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Evaluation of Dry Sensors for Neonatal EEG Recordings

Fridman, Igor; Cordeiro, Malaika; Rais-Bahrami, Khodayar; McDonald, Neil J.; Reese, James J. Jr; Massaro, An N.; Conry, Joan A.; Chang, Taeun; Soussou, Walid; Tsuchida, Tammy N.

Journal of Clinical Neurophysiology: April 2016 - Volume 33 - Issue 2 - p 149–155
doi: 10.1097/WNP.0000000000000237
Original Research

Purpose: Neonatal seizures are a common neurologic diagnosis in neonatal intensive care units, occurring in approximately 14,000 newborns annually in the United States. Although the only reliable means of detecting and treating neonatal seizures is with an electroencephalography (EEG) recording, many neonates do not receive an EEG or experience delays in getting them. Barriers to obtaining neonatal EEGs include (1) lack of skilled EEG technologists to apply conventional wet electrodes to delicate neonatal skin, (2) poor signal quality because of improper skin preparation and artifact, and (3) extensive time needed to apply electrodes. Dry sensors have the potential to overcome these obstacles but have not previously been evaluated on neonates.

Methods: Sequential and simultaneous recordings with wet and dry sensors were performed for 1 hour on 27 neonates from 35 to 42.5 weeks postmenstrual age. Recordings were analyzed for correlation and amplitude and were reviewed by neurophysiologists. Performance of dry sensors on simulated vernix was examined.

Results: Analysis of dry and wet signals showed good time-domain correlation (reaching >0.8), given the nonsuperimposed sensor positions and similar power spectral density curves. Neurophysiologist reviews showed no statistically significant difference between dry and wet data on most clinically relevant EEG background and seizure patterns. There was no skin injury after 1 hour of dry sensor recordings. In contrast to wet electrodes, impedance and electrical artifact of dry sensors were largely unaffected by simulated vernix.

Conclusions: Dry sensors evaluated in this study have the potential to provide high-quality, timely EEG recordings on neonates with less risk of skin injury.

*Quantum Applied Science and Research, Inc (QUASAR), San Diego, California, U.S.A.;

Department of Neonatology, La Paz University Hospital, Madrid, Spain; and

Departments of Neonatology and

§Neurology, Children's National Health System, Washington, District of Columbia, U.S.A.

Address correspondence and reprint requests to Walid Soussou, PhD, QUASAR, Inc, 5754 Pacific Center Boulevard, Suite 203B, San Diego, CA 92121, U.S.A.; e-mail: walid@quasarusa.com.

Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health under award number R43HD074430. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

I. Fridman, N. J. McDonald, and W. Soussou are employees and shareholders of QUASAR, Inc., which is developing and commercializing the technology described in this article.

© 2016 by the American Clinical Neurophysiology Society