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Browsing ESS - NEU - Artigos by Author "Borges, Daniel Filipe"
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- A custom-built single-channel in-ear electroencephalography sensor for sleep phase detection: an interdependent solution for at-home sleep studiesPublication . Borges, Daniel Filipe; Soares, Joana Isabel; Silva, Heloísa; Felgueiras, João; Batista, Carla; Ferreira, Simão; Rocha, Nuno; Leal, AlbertoSleep is vital for health. It has regenerative and protective functions. Its disruption reduces the quality of life and increases susceptibility to disease. During sleep, there is a cyclicity of distinct phases that are studied for clinical purposes using polysomnography (PSG), a costly and technically demanding method that compromises the quality of natural sleep. The search for simpler devices for recording biological signals at home addresses some of these issues. We have reworked a single-channel in-ear electroencephalography (EEG) sensor grounded to a commercially available memory foam earplug with conductive tape. A total of 14 healthy volunteers underwent a full night of simultaneous PSG, in-ear EEG and actigraphy recordings. We analysed the performance of the methods in terms of sleep metrics and staging. In another group of 14 patients evaluated for sleep-related pathologies, PSG and in-ear EEG were recorded simultaneously, the latter in two different configurations (with and without a contralateral reference on the scalp). In both groups, the in-ear EEG sensor showed a strong correlation, agreement and reliability with the ‘gold standard’ of PSG and thus supported accurate sleep classification, which is not feasible with actigraphy. Single-channel in-ear EEG offers compelling prospects for simplifying sleep parameterisation in both healthy individuals and clinical patients and paves the way for reliable assessments in a broader range of clinical situations, namely by integrating Level 3 polysomnography devices. In addition, addressing the recognised overestimation of the apnea-hypopnea index, due to the lack of an EEG signal, and the sparse information on sleep metrics could prove fundamental for optimised clinical decision making.
- Spike detection in the wild: Screening of suspected temporal lobe epilepsy cases using a tailored 2-channel wearable EEGPublication . Borges, Daniel Filipe; Soares, Joana Isabel; Dias, Daniela; Cordeiro, Helena; Leal, Alberto; Borges, Daniel FilipeTo clinically validate the contribution of a custom-built-wearable device (waEEG) compared to a full 10–20 electrode array ambulatory EEG (aEEG) for screening epilepsy cases in patients with suspected temporal lobe epilepsy (TLE) but negative routine EEGs. Patients (aged 16–91 years) with clinically suspected TLE who were referred for a 24 h aEEG were fitted with an additional 2-channel bipolar waEEG device and prospectively enrolled in the study until 20 TLE diagnoses were confirmed by aEEG. 41 patients were included and their waEEG was blindly reviewed by two experienced clinical neurophysiologists and a semi-automated spike detection software to categorize patients into TLE (spikes present) and non-TLE (no spikes) groups. The experts achieved good sensitivity (95%–100%) and accuracy (98%–93%) with excellent interrater agreement (kappa>0.80) in patient labelling. The semi-automated software performed poorly (40% sensitivity, 68% accuracy) and failed to classify TLE in more than half the cases. Classification was not affected by restricting spike detection to the evening and night time, which reduced the average length of the analyzed EEG from 23.4 to 10.4 h. Three false-positive spike detections were thoroughly analyzed and reclassified as artifacts due to eye and body movements and electrocardiographic contamination. To better control cardiac artifacts, the addition of an ECG channel to the waEEG is recommended. Detection of spikes with waEEG allows accurate detection of epilepsy in suspected TLE cases, with less technical and professional effort and improved acceptance. This screening tool could improve the yield of follow-up with a conventional aEEG and provide an accessible method for monitoring interictal epileptiform activity in TLE. Epilepsy is a chronic short circuit in the brain. In adults, it most often affects the temporal lobes, resulting in temporal lobe epilepsy (TLE). Seizures are infrequent but difficult to treat. Electroencephalography (EEG) is the best method to detect the electrical disturbances and is crucial to distinguish epilepsy from other non-epileptic disorders. Developing simple, inexpensive and easily accessible portable EEG methods that complement in-hospital assessment could significantly impact patient care. Our study aims to clinically validate a wearable epilepsy screening device to aid in TLE management, reduce delays in diagnosis and enable straightforward assessment of epileptic activity.
- The Dianalund experience: A review of the 6th ILAE School on Advanced EEG and EpilepsyPublication . Borges, Daniel Filipe; Primicerio, Giulia; Perjoc, Radu‐Ștefan; Bloch, Lars Ølgaard; Cacic Hribljan, MelitaThe 6th International League Against Epilepsy (ILAE)School on Advanced EEG and Epilepsy (DSSEE6) tookplace between July 20 and 28, 2024. It is a biennial courseheld in Dianalund @ Danish Epilepsy Center—Filadelfia,Denmark, since 2012. This year's event was hosted in ahybrid format and was organized under the auspices ofthe ILAE Academy and the Danish Epilepsy Society.
- The prevalence of post-therapy epilepsy in patients treated for high-grade glial tumors: a systematic review and meta-analysisPublication . Ferreira, Marta Pereira; Carvalho, Ruben Lopes; Soares, Joana Isabel; Casalta‑Lopes, João; Borges, Daniel Filipe; Borges, Daniel Filipe; Soares, Joana I.Gliomas are the most prevalent type of primary brain tumor of the adult central nervous system. High-grade gliomas (HGG) are the most common type of glioma. Epilepsy is often the first clinical manifestation of HGG. Since epilepsy leads to increased morbidity and mortality rates, seizure control is one of the main therapeutic goals for patients with glioma-related epilepsy. Post-therapy epilepsy is observed in a significant percentage of patients, hence, this work aimed to quantify the prevalence of post-therapy epilepsy after HGG treatment. Our search was conducted across PubMed®, EMBASE®, Web of Science™, Cochrane Library, Sicelo and Scopus, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This review included articles published in Portuguese or English that evaluate adult patients with newly diagnosed HGG, who were treated with at least surgery or radiation. Thirty-six studies reporting on 4036 HGG patients were included in our meta-analysis. The mean age ranged from 44 to 73 years. Glioblastoma was the most commonly observed HGG, representing 77,8% of all glioma patients. The pre-treatment seizure frequency was observed in 21,2%. All patients underwent surgery as the main therapy, and 1842 patients received standard adjuvant therapy. We also observed a pooled prevalence of post-therapy seizures of 25.5% (95% confidence interval of [19.9%; 31.1%]). Substantial heterogeneity in all assessed variables was observed. Conducting larger prospective studies with suitable epilepsy diagnostic methods would help provide a more precise estimate of the number of HGG patients who develop post-therapy epilepsy.
- The sound of silence: Quantification of typical absence seizures by sonifying EEG signals from a custom‐built wearable devicePublication . Borges, Daniel Filipe; Fernandes, João; Soares, Joana Isabel; Casalta‐Lopes, João; Carvalho, Daniel; Beniczky, Sándor; Leal, AlbertoObjective: To develop and validate a method for long- term (24- h) objective quantification of absence seizures in the EEG of patients with childhood absence epilepsy (CAE) in their real home environment using a wearable device (waEEG), comparing automatic detection methods with auditory recognition after seizure sonification. Methods: The waEEG recording was acquired with two scalp electrodes. Automatic analysis was performed using previously validated software (Persyst® 14) and then fully reviewed by an experienced clinical neurophysiologist. The EEG data were converted into an audio file in waveform format with a 60- fold time compression factor. The sonified EEG was listened to by three inexperienced observers and the number of seizures and the processing time required for each data set were recorded blind to other data. Quantification of seizures from the patient diary was also assessed. Results: Eleven waEEG recordings from seven CAE patients with an average age of 8.18 ± 1.60 years were included. No differences in the number of seizures were found between the recordings using automated methods and expert audio assessment, with significant correlations between methods (ρ > .89, p < .001) and between observers (ρ > .96, p < .001). For the entire data set, the audio assessment yielded a sensitivity of .830 and a precision of .841, resulting in an F1 score of .835. Significance: Auditory waEEG seizure detection by lay medical personnel provided similar accuracy to post- processed automatic detection by an experienced clinical neurophysiologist, but in a less time- consuming procedure and without the need for specialized resources. Sonification of long- term EEG recordings in CAE provides a user- friendly and cost- effective clinical workflow for quantifying seizures in clinical practice, minimizing human and technical constraints.
- The sound of silence: Quantification of typical absence seizures by sonifying EEG signals from a custom‐built wearable devicePublication . Borges, Daniel Filipe; Fernandes, João; Soares, Joana Isabel; Casalta‐Lopes, João; Carvalho, Daniel; Beniczky, Sándor; Leal, AlbertoTo develop and validate a method for long-term (24-h) objective quantification of absence seizures in the EEG of patients with childhood absence epilepsy (CAE) in their real home environment using a wearable device (waEEG), comparing automatic detection methods with auditory recognition after seizure sonification. The waEEG recording was acquired with two scalp electrodes. Automatic analysis was performed using previously validated software (Persyst® 14) and then fully reviewed by an experienced clinical neurophysiologist. The EEG data were converted into an audio file in waveform format with a 60-fold time compression factor. The sonified EEG was listened to by three inexperienced observers and the number of seizures and the processing time required for each data set were recorded blind to other data. Quantification of seizures from the patient diary was also assessed. Eleven waEEG recordings from seven CAE patients with an average age of 8.18 ± 1.60 years were included. No differences in the number of seizures were found between the recordings using automated methods and expert audio assessment, with significant correlations between methods (ρ > .89, p < .001) and between observers (ρ > .96, p < .001). For the entire data set, the audio assessment yielded a sensitivity of .830 and a precision of .841, resulting in an F1 score of .835. Auditory waEEG seizure detection by lay medical personnel provided similar accuracy to post-processed automatic detection by an experienced clinical neurophysiologist, but in a less time-consuming procedure and without the need for specialized resources. Sonification of long-term EEG recordings in CAE provides a user-friendly and cost-effective clinical workflow for quantifying seizures in clinical practice, minimizing human and technical constraints.