A novel signal processing method for intraoperative neurophysiological monitoring in spinal surgeries

Intraoperative neurophysiologic monitoring is an integral part of spinal surgeries and involves the recording of somatosensory evoked potentials (SSEP). However, clinical application of IONM still requires anywhere between 200 to 2000 trials to obtain an SSEP signal, which is excessive and introduces a significant delay during surgery to detect a possible neurological damage. The aim of this study is to develop a means to obtain the SSEP using a much less, twelve number of recordings. The preliminary step involved was to distinguish the SSEP with the ongoing brain activity. We first establish that the brain activity is indeed quasi-stationary whereas an SSEP is expected to be identical every time a trial is recorded. An algorithm was developed using Chebychev time windowing for preconditioning of SSEP trials to retain the morphological characteristics of somatosensory evoked potentials (SSEP). This preconditioning was followed by the application of a principal component analysis (PCA)-based algorithm utilizing quasi-stationarity of EEG on 12 preconditioned trials. A unique Walsh transform operation was then used to identify the position of the SSEP event. An alarm is raised when there is a 10% time in latency deviation and/or 50% peak-to-peak amplitude deviation, as per the clinical requirements. The algorithm shows consistency in the results in monitoring SSEP in up to 6-hour surgical procedures even under this significantly reduced number of trials. In this study, the analysis was performed on the data recorded in 29 patients undergoing surgery during which the posterior tibial nerve was stimulated and SSEP response was recorded from scalp. This method is shown empirically to be more clinically viable than present day approaches. In all 29 cases, the algorithm takes 4sec to extract an SSEP signal, as compared to conventional methods, which take several minutes. The monitoring process using the algorithm was successful and proved conclusive under the clinical constraints throughout the different surgical procedures with an accuracy of 91.5%. Higher accuracy and faster execution time, observed in the present study, in determining the SSEP signals provide a much improved and effective neurophysiological monitoring process.

Elevated progesterone in yolk as a moderator of prenatal and postnatal auditory learning in bobwhite quail

Recent studies have established that yolk hormones of maternal origin have significant effects on the physiology and behavior of offspring in birds. Herrington (2012) demonstrated that an elevation of progesterone in yolk elevates emotional reactivity in bobwhite quail neonates. Chicks that hatched from progesterone treated eggs displayed increased latency in tonic immobility and did not emerge as quickly from a covered location into an open field compared to control groups. For the present study, three experimental groups were formed: chicks hatched from eggs with artificially elevated progesterone (P), chicks hatched from an oil-vehicle control group (V), and chicks hatched from a non-manipulated control group (C). Experiment 1 examined levels of progesterone with High Performance Liquid Chromatography/tandem Mass Spectroscopy (HPLC/MS) from prenatal day 1 to prenatal day 17 in bobwhite quail egg yolk. In Experiment 2, bobwhite quail embryos were passively exposed to an individual maternal assembly call for 24 hours prior to hatching. Chicks were then tested individually for their preference between the familiarized call and a novel call at 24 and 48 hours following hatching. For Experiment 3, newly hatched chicks were exposed to an individual maternal assembly call for 24-hrs. Chicks were then tested for their preference for the familiarized call at 24 and 48-hrs after hatch. Results of Experiment 1 showed that yolk progesterone levels were significantly elevated in treated eggs and were present in the egg yolk longer into prenatal development than the two control groups. Results from Experiment 2 indicated that chicks from the P group failed to demonstrate a preference for the familiar bobwhite maternal assembly call at 24 or 48-hrs after hatch following 24-hrs of prenatal exposure. In contrast, chicks from the C and V groups demonstrated a significant preference for the familiarized call. In Experiment 3, chicks from the P group showed an enhanced preference for the familiarized bobwhite maternal call compared to chicks from the C and V groups at 24 and 48-hrs after hatch. The results of these experiments suggest that elevated maternal yolk hormone levels in pre-incubated bobwhite quail eggs can influence auditory perceptual learning in embryos and neonates.^