6
P. V. E. McClintock and A. Stefanovska
1.4 Applications
One of the main impediments to widespread use of physiological oscillations
in diagnostics and medical instrumentation has, arguably, been their inherently
non-autonomous character and variability. Traditionally, these features have been
extremely hard to model. However, the substantial progress currently being made
towards an understanding of such processes—forming the main raison d’être of the
book—shows that this problem is being overcome so that faster progress in the development of useful applications in medicine may now be anticipated. In Part IV we
consider some examples, both actual and potential.
In Chap. 22, Lehnertz provides an update on the use of EEG oscillations to predict
epileptic seizures. These are usually associated with an overly-synchronized firing
of neurons, as detected from the observed EEG oscillations, which often appears
via a transformation of otherwise normal brain rhythms. The aim is therefore to
apply methods from nonlinear dynamics, statistical physics, synchronization and
network theory to identify precursor rhythms that can be used to warn the patient
of an impending seizure. It is a long-term project that has been running for more
than three decades. The author discusses progress to date and recent developments,
including implantable devices for seizure prediction and prevention, and considers
the remaining problems still to be solved.
The next two chapters both deal with anaesthesia and, in particular, exploitation
of the changes in physiological oscillations that occur between the awake and anaesthetised states to provide a quantitative measure of the depth of anaesthesia, i.e. how
close the patient is to becoming aware. There is obvious potential for preventing
the unintentional awareness that still occurs occasionally, and which can be very
distressing for everybody involved, not just the patient. In Chap. 23, Raeder reports
on the European project BRACCIA (brain, respiration and cardiac causalities in
anaesthesia). Although publication of the results has not yet been completed, it has
already been shown that, even without inclusion of EEG data, measurements of the
oscillations in ECG, respiration, skin temperature, and skin conductivity, coupled
with the use of a classification analysis based on an optimal set of discriminatory
parameters, can distinguish with 95% success between the awake and anaesthetised
states. Chapter 24, by Martínez-Vázquez et al. describes an anaesthetic monitor that
is already on the market: the qCON™ from Quantium Medical (Barcelona). Like
the market leader BIS™, its operation is based on the analysis of EEG oscillations.
The authors describe the main EEG activity changes induced by hypnotic anaesthetic
agents, and the analysis perspectives. They also discuss the design principles, minimal necessary validation requirements, current limitations and challenges yet to be
overcome.
In Chap. 25, Thorn and Shore review medical products that have been developed
to enhance the oscillatory nature of blood circulation through the external application
of intermittent pneumatic compression (IPC). They remark that further research is
required, at a microcirculatory level, to understand and optimise the observed clinical
benefits of IPC.
P. V. E. McClintock and A. Stefanovska
1.4 Applications
One of the main impediments to widespread use of physiological oscillations
in diagnostics and medical instrumentation has, arguably, been their inherently
non-autonomous character and variability. Traditionally, these features have been
extremely hard to model. However, the substantial progress currently being made
towards an understanding of such processes—forming the main raison d’être of the
book—shows that this problem is being overcome so that faster progress in the development of useful applications in medicine may now be anticipated. In Part IV we
consider some examples, both actual and potential.
In Chap. 22, Lehnertz provides an update on the use of EEG oscillations to predict
epileptic seizures. These are usually associated with an overly-synchronized firing
of neurons, as detected from the observed EEG oscillations, which often appears
via a transformation of otherwise normal brain rhythms. The aim is therefore to
apply methods from nonlinear dynamics, statistical physics, synchronization and
network theory to identify precursor rhythms that can be used to warn the patient
of an impending seizure. It is a long-term project that has been running for more
than three decades. The author discusses progress to date and recent developments,
including implantable devices for seizure prediction and prevention, and considers
the remaining problems still to be solved.
The next two chapters both deal with anaesthesia and, in particular, exploitation
of the changes in physiological oscillations that occur between the awake and anaesthetised states to provide a quantitative measure of the depth of anaesthesia, i.e. how
close the patient is to becoming aware. There is obvious potential for preventing
the unintentional awareness that still occurs occasionally, and which can be very
distressing for everybody involved, not just the patient. In Chap. 23, Raeder reports
on the European project BRACCIA (brain, respiration and cardiac causalities in
anaesthesia). Although publication of the results has not yet been completed, it has
already been shown that, even without inclusion of EEG data, measurements of the
oscillations in ECG, respiration, skin temperature, and skin conductivity, coupled
with the use of a classification analysis based on an optimal set of discriminatory
parameters, can distinguish with 95% success between the awake and anaesthetised
states. Chapter 24, by Martínez-Vázquez et al. describes an anaesthetic monitor that
is already on the market: the qCON™ from Quantium Medical (Barcelona). Like
the market leader BIS™, its operation is based on the analysis of EEG oscillations.
The authors describe the main EEG activity changes induced by hypnotic anaesthetic
agents, and the analysis perspectives. They also discuss the design principles, minimal necessary validation requirements, current limitations and challenges yet to be
overcome.
In Chap. 25, Thorn and Shore review medical products that have been developed
to enhance the oscillatory nature of blood circulation through the external application
of intermittent pneumatic compression (IPC). They remark that further research is
required, at a microcirculatory level, to understand and optimise the observed clinical
benefits of IPC.