Multiparametric EEG analysis of brain network dynamics during neonatal seizures

Background: One of the most challenging issues in paediatric neurology is the diagnosis of neonatal seizures, whose delayed treatment may affect the neurodevelopment of the newborn. Formulation of the correct diagnosis is conditioned by the high number of perceptually or automatically detected false positives. New Method: New methodologies are proposed to assess neonatal seizures trend over time. Our approach is based on the analysis of standardized trends of two properties of the brain network: the Synchronizabilty (S) and the degree of phase synchronicity given by the Circular Omega Complexity (COC). Qualitative and quantitative methods based on network dynamics allow differentiating seizure events from interictal periods and seizure-free patients. Results: The methods were tested on a public dataset of labelled neonatal seizures. COC shows significant differences among seizure and non-seizure events (p-value <0.001, Cohen's d 0.86). Combining S and COC in standardized temporal instants provided a reliable description of the physiological behaviour of the brain's network during neonatal seizures. Comparison with Existing Method(s): Few of the existing network methods propose an operative way for carrying their analytical approach into the diagnostic process of neonatal seizures. Our methods offer a simple representation of brain network dynamics easily implementable and understandable also by less experienced staff. Conclusions: Our findings confirm the usefulness of the evaluation of brain network dynamics over time for a better understanding and interpretation of the complex mechanisms behind neonatal seizures. The proposed methods could also reliably support existing seizure detectors as a post-processing step in doubtful cases.