Comparing the quality of signals recorded with a rapid response EEG and conventional clinical EEG systems

OBJECTIVES: To compare the quality of electroencephalography (EEG) signals recorded with a rapid response EEG system and the signals recorded with conventional clinical EEG recordings. METHODS: We studied the differences between EEG recordings taken with a rapid response EEG system (Ceribell) compared to conventional EEG through two separate set of studies. First, we conducted simultaneous recording on a healthy subject in an experimental laboratory setting where the rapid response EEG and two conventional EEG recording systems (Nihon Kohden and Natus) were used at the same time on the same subject using separate but adjacently placed electrodes. The rapid response EEG was applied by a user without prior training in EEG set up while two separate sets of conventional EEG electrodes were placed by a trained EEG technologist. The correlation between each of the recordings was calculated and quantitatively compared. In the second study, we performed a set of consecutive recordings on 22 patients in an ICU environment. The rapid response EEG system was applied by clinical ICU fellows without prior training in EEG set up while waiting for the conventional EEG system to arrive, after which the rapid response EEG was stopped and the conventional EEG was applied by a trained EEG technologist. We measured and compared several metrics of EEG quality using comparative metrics. RESULTS: For the simultaneous recording performed in a laboratory environment, the tested rapid response EEG and conventional EEG recordings showed agreement when aligned and visually compared in the time domain, all EEG waveform features were distinguishable in both recordings. The correlation between each pair of recordings also showed that the correlation between the rapid response EEG recording and each of the two conventional recordings was statistically the same as the correlation between the two conventional recordings. For the consecutive recordings performed in real life clinical ICU environment, Hjorth parameters, spike count, baseline wander, and kurtosis measures were statistically similar (p > 0.05, Wilcoxon signed rank test) for the rapid response EEG and conventional clinical EEG recordings. The rapid response EEG data had significantly lower 60 Hz noise compared to recordings made with the conventional systems both in laboratory and ICU settings. Lastly, the clinical information obtained with the rapid response EEG system was concordant with the diagnostic information obtained with the conventional EEG recordings in the ICU setting. CONCLUSIONS: Our findings show that the tested rapid response EEG system provides EEG recording quality that is equivalent to conventional EEG systems and even better when it comes to 60 Hz noise level. The concordance between the rapid response EEG and conventional EEG systems was demonstrated both in a controlled laboratory environment as well as in the noisy environment of a hospital ICU on patients with altered mental status. SIGNIFICANCE: Our findings clearly confirm that the tested rapid response EEG system provides EEG data that is equivalent in quality to the recordings made using conventional EEG systems despite the fact that the rapid response system can be applied within few minutes and with no reliance on specialized technologists. This can be important for urgent situations where the use of conventional EEG systems is hindered by the lengthy setup time and limited availability of EEG technologists.