Tripolar concentric EEG electrodes reduce noise. Issue 1 (January 2020)

• Record Type: Journal Article
• Authors: Aghaei-Lasboo, Anahita; Inoyama, Katherine; Fogarty, Adam S.; Kuo, Jonathan; Meador, Kimford J.; Walter, Jessica J.; Le, Scheherazade T.; Graber, Kevin D.; Razavi, Babak; Fisher, Robert S.
• Is Part Of: Clinical neurophysiology. Volume 131:Issue 1(2020:Jan.)
• Page Start: 193
• Page End: 198
• Publication Date: 2020-01
• Subjects: EEG electrodes -- Artifact -- Interictal spikes -- Seizures; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2019.10.022
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: Tripolar concentric ring electrodes (TCRE) provide differential recordings and reduced muscle artifact. TCRE are better at detecting focal slowing, but worse at detecting spikes. Both see seizures. Using both regular and TCRE electrodes may maximize detection of EEG patterns. Abstract: Objective: To assay EEG signal quality recorded with tripolar concentric ring electrodes (TCREs) compared to regular EEG electrodes. Methods: EEG segments were recorded simultaneously by TCREs and regular electrodes, low-pass filtered at 35 Hz (REG35) and 70 Hz (REG70). Clips were rated blindly by nine electroencephalographers for presence or absence of key EEG features, relative to the "gold-standard" of the clinical report. Results: TCRE showed less EMG artifact ( F = 15.4, p < 0.0001). Overall quality rankings were not significantly different. Focal slowing was better detected by TCRE and spikes were better detected by regular electrodes. Seizures (n = 85) were detected by TCRE in 64 cases (75.3%), by REG70 in 75 (88.2%) and REG35 in 69 (81.2%) electrodes. TCRE detected 9 (10.6%) seizures not detected by one of the other 2 methods. In contrast, 14 seizures (16.5%) were not detected by TCRE, but were by REG35 electrodes. Each electrode detected interictal spikes when the other did not. Conclusions: TCRE produced similar overall quality and confidence ratings versus regular electrodes, but less muscle artifact. TCRE recordings detected seizures in 7% of instances where regular electrodes did not. Significance: The combination of the two types increased detection of epileptiform events compared to either alone.