Abstract

Early diagnosis and prognosis of babies with signs of hypoxic-ischemic encephalopathy (HIE) is currently limited and requires reliable prognostic biomarkers to identify at risk infants. Using our pre-clinical fetal sheep models, we have demonstrated that micro-scale patterns evolve over a profoundly suppressed EEG background within the first 6 hours of recovery, post HI insult. In particular, we have shown that high-frequency micro-scale spike transients (in the gamma frequency band, 80-120Hz) emerge immediately after an HI event, with much higher numbers around 2-2.5 h of the insult, with numbers gradually declining thereafter. We have also shown that the automatically quantified sharp waves in this phase are predictive of neural outcome. Initiation of some neuroprotective treatments within this limited window of opportunity, such as therapeutic hypothermia, optimally reduces neural injury. In clinical practice, it is hard to determine the exact timing of the injury, therefore, reliable automatic identification of EEG transients could be beneficial to help specify the phases of injury. Our team has previously developed successful machine- and deep-learning strategies for the identification of post-HI EEG patterns in an HI preterm fetal sheep model.This paper introduces, for the first time, a novel online fusion approach to train an 11-layers deep convolutional neural network (CNN) classifier using Wavelet-Fourier (WF) spectral features of EEG segments for accurate identification of high-frequency micro-scale spike transients in 1024Hz EEG recordings in our preterm fetal sheep. Sets of robust features were extracted using reverse biorthogonal wavelet (rbio2.8 at scale 7) and considering an 80-120Hz spectral frequency range. The WF-CNN classifier was able to accurately identify spike transients with a reliable high-performance of 99.03±0.86%.Clinical relevance-Results confirm the expertise of the method for the identification of similar patterns in the EEG of neonates in the early hours after birth.

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