of ASR for people requiring augmented assistance devices and alternative communication remains unrealized. We suggest potential methods to improve ASR for those with impaired speech.
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    Learning receptive field properties of complex cells in V1
    Lian, Y ; Almasi, A ; Grayden, DB ; Kameneva, T ; Burkitt, AN ; Meffin, H ; Einhäuser, W (PUBLIC LIBRARY SCIENCE, 2021-03)
    There are two distinct classes of cells in the primary visual cortex (V1): simple cells and complex cells. One defining feature of complex cells is their spatial phase invariance; they respond strongly to oriented grating stimuli with a preferred orientation but with a wide range of spatial phases. A classical model of complete spatial phase invariance in complex cells is the energy model, in which the responses are the sum of the squared outputs of two linear spatially phase-shifted filters. However, recent experimental studies have shown that complex cells have a diverse range of spatial phase invariance and only a subset can be characterized by the energy model. While several models have been proposed to explain how complex cells could learn to be selective to orientation but invariant to spatial phase, most existing models overlook many biologically important details. We propose a biologically plausible model for complex cells that learns to pool inputs from simple cells based on the presentation of natural scene stimuli. The model is a three-layer network with rate-based neurons that describes the activities of LGN cells (layer 1), V1 simple cells (layer 2), and V1 complex cells (layer 3). The first two layers implement a recently proposed simple cell model that is biologically plausible and accounts for many experimental phenomena. The neural dynamics of the complex cells is modeled as the integration of simple cells inputs along with response normalization. Connections between LGN and simple cells are learned using Hebbian and anti-Hebbian plasticity. Connections between simple and complex cells are learned using a modified version of the Bienenstock, Cooper, and Munro (BCM) rule. Our results demonstrate that the learning rule can describe a diversity of complex cells, similar to those observed experimentally.