A Calibration-Free Hybrid Approach Combining SSVEP and EOG for Continuous Control.

While SSVEP-BCI has been widely developed to control external devices, most of them rely on the discrete control strategy. The continuous SSVEP-BCI enables users to continuously deliver commands and receive real-time feedback from the devices, but it suffers from the transition state problem, a period the erroneous recognition, when users shift their gazes between targets. To resolve this issue, we proposed a novel calibration-free Bayesian approach by hybridizing SSVEP and electrooculography (EOG). First, canonical correlation analysis (CCA) was applied to detect the evoked SSVEPs, and saccade during the gaze shift was detected by EOG data using an adaptive threshold method. Then, the new target after the gaze shift was recognized based on a Bayesian optimization approach, which combined the detection of SSVEP and saccade together and calculated the optimized probability distribution of the targets. Eighteen healthy subjects participated in the offline and online experiments. The offline experiments showed that the proposed hybrid BCI had significantly higher overall continuous accuracy and shorter gaze-shifting time compared to FBCCA, CCA, MEC, and PSDA. In online experiments, the proposed hybrid BCI significantly outperformed CCA-based SSVEP-BCI in terms of continuous accuracy (77.61 ± 1.36%vs. 68.86 ± 1.08% and gaze-shifting time (0.93 ± 0.06s vs. 1.94 ± 0.08s). Additionally, participants also perceived a significant improvement over the CCA-based SSVEP-BCI when the newly proposed decoding approach was used. These results validated the efficacy of the proposed hybrid Bayesian approach for the BCI continuous control without any calibration. This study provides an effective framework for combining SSVEP and EOG, and promotes the potential applications of plug-and-play BCIs in continuous control.

Standardization of neurophysiology signal data into the DICOM® standard.

A standard format for neurophysiology data is urgently needed to improve clinical care and promote research data exchange. Previous neurophysiology format standardization projects have provided valuable insights into how to accomplish the project. In medical imaging, the Digital Imaging and Communication in Medicine (DICOM) standard is widely adopted. DICOM offers a unique environment to accomplish neurophysiology format standardization because neurophysiology data can be easily integrated with existing DICOM-supported elements such as video, ECG, and images and also because it provides easy integration into hospital Picture Archiving and Communication Systems (PACS) long-term storage systems. Through the support of the International Federation of Clinical Neurophysiology (IFCN) and partners in industry, DICOM Working Group 32 (WG-32) has created an initial set of standards for routine electroencephalography (EEG), polysomnography (PSG), electromyography (EMG), and electrooculography (EOG). Longer and more complex neurophysiology data types such as high-definition EEG, long-term monitoring EEG, intracranial EEG, magnetoencephalography, advanced EMG, and evoked potentials will be added later. In order to provide for efficient data compression, a DICOM neurophysiology codec design competition will be held by the IFCN and this is currently being planned. We look forward to a future when a common DICOM neurophysiology data format makes data sharing and storage much simpler and more efficient.

ISCEV Standard for clinical electro-oculography (2017 update).

The clinical electro-oculogram (EOG) is an electrophysiological test of the outer retina and retinal pigment epithelium (RPE) in which changes in the electrical potential across the RPE are recorded during successive periods of dark and light adaptation. This document presents the 2017 EOG Standard from the International Society for Clinical Electrophysiology of Vision (ISCEV: www.iscev.org ). This standard has been reorganized and updated to include an explanation of the mechanism of the EOG, but without substantive changes to the testing protocol from the previous version published in 2011. It describes methods for recording the EOG in clinical applications and gives detailed guidance on technical requirements, practical issues and reporting of results with the main clinical measure (the Arden ratio) now termed the light peak:dark trough ratio. The standard is intended to promote consistent quality of testing and reporting within and between clinical centers.

Spinocerebellar ataxia type 2: Measures of saccade changes improve power for clinical trials

BACKGROUND:Saccadic eye movement abnormalities are common in patients with spinocerebellar ataxia type 2, but it is unclear how these alterations progress over time. The aim of this study was to assess the progression of saccade involvement in spinocerebellar ataxia type 2 patients, identify its main determinants, and evaluate its usefulness as outcome measures in clinical trials.METHODS:A prospective 5-year follow-up study was performed with 30 spinocerebellar ataxia type 2 patients and their matched healthy controls, who were evaluated a total of four times by clinical and electrooculographical assessments of horizontal saccades and by the scoring of ataxia.RESULTS:Patients showed significant decreases in saccade peak velocity and saccade accuracy as well as increases of saccadic latency during the follow-up period. Annual progression rates were significantly higher in patients compared to controls. Faster progression rates of saccade slowing were associated with higher trinucleotide cytosine-adenine-guanine repeat expansions. Sample-size estimates for two-arm trials would require 19 patients per group to detect a 50 percent reduction in disease progression using saccade peak velocity as outcome variable, but 44 and 124 patients using saccade latency and accuracy, respectively (power, 80 percent; alpha = 0.05).CONCLUSIONS:Electrooculographical measures of saccade changes are useful for the objective quantification of disease course in spinocerebellar ataxia type 2. The progression rate of saccade slowing is influenced by the expansion size, providing novel insight into the cumulative polyglutamine neurotoxicity, and supporting the usefulness of saccade peak velocity as a sensitive biomarker during the natural history of the disease, and as suitable outcome measure for therapeutic trials (AU)

Spinocerebellar ataxia type 2: Measures of saccade changes improve power for clinical trials.

BACKGROUND: Saccadic eye movement abnormalities are common in patients with spinocerebellar ataxia type 2, but it is unclear how these alterations progress over time. The aim of this study was to assess the progression of saccade involvement in spinocerebellar ataxia type 2 patients, identify its main determinants, and evaluate its usefulness as outcome measures in clinical trials. METHODS: A prospective 5-year follow-up study was performed with 30 spinocerebellar ataxia type 2 patients and their matched healthy controls, who were evaluated a total of four times by clinical and electrooculographical assessments of horizontal saccades and by the scoring of ataxia. RESULTS: Patients showed significant decreases in saccade peak velocity and saccade accuracy as well as increases of saccadic latency during the follow-up period. Annual progression rates were significantly higher in patients compared to controls. Faster progression rates of saccade slowing were associated with higher trinucleotide cytosine-adenine-guanine repeat expansions. Sample-size estimates for two-arm trials would require 19 patients per group to detect a 50% reduction in disease progression using saccade peak velocity as outcome variable, but 44 and 124 patients using saccade latency and accuracy, respectively (power, 80%; alpha = 0.05). CONCLUSIONS: Electrooculographical measures of saccade changes are useful for the objective quantification of disease course in spinocerebellar ataxia type 2. The progression rate of saccade slowing is influenced by the expansion size, providing novel insight into the cumulative polyglutamine neurotoxicity, and supporting the usefulness of saccade peak velocity as a sensitive biomarker during the natural history of the disease, and as suitable outcome measure for therapeutic trials.

Removal of EOG artifacts from EEG recordings using stationary subspace analysis.

An effective approach is proposed in this paper to remove ocular artifacts from the raw EEG recording. The proposed approach first conducts the blind source separation on the raw EEG recording by the stationary subspace analysis (SSA) algorithm. Unlike the classic blind source separation algorithms, SSA is explicitly tailored to the understanding of distribution changes, where both the mean and the covariance matrix are taken into account. In addition, neither independency nor uncorrelation is required among the sources by SSA. Thereby, it can concentrate artifacts in fewer components than the representative blind source separation methods. Next, the components that are determined to be related to the ocular artifacts are projected back to be subtracted from EEG signals, producing the clean EEG data eventually. The experimental results on both the artificially contaminated EEG data and real EEG data have demonstrated the effectiveness of the proposed method, in particular for the cases where limited number of electrodes are used for the recording, as well as when the artifact contaminated signal is highly nonstationary and the underlying sources cannot be assumed to be independent or uncorrelated.

Automatic drift calibration for EOG-based gaze input interface.

A drift calibration technique for DC-coupled EOG (electrooculogram) systems is proposed. It assumes a non-linear relationship between EOG and eye angle and estimates the absolute eye angle by the EOG differences during saccade. Drift is calibrated every saccade without user's explicit action, so it is especially suitable for long-term gaze input interfaces. An experiment confirms that it can estimate horizontal absolute eye angle with an error of about 5° in addition to accurate eye movement.

Scoring accuracy of automated sleep staging from a bipolar electroocular recording compared to manual scoring by multiple raters.

OBJECTIVES: Electroencephalography (EEG) assessment in research and clinical studies is limited by the patient burden of multiple electrodes and the time needed to manually score records. The objective of our study was to investigate the accuracy of an automated sleep-staging algorithm which is based on a single bipolar EEG signal. METHODS: Three raters each manually scored the polysomnographic (PSG) records from 44 patients referred for sleep evaluation. Twenty-one PSG records were scored by Rechtschaffen and Kales (R&K) criteria (group 1) and 23 PSGs were scored by American Academy of Sleep Medicine (AASM) 2007 criteria (group 2). Majority agreement was present in 98.4% of epochs and was used for comparison to automated scoring from a single EEG lead derived from the left and right electrooculogram. RESULTS: The κ coefficients for interrater manual scoring ranged from 0.46 to 0.89. The κ coefficient for the auto algorithm vs manual scoring by rater ranged from 0.42 to 0.63 and was 0.61 (group 1, κ=0.61 and group 2, κ=0.62) for majority agreement for all studies. The mean positive percent agreement across subjects and stages was 72.6%, approximately 80% for stages wake (78.3%), stage 2 sleep (N2) (80.9%), and stage 3 sleep (N3) (78.1%); the percentage slightly decreased to 73.2% for rapid eye movement (REM) sleep and dropped to 31.9% for stage 1 sleep (N1). Differences in agreement were observed based on raters, obstructive sleep apnea (OSA) severity, medications, and signal quality. CONCLUSIONS: Our study demonstrated that automated scoring of sleep obtained from a single-channel of forehead EEG results in agreement to majority manual scoring are similar to results obtained from studies of manual interrater agreement. The benefit in assessing auto-staging accuracy with consensus agreement across multiple raters is most apparent in patients with OSA; additionally, assessing auto-staging accuracy limited disagreements in patients on medications and in those with compromised signal quality.

Methods to eliminate stimulus transduction artifact from insert earphones during electroencephalography.

OBJECTIVE: To reduce stimulus transduction artifacts in EEG while using insert earphones. DESIGN: Reference Equivalent Threshold SPLs were assessed for Etymotic ER-4B earphones in 15 volunteers. Auditory brainstem responses (ABRs) and middle latency responses (MLRs)-as well as long-duration complex ABRs-to click and /dα/ speech stimuli were recorded in a single-case design. RESULTS: Transduction artifacts occurred in raw EEG responses, but they were eliminated by shielding, counter-phasing (averaging across stimuli 180° out of phase), or rereferencing. CONCLUSIONS: Clinical grade ABRs, MLRs, and cABRs can be recorded with a standard digital EEG system and high-fidelity insert earphones, provided one or more techniques are used to remove the stimulus transduction artifact.

ISCEV standard for clinical electro-oculography (2010 update).

The clinical electro-oculogram (EOG) is an electrophysiological test of function of the outer retina and retinal pigment epithelium (RPE) in which changes in electrical potential across the RPE are recorded during successive periods of dark and light adaptation. This document presents the 2010 EOG Standard from the International Society for Clinical Electrophysiology of Vision (ISCEV: www.iscev.org ). This revision has been reorganized and updated, but without changes to the testing protocol from the previous version published in 2006. It describes methods for recording the EOG in clinical applications and gives detailed guidance on technical requirements, practical issues, and reporting of results. It is intended to promote consistent quality of testing and reporting within and between clinical centers.

Wireless physiological monitoring and ocular tracking: 3D calibration in a fully-immersive virtual health care environment.

Wireless physiological/neurological monitoring in virtual reality (VR) offers a unique opportunity for unobtrusively quantifying human responses to precisely controlled and readily modulated VR representations of health care environments. Here we present such a wireless, light-weight head-mounted system for measuring electrooculogram (EOG) and electroencephalogram (EEG) activity in human subjects interacting with and navigating in the Calit2 StarCAVE, a five-sided immersive 3-D visualization VR environment. The system can be easily expanded to include other measurements, such as cardiac activity and galvanic skin responses. We demonstrate the capacity of the system to track focus of gaze in 3-D and report a novel calibration procedure for estimating eye movements from responses to the presentation of a set of dynamic visual cues in the StarCAVE. We discuss cyber and clinical applications that include a 3-D cursor for visual navigation in VR interactive environments, and the monitoring of neurological and ocular dysfunction in vision/attention disorders.

[Progress of standardizations for clinical visual electrophysiology].

To meet the needs for standardizations of clinical visual electrophysiology, the International Society for Clinical Electrophysiology of Vision (ISCEV) has issued serial proposals of standards since the last decade of the 20th century. The present state of standardization in the laboratories of our country has been improved, but it needs more efforts to meet the latest requirements. This article reviewed the main contents of these standards.

ISCEV Standard for Clinical Electro-oculography (EOG) 2006.

The Clinical Electro-oculogram (EOG) is an electrophysiological test of function of the outer retina and retinal pigment epithelium (RPE) in which the change in the electrical potential between the cornea and the ocular fundus is recorded during successive periods of dark and light adaptation. This document sets out a Standard Method for performance of the test, and also gives detailed guidance on technical and practical issues, and on reporting test results. The main object of the Standard is to promote consistent quality of testing and reporting within and between centres. This 2006 Standard, from the International Society for Clinical Electrophysiology of Vision (ISCEV: www.iscev.org ), is a revision of the previous Standard published in 1993, and reviewed and re-issued in 1998.

Computerized processing of EEG-EOG-EMG artifacts for multi-centric studies in EEG oscillations and event-related potentials.

The aim of this study is to present a package including standard software for the electroencephalographic (EEG), electro-oculographic (EOG) and electromyographic (EMG) preliminary data analysis, which may be suitable to standardize the results of many EEG research centers studies (i.e. multi-centric studies) especially focused on event-related potentials. In particular, our software package includes (semi)automatic procedures for (i) EOG artifact detection and correction, (ii) EMG analysis, (iii) EEG artifact analysis, (iv) optimization of the ratio between artifact-free EEG channels and trials to be rejected. The performances of the software package on EOG-EEG-EMG data related to cognitive-motor tasks were evaluated with respect to the preliminary data analysis performed by two expert electroencephalographists (gold standard). Due to its extreme importance for multi-centric EEG studies, we compared the performances of two representative "regression" methods for the EOG correction in time and frequency domains. The aim was the selection of the most suitable method in the perspective of a multi-centric EEG study. The results showed an acceptable agreement of approximately 95% between the human and software behaviors, for the detection of vertical and horizontal EOG artifacts, the measurement of hand EMG responses for a cognitive-motor paradigm, the detection of involuntary mirror movements, and the detection of EEG artifacts. Furthermore, our results indicated a particular reliability of a 'regression' EOG correction method operating in time domain (i.e. ordinary least squares). These results suggest that such a software package could be used for multi-centric EEG studies.

[Detecting method of the clinical visual electrophysiological signals].

According to the characteristics of anatomy and electrophysiology of vision, this paper describes the method of sampling along the visual path to obtain the integrated information of electrophysiology of vision. The developed system MET01 can detect and analyze EOG, ERG and VEP signals as a whole, and has a clinical value.

EOG correction: a new perspective.

OBJECTIVE: In the field of EOG correction, discrepancies have been found between the propagation rates for different types and frequencies of eye movement. This study attempted to determine whether these differences could be explained by the affect of EOG magnitude on the correction procedure. METHODS: Experiment 1 utilized simulated data to determine whether the combination of EOG magnitude and other forms of interference distorted the estimation of the propagation coefficients (Bs). Experiment 2 used real data to determine if the patterns obtained in Expt. 1 were apparent in real data. RESULTS: Matched t tests found that simulated low power EOG produced inflated Bs as a function of interference in Expt. 1. Experiment 2 found the same relationship between B and EOG magnitude as with the simulations. CONCLUSIONS: The findings are consistent with the thesis that eye movement related fields propagate similarly for a range of EOG types and frequencies, suggesting that the B differences reported in the literature are artifactual, and indicating the need for a new correction procedure.

EOG correction: a new aligned-artifact average solution.

OBJECTIVE: In the field of EOG correction, discrepancies have been found between the propagation rates for different types and frequencies of eye movement. However, Croft and Barry demonstrated that these differences can be explained by the affect of EOG magnitude on the correction procedure (Croft, R.J. and Barry, R.J. EOG correction: a new perspective. Electroenceph. clin. Neurophysiol., 1998, 107: 387-394). This study utilized a new 'aligned-artifact average' technique (AAA) to examine whether propagation is constant across eye movement types and frequencies, and tested the AAA as an EOG correction tool. METHODS: Two experiments manipulated interference levels in real data sets to determine if interference affected propagation coefficients (Bs). The third tested real data for the effect of forward propagation of eye movement related neural potentials on Bs, and the fourth utilized computer simulations to assess the effectiveness of the new AAA correction procedure. RESULTS: Interference was found to inflate B at low EOG amplitude, and its removal removed B variation and inflation. The forward propagation of eye movement related neural potentials had very little effect on B. The AAA procedure produced near perfect corrections of the simulated data, superior to a comparison method. CONCLUSIONS: EOG propagation is constant across eye movement types and frequencies, and thus only one correction coefficient should be calculated and applied to data. The AAA method provides a more accurate correction and makes possible, for the first time, the adequate correction of posterior sites.

Guidelines for calibration of stimulus and recording parameters used in clinical electrophysiology of vision. Calibration Standard Committee of the International Society for Clinical Electrophysiology of Vision (ISCEV).

In order to perform a technically adequate clinical electrophysiological procedure it is necessary to calibrate the stimulating and recording equipment. Published standards for the electroretinogram (ERG), electro-oculogram (EOG), visual evoked potential (VEP), and guidelines for the Pattern ERG (PERG) specify stimulus and recording parameters. Yet, most commercial instruments do not provide the means for calibration of these parameters. The goal of this document is to provide guidelines for proper calibration of stimulus and recording equipment. The need for such guidelines is clear on both clinical and scientific grounds. Stimulus and amplifier characteristics have substantial effects on the peak latency and amplitude measurements that are commonly used in clinical electrophysiology. Many review articles on clinical electrophysiology emphasize the need for establishing norms for each laboratory as a function of age and gender rather than relying on published norms. However, if stimulus and recording parameters are not calibrated periodically, then these norms may actually be misleading due to changes in stimulus or recording conditions induced by aging of equipment or inadvertent change in settings. This document is divided into two major sections. The first is concerned with calibration of the visual stimulus. It begins with background technical information on the physics of light and its measurement. This is followed by protocols for measurement of the luminous intensity of flash stimuli and the mean luminance, contrast, and visual angle of pattern stimuli. The second section is concerned with calibration of electrophysiologic recording systems. It begins with a description of the characteristics of bioelectrical signals and their measurement. This is followed by protocols for measurement of electrode impedance and amplifier calibration. Although this document was prepared as guidelines for clinical electrophysiological testing, it should be noted that the techniques described are more generally applicable to studies which are dependent upon accurate measurement of luminance or electrophysiological signals.