Resting-State Functional Connectivity Predicts Cochlear-Implant Speech Outcomes.

OBJECTIVES: Cochlear implants (CIs) have revolutionized hearing restoration for individuals with severe or profound hearing loss. However, a substantial and unexplained variability persists in CI outcomes, even when considering subject-specific factors such as age and the duration of deafness. In a pioneering study, we use resting-state functional near-infrared spectroscopy to predict speech-understanding outcomes before and after CI implantation. Our hypothesis centers on resting-state functional connectivity (FC) reflecting brain plasticity post-hearing loss and implantation, specifically targeting the average clustering coefficient in resting FC networks to capture variation among CI users. DESIGN: Twenty-three CI candidates participated in this study. Resting-state functional near-infrared spectroscopy data were collected preimplantation and at 1 month, 3 months, and 1 year postimplantation. Speech understanding performance was assessed using consonant-nucleus-consonant words in quiet and Bamford-Kowal-Bench sentences in noise 1-year postimplantation. Resting-state FC networks were constructed using regularized partial correlation, and the average clustering coefficient was measured in the signed weighted networks as a predictive measure for implantation outcomes. RESULTS: Our findings demonstrate a significant correlation between the average clustering coefficient in resting-state functional networks and speech understanding outcomes, both pre- and postimplantation. CONCLUSIONS: This approach uses an easily deployable resting-state functional brain imaging metric to predict speech-understanding outcomes in implant recipients. The results indicate that the average clustering coefficient, both pre- and postimplantation, correlates with speech understanding outcomes.

A Parametric Model for Characterizing Time-Variant Single Trials of Block-Design fNIRS Experiments.

Block-design is a popular experimental paradigm for functional near-infrared spectroscopy (fNIRS). Traditional block-design analysis techniques such as generalized linear modeling (GLM) and waveform averaging (WA) assume that the brain is a time-invariant system. This is a flawed assumption. In this paper, we propose a parametric Gaussian model to quantify the time-variant behavior found across consecutive trials of block-design fNIRS experiments. Using simulated data at different signal-to-noise ratios (SNRs), we demonstrate that our proposed technique is capable of characterizing Gaussian-like fNIRS signal features with ≥3dB SNR. When used to fit recorded data from an auditory block-design experiment, model parameter values quantitatively revealed statistically significant changes in fNIRS responses across trials, consistent with visual inspection of data from individual trials. Our results suggest that our model effectively captures trial-to-trial differences in response, which enables researchers to study time-variant brain responses using block-design fNIRS experiments.

Brain Functional Connectivity Networks do not Return to Resting-state During Control Trials in Block Design Experiments.

Many studies on morphology analysis show that if short inter-stimulus intervals separate tasks, the hemodynamic response amplitude will return to the resting-state baseline before the subsequent stimulation onset; hence, responses to successive tasks do not overlap. Accordingly, popular brain imaging analysis techniques assume changes in hemodynamic response amplitude subside after a short time (around 15 seconds). However, whether this assumption holds when studying brain functional connectivity has yet to be investigated. This paper assesses whether or not the functional connectivity network in control trials returns to the resting-state functional connectivity network. Traditionally, control trials in block-design experiments are used to evaluate response morphology to no stimulus. We analyzed data from an event-related experiment with audio and visual stimuli and resting state. Our results showed that functional connectivity networks during control trials were more similar to that of tasks than resting-state networks. In other words, contrary to task-related changes in the hemodynamic amplitude, where responses settle after a short time, the brain's functional connectivity networks do not return to their intrinsic resting-state network in such short intervals.

A clinical set-up for noninvasive blood pressure monitoring using two photoplethysmograms and based on convolutional neural networks.

Blood pressure is a reliable indicator of many cardiac arrhythmias and rheological problems. This study proposes a clinical set-up using conventional monitoring systems to estimate systolic and diastolic blood pressures continuously based on two photoplethysmogram signals (PPG) taken from the earlobe and toe. Several amendments were applied to conventional clinical monitoring devices to construct our project plan. We used two monitors to acquire two PPGs, one ECG, and invasive blood pressure as the reference to evaluate the estimation accuracy. One of the most critical requirements was the synchronization of the acquired signals that was accomplished by using ECG as the time reference. Following data acquisition and preparation procedures, the performance of each PPG signal alone and together was investigated using deep convolutional neural networks. The proposed architecture was evaluated on 32 records acquired from 14 patients after cardiovascular surgery. The results showed a better performance for toe PPG in comparison with earlobe PPG. Moreover, they indicated the algorithm accuracy improves if both signals are applied together to the network. According to the British Hypertension Society standards, the results achieved grade A for both blood pressure measurements. The mean and standard deviation of estimation errors were +0.3 ± 4.9 and +0.1 ± 3.2 mmHg for systolic and diastolic BPs, respectively. Since the method is based on conventional monitoring equipment and provides a high estimation consistency, it can be considered as a possible alternative for inconvenient invasive BP monitoring in clinical environments.

Cuffless blood pressure estimation methods: physiological model parameters versus machine-learned features.

Objective.For the first time in the literature, this paper investigates some crucial aspects of blood pressure (BP) monitoring using photoplethysmogram (PPG) and electrocardiogram (ECG). In general, the proposed approaches utilize two types of features: parameters extracted from physiological models or machine-learned features. To provide an overview of the different feature extraction methods, we assess the performance of these features and their combinations. We also explore the importance of the ECG waveform. Although ECG contains critical information, most models merely use it as a time reference. To take this one step further, we investigate the effect of its waveform on the performance.Approach.We extracted 27 commonly used physiological parameters in the literature. In addition, convolutional neural networks (CNNs) were deployed to define deep-learned representations. We applied the CNNs to extract two different feature sets from the PPG segments alone and alongside corresponding ECG segments. Then, the extracted feature vectors and their combinations were fed into various regression models to evaluate our hypotheses.Main results.We performed our evaluations using data collected from 200 subjects. The results were analyzed by the mean difference t-test and graphical methods. Our results confirm that the ECG waveform contains important information and helps us to improve accuracy. The comparison of the physiological parameters and machine-learned features also reveals the superiority of machine-learned representations. Moreover, our results highlight that the combination of these feature sets does not provide any additional information.Significance.We conclude that CNN feature extractors provide us with concise and precise representations of ECG and PPG for BP monitoring.

A multistage deep neural network model for blood pressure estimation using photoplethysmogram signals.

OBJECTIVE: Easy access bio-signals are useful to alleviate the shortcomings and difficulties of cuff-based and invasive blood pressure (BP) measuring techniques. This study proposes a multistage model based on deep neural networks to estimate systolic and diastolic blood pressures using the photoplethysmogram (PPG) signal. METHODS: The proposed model consists of two key ingredients, using two successive stages. The first stage includes two convolutional neural networks (CNN) to extract morphological features from each PPG segment and then to estimate systolic and diastolic BPs separately. The second stage relies on long short-term memory (LSTM) to capture temporal dependencies. Further, the method incorporates the dynamic relationship between systolic and diastolic BPs to improve accuracy. RESULTS: The proposed multistage model was evaluated on 200 subjects using the standards of the British Hypertension Society (BHS) and the Association for the Advancement of Medical Instrumentation (AAMI). The results revealed that our model performance met the requirements of the AAMI standard. Also, according to the BHS standard, it achieved grade A in estimating both systolic and diastolic BPs. The mean and standard deviation of error for systolic and diastolic blood pressure estimations were +1.91±5.55mmHg and +0.67±2.84mmHg, respectively. CONCLUSION: Our results highlight the benefits of the proposed model in terms of appropriate feature extraction as well as estimation consistency.