EEG contd..

• EEG represents the general function of the brain activity- is the

superimposed wave of neuron potentials operating in a non-
synchronized manner.
• EEG signals exhibit several patterns of rhythmic or periodic activity.
• The commonly used terms for EEG frequency (f) bands are:
• Delta (δ): 0.5 ≤ f < 4 Hz
• Theta (θ): 4 ≤ f < 8 Hz
• Alpha (α): 8 ≤ f ≤ 13 Hz
• Beta (β): 13 ≤ f ≤ 22 Hz.
• Gamma (γ) 22–30 Hz
 From top to bottom: (a) delta rhythm; (b) theta rhythm; (c) alpha rhythm; (d) beta
rhythm; (e) blocking of the alpha rhythm by eye opening; (f) 1 s time markers and
50 µV marker.
• The alpha rhythm is one of the principal components of the EEG and
is an indicator of the state of ‘alertness’ of the brain ( indicates the
depth of anaesthesia in the operating room).
• The mental activity of a person reflects on the frequency of the EEG
signal.
• The alpha rhythm is common in wakeful, resting adults, especially in
the occipital area, with bilateral synchrony
• Auditory and mental arithmetic tasks with the eyes closed lead to
strong alpha waves, which are suppressed when the eyes are opened
• The alpha wave is replaced by slower rhythms at various stages of
sleep.
• Theta waves appear at the beginning stages of sleep.
• Delta waves appear at deep-sleep stages.
• High-frequency beta waves appear as background activity in tense and
anxious subjects.
• The depression or absence of the normal (expected) rhythm in a
certain state of the subject could indicate abnormality.
• The presence of delta or theta (slow) waves in a wakeful adult may be
considered to be abnormal.
• Focal brain injury and tumors lead to abnormal slow waves in the
corresponding regions.
• Unilateral depression (left–right asymmetry) of a rhythm could indicate
disturbances in cortical pathways.
 Action potential in a neuron

• The interior of the neuron is at a potential of about –70 mV relative

to the exterior.

• When a neuron is exposed to a stimulus above a certain threshold, a

nerve impulse, seen as a change in membrane potential, is generated
which spreads in the cell resulting in the depolarization of the cell.

• Shortly afterwards repolarization occurs.

• The EEG signal can be picked up with electrodes either from the scalp
or directly from the cerebral cortex.
• The peak-to-peak amplitude of the waves that can be picked up from
the scalp is normally 100 μV or less while that on the exposed brain, is
about 1 mV.
• The frequency varies greatly with different behavioural states.
• The normal EEG frequency content ranges from 0.5 to 50 Hz.
• The nature of the wave varies over the different parts of the scalp.
• The variations in EEG signals both in terms of amplitude and
frequency are of diagnostic value.
• EEG monitoring is an effective method for diagnosing many
neurological illnesses and diseases:
• Epilepsy, tumour, cerebrovascular lesions, ischemia and problems
associated with trauma.
• Effectively used in the operating room to facilitate anaesthetics and to
establish the integrity of the anaesthetized patient’s nervous system.
• Compact computer-based EEG analyzers are used for this purpose.
• Consequently, routine EEG monitoring in the operating room and
intensive care units is becoming popular.
• Gross abnormalities like epileptic seizures and sleep disorders have
characteristic EEG waveforms.
• The recording of ‘evoked response’ which indicates the disturbance in
the EEG pattern resulting from external stimuli is also important in
studying some specific parts of the brain.
• Stimuli could be a flash of light, a click of sound or reversal of a
checker board pattern.
• The evoked response can be separated out from the rest of the EEG
activity by averaging techniques.
• EEG may be recorded by picking up the voltage difference between
an active electrode on the scalp with respect to a reference electrode
on the ear lobe or any other part of the body.
• This type of recording is called ‘monopolar’ recording.
• In ‘bipolar’ recording the voltage difference between two scalp
electrodes is recorded and are done with multi-channel
electroencephalographs.
• EEG signals picked up by the surface electrodes have typically 50
microvolts peak-to-peak.
• The brain waves, unlike the electrical activity of the heart, do not
represent the same pattern over and over again. Therefore, brain
recordings are made over a much longer interval of time.
 The phonocardiogram (PCG)
• The PCG is a vibration or sound signal related to the contractile
activity of the cardiohemic system (the heart and blood together).
• Represents a recording of the heart sound signal which requires a
transducer to convert the vibration or sound signal into an electronic
signal.
• Normal heart sounds provide an indication of the general state of the
heart in terms of rhythm and contractility.
• In case of cardiovascular diseases and defects changes are caused to
the heart sounds or additional sounds and murmurs are heard.
 Origin of heart sounds
• The sounds are produced by the mechanical events that occur during
the heart cycle.
• These sounds can be from the movement of the heart wall, closure of
walls and turbulence and leakage of blood flow.
• The first sound, which corresponds to the R wave of the ECG, is longer
in duration, lower in frequency, and greater in intensity than the
second sound.
• Principally produced by closure of the valves between the upper and
lower chambers of the heart-it occurs at the termination of the atria
contraction and at the onset of the ventricular contraction ( closure of
mitral and tricuspid valves)
• The frequencies of these sounds are generally in the range of 30 to 100 Hz and
the duration is between 50 to 100 ms.
• The second sound is has frequencies above 100 Hz and the duration between 25
to 50 ms.
• This sound is produced by the slight back flow of blood into the heart before the
valves close and then by the closure of the valves in the arteries leading out of
the ventricles.
• This means that it occurs at the closure of aortic and the pulmonary valves.
• The heart also produces third and fourth sounds but they are much lower in
intensity and are usually inaudible.
• The third sound is produced by the inflow of blood to the ventricles and the
fourth sound is produced by the contraction of the atria – referred to as the
diastolic sounds.
• A normal cardiac cycle contains two major sounds — the first heart sound (S1) and
the second heart sound (S2).

• S1 occurs at the onset of ventricular contraction, and corresponds in timing to the

QRS complex in the ECG signal.

The first heart sound S1 has 4 components:

• The initial vibrations in S1 occur when the first myocardial contractions in the
ventricles move blood toward the atria, sealing the AV (mitral and tricuspid) valves.

• The second component of S1 begins with abrupt tension of the closed AV valves,
decelerating the blood during which all the four cardiac valves are closed.
• Next, the semilunar (aortic and pulmonary) valves open and the
blood is ejected out of the ventricles.

• The third component of S1 may be caused by oscillation of blood

between the root of the aorta and the ventricular walls.

• The fourth component of S1, may be due to vibrations caused by

turbulence in the ejected blood flowing rapidly through the ascending
aorta and the pulmonary artery.
• The second sound S2 is caused by the closure of the semilunar valves.
• Vibrations are primarily due to:
• Deceleration of blood, vibration of the ventricles and atria,
transmission of vibrations through the blood, the valves, and the
valve rings.
• S2 has two components, one due to closure of the aortic valve (A2)
and another due to closure of the pulmonary valve (P2).
• The aortic valve normally closes before the pulmonary valve, and
hence A2 precedes P2 by a few milliseconds. The A2–P2 gap is
widened in normal subjects during inspiration.
Three-channel simultaneous record of the PCG,
ECG, and carotid pulse signals of a normal male
adult.
Basic heart sounds in a typical phonocardiogram
recording
Schematic representation of the genesis of heart
sounds.
 Heart murmurs:

• The intervals between S1 and S2, and S2 and S1 of the next cycle are
normally silent.
• Murmurs are caused by certain cardiovascular defects and diseases,
may occur in these intervals.
• Murmurs are high-frequency noise-like sounds that arise when the
velocity of blood becomes high as it flows through an irregularity,
such as a constriction, an orifice etc.
• Turbulence in blood flow are due to valvular stenosis and
insufficiency which reflect certain conditions of the cardiovascular
system.
• Stenosis- Due to the deposition of calcium or other reasons, the
valve leaflets get stiffened - do not open completely, thereby causing
an obstruction or baffle in the path of the blood being ejected.
• A valve is said to be insufficient when it cannot close effectively and
causes reverse leakage or regurgitation of blood through a narrow
opening.
• Systolic murmurs are caused by conditions such as ventricular septal
defect , aortic stenosis, pulmonary stenosis, mitral insufficiency, and
tricuspid insufficiency.
• Diastolic murmurs are caused by conditions such as aortic
insufficiency, pulmonary insufficiency, mitral stenosis, and tricuspid
stenosis.
 Biomedical Signal Processing: Objectives and
contexts
• Biomedical signals have often been assessed visually, and manual
ruler-based procedures were developed so that measurements could
be obtained in a standardized manner.
• Relatively poor concordance between manually obtained
measurements - leads to unreliable diagnostic conclusions.
• A fundamental objective of biomedical signal processing is therefore
to reduce the subjectivity of manual measurements.
• The introduction of computer based methods for the purpose of
objectively quantifying different signal characteristics- to improve
measurement accuracy as well as reproducibility.
• Biomedical signal processing is used for developing methods that
extract features to help characterize and understand the information
contained in a signal.
• Feature extraction methods can mimic manual measurements, but
are equally often designed to extract information which is not readily
available from the signal through visual assessment.
• Eg: Heart rate variability that cannot be perceived by the human eye
contains very valuable clinical information when quantified in detail
using a suitable signal processing technique.
• The recorded signal is corrupted by different types of noise and
interference, sometimes originating from another physiological
process of the body.
• Ocular activity sometimes interferes with the desired brain signal, when
electrodes are poorly attached to the body surface.
• External source such as the sinusoidal 50/60 Hz powerline also interferes
with the signal.
• Noise reduction represents a crucial objective of biomedical signal
processing.
• BSP helps to mitigate the technical deficiencies of a recording, as well as
to separate the desired physiological process from interfering processes.
• The desired signal in certain situations gets dramatically masked by noise
that its very presence can only be revealed once appropriate signal
processing has been applied e.g late potentials ( cardiac related) and
evode potentials ( EEG related).
• Analysis of abnormal sleep patterns or intermittently occurring
disturbances in the heart rhythm requires recording over a long
duration of time.
• The resulting recording involves many channels, amounts to huge
data sizes.
• Transmission of biomedical signals across public telephone networks
is another, increasingly important application in which large amounts
of data are involved.
• Data compression of the digitized signal is essential and hence
another objective of biomedical signal processing.
• Tailored algorithms for data compression of biomedical signals
required as the conventional methods cannot be employed.
• It is highly desirable to develop signal processing algorithms which are able
to determine and delimit clinically significant episodes
• Mathematical signal modeling and simulation constitute other important
objective in biomedical signal processing which can help to attain a better
understanding of physiological processes.
• Signal modeling is also central to the branch of signal processing called
"model-based signal processing," where algorithm development is based
on the optimization of an appropriately selected performance criterion.
• The complexity of a signal model depends on the problem to be solved.
• A "phenomenological" model which only accounts for phenomena which
are relevant to the specific problem at hand needs to be developed.
Contexts
• The three major clinical contexts in which algorithms for biomedical signal
processing are designed are:
a) Diagnosis b) Therapy c) Monitoring.
• Medical conditions are identified from the examination of signal information,
reflecting the function of an organ such as the brain or the heart, in combination
with other symptoms and clinical signs.
• Signal is often acquired by a noninvasive procedure which makes the examination
less taxing on the patient.
• Signal analysis can be done off-line on a personal computer.
• Relies on standardized hardware and operating system, possibly supplemented
with a digital signal processor (DSP) board for accelerating certain bottleneck
computations.
• BSP algorithms perform a simple filtering operation to forming a more substantial
part of the clinical decision-making.
• Therapy generally signifies the treatment of disease and often involves
drug therapy or surgery.
• In a therapeutic context, an algorithm is commonly designed for
implementation in an implantable device like a heart defibrillator.
• Need not strictly comply with the demands of on-line, real-time
analysis.
• Low power consumption is another critical factor to be considered in
connection with devices that are implanted through a surgical
procedure.
• So algorithms which involve computationally demanding signal
processing techniques are less suitable for use in a therapeutic context.
• Biomedical signal processing algorithms form an important part of realtime
systems for monitoring of patients who suffer from a life-threatening condition.

• Systems are usually designed to detect changes in cardiac or neurological

function and to predict the outcome of a patient admitted to the intensive care
unit (ICU).

• Such changes can be made reversible with early intervention- irreversible

damage can sometimes be prevented.

• The signal is processed during monitoring in an essentially sequential fashion

such that past samples constitute the main basis for a decision, while just a few
seconds of the future samples may also be considered.
 Objectives of Biomedical Signal Analysis

• The representation of biomedical signals in electronic form facilitates

computer processing and analysis of the datacesses involved in
computer-aided diagnosis (CAD) and therapy based upon biomedical
signal analysis.
• Information gathering — measurement of phenomena to interpret a
system ( prelimnary step in satisfying the major objective of a
biomedical instrumentation and signal analysis system).
• Evaluation — objective analysis to determine the ability to meet
functional requirements, obtain proof of performance, perform
quality control, or quantify the effect of treatment ( final step )
 Signal acquisition
• Invasive versus noninvasive procedures:
Invasive procedures involve the placement of transducers or other devices inside
the body ( needle electrodes to record MUAPs, or insertion of catheter-tip
sensors into the heart via a major artery or vein to record intracardiac signals).

Noninvasive procedures are desirable in order to minimize risk to the subject

(Recording of the ECG using limb or chest electrodes, the EMG with surface
electrodes, or the PCG with microphones or accelerometer)
 Active versus passive procedures:

• Active data acquisition procedures require external stimuli to be applied

to the subject.
• Requires the subject to perform a certain activity to stimulate the
system of interest in order to elicit the desired response or signal.
• Eg: recording an EMG signal, recording the VAG signal from the knee,
recording visual ERP signals.
• Passive procedures do not require the subject to perform any activity.
• Eg: Recording of the ECG using limb or chest electrodes, the EEG during
sleep using scalp-surface electrodes, or the PCG with microphones or
accelerometers placed on the chest are passive procedures.
• Contact between the subject and the instruments is required in the
passive case
• The procedure being passive, the system of interest is active under its
own natural control in these procedures.
• Ethics committee approval is required in recording most of the
biosignals from hospitals.
 Tasks in Biomedical Signal Processing
• Accessibility of the variables to measurement:
• Most of the systems and organs of interest, such as the cardiovascular
system and the brain, are located well within the body in protective
enclosures.
• While the ECG may be recorded using limb electrodes, the signal so
acquired is only a projection of the true 3D cardiac electrical vector on to
the axis of the electrodes.
• Such a signal may be sufficient for rhythm monitoring, but could be
inadequate for more specific analysis of the cardiac system such as atrial
electrical activity.
• Accessing the atrial electrical activity at the source requires the insertion
of an electrode close to the atrial surface or within the atria.
• Measurement of BP using a pressure cuff over an arm gives an
estimate of the brachial arterial pressure.
• Detailed study of pressure variations within the cardiac chambers or
arteries over a cardiac cycle would require the insertion of catheters
with pressure sensors into the heart.
• Such invasive procedures provide access to the desired signals at their
sources and often provide clear and useful signals, but carry high risks.
• Acquisition of SMUAPs requires access to the specific muscle layer or
unit of interest by insertion of finewire or needle electrodes.
• The procedure carries risks of infection and damage to muscle fibers,
and it causes pain to the subject during muscular activity
• Minimal level of intervention is absolutely essential for the data
acquisition procedure, which is a major requirement in biomedical
signal processing.
• A trade-off between the integrity and quality of the information
acquired versus the pain and risks to the subject may be needed.
Variability of the signal source:
• Biomedical signals represent the dynamic activity of physiological
systems and the states of their constituent variables.
• The nature of the processes or the variables could be deterministic or
random (stochastic)
• The dynamic nature of biological systems causes most signals to
exhibit stochastic and nonstationary behaviour.
• Hence signal statistics such as mean, variance, and spectral density
change with time.
• So signals from a dynamic system should be analyzed over extended
periods of time including various possible states of the system.
Interrelationships and interactions among physiological systems:
• Systems that compose the human body are not mutually independent
they are interrelated and interact in various ways.
• Misinterpretation of the signal happens when such interrelationships are
ignored.
Effect of the instrumentation or procedure on the system:
• The placement of transducers on a subject and connecting a system to
instruments- causes spurious variations in the parameters being
investigated.

• The experimental procedure or activity required to elicit the signal may

lead to certain effects that could alter signal characteristics.

• Repetitions of an experimental procedure results in fatigue- subsequent

measurements may not be indicative of the true behavior of the system.
Physiological artifacts and interference:
• Good ECG signal recording is possible from a subject when he remains
relaxed and still with no movement.
• Coughing, tensing of muscles, and movement of the limbs cause the
corresponding EMG to appear as an undesired artifact.
• Even normal breathing could cause the associated EMG of the chest
muscles to interfere with the desired ECG.
• While acquiring the ECG of a fetus through surface electrodes placed
over the expectant mother’s abdomen: the maternal ECG appears as
an interference in this situation.
 Energy limitations:
• Biomedical signals have magnitudes of microvolt or millivolt levels.
• Recording such signals requires sensitive transducers and
instrumentation with low noise levels.
• The connectors and cables need to be shielded to prevent pickup of
ambient electromagnetic (EM) signals.
• Transducers with integrated amplifiers and signal conditioners are
needed in some cases so that the signal leaving the subject at the
transducer is much stronger than ambient sources of potential
interference.
• A Faraday cage or shield-the entire data acquisition setup including
the subject and all devices are enclosed within the shield to prevent
external EM waves from contaminating the signals being recorded.
Applying external stimuli…
• Using external stimuli to elicit a certain response from a system, the
level of the stimulus is constrained due to safety factors and
physiological limitations.
• Electrical stimuli to record the ENG need to be limited in voltage level
so as to not cause local burns or interfere with the electrical control
signals of the cardiac or nervous systems.
• Auditory and visual stimuli are constrained by the:
i) lower thresholds of detectability
ii) upper thresholds related to frequency response, saturation,
or pain.
 Patient safety:

• Protection of the subject or patient from electrical shock or radiation

hazards is an important requirement.

• The relative levels of any other risks involved should be assessed when
a choice is available between various procedures and should be
analyzed against their relative benefits.

• Due to the various difficulties encountered in the acquisition of

biomedical signals, several institutions and agencies have supported
efforts to develop public databases of annotated signals.
 Need for CAD
• Humans are highly skilled and fast in the analysis of visual patterns and
waveforms- slow in arithmetic operations with large numbers of values.
• If signals need to be processed to remove noise or extract a parameter, it would
not be practical for a person to perform such computation.
• Computers can perform millions of arithmetic operations per second.
• Recognition of waveforms and images using mathematical procedures typically
requires huge numbers of operations that could lead to slow responses in such
tasks from low-level computers.
• Humans could be affected by fatigue, boredom, and environmental factors, and
are susceptible to committing errors.
• Long-term monitoring of certain biosignals of a critically ill patient, by a human
observer watching an oscilloscope or computer display is neither economical nor
feasible.
• A human observer could be distracted by other events in the surrounding
areas and may miss short episodes or transients in the signal.
• Computers, being inanimate but mathematically accurate and consistent
machines, can be designed to perform computationally specific and
repetitive tasks.
• Analysis by humans is usually subjective and qualitative.
• Specific or objective comparison to the accuracy of the order of a few
milliseconds requires the use of electronic instrumentation or a
computer.
• Derivations of quantitative or numerical features from signals with large
numbers of samples would demands for the use of computers.
• Analysis by humans is subject to interobserver as well as
intraobserver variations (with time).
• Computers can apply a given procedure repeatedly and whenever
recalled in a consistent manner.
• Possible to encode the knowledge (to be more specific, the logic) of
many experts into a single computational procedure.
• Enables a computer to have the collective intelligence of several
human experts in the area of interest.
• Computers could be used for off-line analysis of prerecorded signals
with sophisticated signal processing and time-consuming modeling
techniques.
Typical configuration of PC based medical
instrument
Computer-aided diagnosis and therapy based upon
biomedical signal analysis