Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

Limitations of single-channel EEG on the forehead for neonatal seizure detection

Journal of Perinatology volume 29, page 588 (2009)Cite this article

We read with interest Wusthoff et al.'s1 investigation of single-channel electroencephalography (EEG) and the amplitude-integrated EEG (aEEG) in a cohort of infants. This study showed that bifrontal electrode placement is associated with the under-detection of seizures. Among the reasons for under-detection, (1) the authors found that fronto-polar seizures were scarce in comparison with those arising from other scalp regions, (2) the artifact was frequent in fronto-polar regions and (3) they hypothesized that interelectrode distance might affect the amplitudes of EEG and aEEG.

We have investigated the engineering aspects of aEEG and can provide evidence supporting their last hypothesis.2 With the use of quantification techniques and actual and synthesized EEG sources, we determined that the amplitude of aEEG varies significantly with the location of scalp placement and is linearly proportional to interelectrode distance. Furthermore, the filter systems (both electronic and algorithmic) used to generate the aEEG signal differ among the manufacturers. Finally, input impedance did not affect signal amplitude (although it distorted signal morphology). We agree with Wusthoff and her co-authors in that single-channel EEG or aEEG is a technique with significant limitations. Although their analysis centered on seizure detection, our data suggest that the determination of the severity of encephalopathy, as determined by aEEG upper and lower ‘border’ levels, may be difficult to compare among different electrode placement techniques or even with aEEG obtained among different aEEG systems.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Wusthoff CJ, Shellhaas RA, Clancy RR . Limitations of single-channel EEG on the forehead for neonatal seizure detection. J Perinatol 2009; 29: 237–242.

    Article  CAS  Google Scholar 

  2. Quigg M, Leiner D . Engineering aspects of the quantified amplitude-integrated EEG in neonatal cerebral monitoring. J Clin Neurophysiol. (in press).

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, University of Virginia, Charlottesville, VA, USA

    M Quigg

  2. School of Engineering and Applied Sciences, University of Virginia, Charlottesville, VA, USA

    D Leiner

Authors
  1. M Quigg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D Leiner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M Quigg.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Quigg, M., Leiner, D. Limitations of single-channel EEG on the forehead for neonatal seizure detection. J Perinatol 29, 588 (2009). https://doi.org/10.1038/jp.2009.52

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2009.52

Search

Advanced search

Quick links