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Electroencephalography (EEG) is a method to record an electrogram of the spontaneous electrical activity of the brain. The biosignals detected by EEG have been shown to represent the postsynaptic potentials of pyramidal neurons in the
neocortex The neocortex, also called the neopallium, isocortex, or the six-layered cortex, is a set of layers of the mammalian cerebral cortex involved in higher-order brain functions such as sensory perception, cognition, generation of motor commands, sp ...
and allocortex. It is typically non-invasive, with the EEG electrodes placed along the scalp (commonly called "scalp EEG") using the International 10-20 system, or variations of it. Electrocorticography, involving surgical placement of electrodes, is sometimes called "
intracranial EEG Electrocorticography (ECoG), or intracranial electroencephalography (iEEG), is a type of electrophysiological monitoring that uses electrodes placed directly on the exposed surface of the brain to record electrical activity from the cerebral cor ...
". Clinical interpretation of EEG recordings is most often performed by visual inspection of the tracing or quantitative EEG analysis. Voltage fluctuations measured by the EEG bioamplifier and electrodes allow the evaluation of normal brain activity. As the electrical activity monitored by EEG originates in neurons in the underlying brain tissue, the recordings made by the electrodes on the surface of the scalp vary in accordance with their orientation and distance to the source of the activity. Furthermore the value recorded is distorted by intermediary tissues and bone which act in a manner akin to resistors and capacitors in an electrical circuit. This means not all neurons will contribute equally to an EEG signal with an EEG predominately reflecting the activity of cortical neurons near to the electrodes on the scalp. Deep structures within the brain further away from the electrodes will not contribute directly to an EEG, these include the base of the cortical gyrus, mesial walls of the major lobes, hippocampus, thalamus and brain stem. A healthy human EEG will show certain patterns of activity which correlate with how awake a person is. The range of frequencies one observes are between 1 to 30 Hz and amplitudes will vary between 20 to 100 μV. The observed frequencies are subdivided in various groups, these are alpha (8-13 Hz), beta (13-30 Hz), delta (0.5-4 Hz) and theta (4-7 Hz). Alpha waves are observed when a person is in a state of relaxed wakefulness and are mostly prominent over parietal and occipital sites. During intense mental activity beta waves are more prominent in frontal areas as well as other regions. If a relaxed person is told to open their eyes one observes alpha activity decreasing and an increase in beta activity. Theta and delta waves are not seen in wakefulness and if they are it is a sign of brain dysfunction. EEG can detect abnormal electrical discharges such as sharp waves, spikes or spike-and-wave complexes that are seen in people with epilepsy, thus it is often used to inform the medical diagnosis. EEG can detect the onset and spatio-temporal (location and time) evolution of seizures and the presence of
status epilepticus Status epilepticus (SE), or status seizure, is a single seizure lasting more than 5 minutes or 2 or more seizures within a 5-minute period without the person returning to normal between them. Previous definitions used a 30-minute time limit. The s ...
. It is also used to help diagnose sleep disorders, depth of
anesthesia Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), ...
,
coma A coma is a deep state of prolonged unconsciousness in which a person cannot be awakened, fails to respond normally to painful stimuli, light, or sound, lacks a normal wake-sleep cycle and does not initiate voluntary actions. Coma patients exhi ...
, encephalopathies, cerebral hypoxia after cardiac arrest, and
brain death Brain death is the permanent, irreversible, and complete loss of brain function which may include cessation of involuntary activity necessary to sustain life. It differs from persistent vegetative state, in which the person is alive and some aut ...
. EEG used to be a first-line method of diagnosis for tumors,
stroke A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...
and other focal brain disorders, but this use has decreased with the advent of high-resolution anatomical imaging techniques such as
magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio wave ...
(MRI) and
computed tomography A computed tomography scan (CT scan; formerly called computed axial tomography scan or CAT scan) is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers ...
(CT). Despite limited spatial resolution, EEG continues to be a valuable tool for research and diagnosis. It is one of the few mobile techniques available and offers millisecond-range temporal resolution which is not possible with CT, PET or MRI. Derivatives of the EEG technique include evoked potentials (EP), which involves averaging the EEG activity time-locked to the presentation of a stimulus of some sort (visual, somatosensory, or auditory). Event-related potentials (ERPs) refer to averaged EEG responses that are time-locked to more complex processing of stimuli; this technique is used in cognitive science,
cognitive psychology Cognitive psychology is the scientific study of mental processes such as attention, language use, memory, perception, problem solving, creativity, and reasoning. Cognitive psychology originated in the 1960s in a break from behaviorism, which ...
, and psychophysiological research.


History

In 1875, Richard Caton (1842–1926), a physician practicing in Liverpool, presented his findings about electrical phenomena of the exposed cerebral hemispheres of rabbits and monkeys in the ''
British Medical Journal ''The BMJ'' is a weekly peer-reviewed medical trade journal, published by the trade union the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world's oldest general medical journals. Origi ...
''. In 1890, Polish physiologist Adolf Beck published an investigation of spontaneous electrical activity of the brain of rabbits and dogs that included rhythmic oscillations altered by light. Beck started experiments on the electrical brain activity of animals. Beck placed electrodes directly on the surface of the brain to test for sensory stimulation. His observation of fluctuating brain activity led to the conclusion of brain waves. In 1912, Ukrainian physiologist Vladimir Vladimirovich Pravdich-Neminsky published the first animal EEG and the evoked potential of the
mammal Mammals () are a group of vertebrate animals constituting the class Mammalia (), characterized by the presence of mammary glands which in females produce milk for feeding (nursing) their young, a neocortex (a region of the brain), fur or ...
ian (dog). In 1914,
Napoleon Cybulski Napoleon Nikodem Cybulski (Polish pronunciation: ; 14 September 1854 – 26 April 1919) was a Polish physiologist and a pioneer of endocrinology and electroencephalography. In 1895, he isolated and identified adrenaline. Life Napoleon Cybulski wa ...
and Jelenska-Macieszyna photographed EEG recordings of experimentally induced seizures. German physiologist and psychiatrist Hans Berger (1873–1941) recorded the first human EEG in 1924. Expanding on work previously conducted on animals by Richard Caton and others, Berger also invented the electroencephalogram (giving the device its name), an invention described "as one of the most surprising, remarkable, and momentous developments in the history of clinical neurology". His discoveries were first confirmed by British scientists Edgar Douglas Adrian and B. H. C. Matthews in 1934 and developed by them. In 1934, Fisher and Lowenbach first demonstrated epileptiform spikes. In 1935, Gibbs, Davis and Lennox described inter
ictal The postictal state is the altered state of consciousness after an epileptic seizure. It usually lasts between 5 and 30 minutes, but sometimes longer in the case of larger or more severe seizures, and is characterized by drowsiness, confusion, nau ...
spike waves and the three cycles/s pattern of clinical
absence seizure Absence seizures are one of several kinds of generalized seizures. These seizures are sometimes referred to as petit mal seizures (from the French for "little illness", a term dated in the late 18th century). Absence seizures are characterized by ...
s, which began the field of clinical electroencephalography. Subsequently, in 1936 Gibbs and Jasper reported the interictal spike as the focal signature of epilepsy. The same year, the first EEG laboratory opened at Massachusetts General Hospital. Franklin Offner (1911–1999), professor of biophysics at Northwestern University developed a prototype of the EEG that incorporated a piezoelectric inkwriter called a Crystograph (the whole device was typically known as the
Offner Dynograph Offner is a surname. Notable people with the surname include: *Arnold A. Offner, (1937-), American historian *Deborah Offner, American actress * Elliot Offner (1931–2010), American sculptor *Mortimer Offner (1900–1965), American photographer * P ...
). In 1947, The American EEG Society was founded and the first International EEG congress was held. In 1953 Aserinsky and Kleitman described
REM sleep Rapid eye movement sleep (REM sleep or REMS) is a unique phase of sleep in mammals and birds, characterized by random rapid movement of the eyes, accompanied by low muscle tone throughout the body, and the propensity of the sleeper to dream viv ...
. In the 1950s, William Grey Walter developed an adjunct to EEG called EEG topography, which allowed for the mapping of electrical activity across the surface of the brain. This enjoyed a brief period of popularity in the 1980s and seemed especially promising for psychiatry. It was never accepted by neurologists and remains primarily a research tool. An electroencephalograph system manufactured by Beckman Instruments was used on at least one of the
Project Gemini Project Gemini () was NASA's second human spaceflight program. Conducted between projects Mercury and Apollo, Gemini started in 1961 and concluded in 1966. The Gemini spacecraft carried a two-astronaut crew. Ten Gemini crews and 16 individual ...
manned spaceflights (1965-1966) to monitor the brain waves of astronauts on the flight. It was one of many Beckman Instruments specialized for and used by NASA. In 1988, report was given by Stevo Bozinovski, Mihail Sestakov, and Liljana Bozinovska on EEG control of a physical object, a robot. In October 2018, scientists connected the brains of three people to experiment with the process of thoughts sharing. Five groups of three people participated in the experiment using EEG. The success rate of the experiment was 81%.


Clinical utility


Epilepsy

EEG is the gold standard diagnostic procedure to confirm epilepsy. The
sensitivity Sensitivity may refer to: Science and technology Natural sciences * Sensitivity (physiology), the ability of an organism or organ to respond to external stimuli ** Sensory processing sensitivity in humans * Sensitivity and specificity, statisti ...
of a routine EEG to detect interictal epileptiform discharges at epilepsy centers has been reported to be in the range of 29-55%. Given the low to moderate sensitivity, a routine EEG (typically with a duration of 20–30 minutes) can be normal in people that have epilepsy. When an EEG shows interictal epileptiform discharges (e.g. sharp waves, spikes, spike-and-wave, etc.) it is confirmatory of epilepsy in nearly all cases (high specificity), however up to 3.5% of the general population may have epileptiform abnormalities in an EEG without ever having had a seizure (low false positive rate) or with a very low risk of developing epilepsy in the future. When a routine EEG is normal and there is a high suspicion or need to confirm epilepsy, it may be repeated or performed with a longer duration in the epilepsy monitoring unit (EMU) or at home with an ambulatory EEG. In addition, there are activating maneuvers such as photic stimulation, hyperventilation and sleep deprivation that can increase the diagnostic yield of the EEG.


Other brain disorders

An EEG might also be helpful for diagnosing or treating the following disorders: * Brain tumor * Brain damage from head injury * Brain dysfunction that can have a variety of causes (encephalopathy) * Inflammation of the brain (encephalitis) * Stroke * Sleep disorders It can also: * distinguish epileptic seizures from other types of spells, such as
psychogenic non-epileptic seizures Psychogenic non-epileptic seizures (PNES) are events resembling an epileptic seizure, but without the characteristic electrical discharges associated with epilepsy. PNES fall under the category of disorders known as functional neurological disor ...
, syncope (fainting), sub-cortical movement disorders and
migraine Migraine (, ) is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hou ...
variants * differentiate "organic" encephalopathy or
delirium Delirium (also known as acute confusional state) is an organically caused decline from a previous baseline of mental function that develops over a short period of time, typically hours to days. Delirium is a syndrome encompassing disturbances in ...
from primary psychiatric syndromes such as catatonia * serve as an adjunct test of
brain death Brain death is the permanent, irreversible, and complete loss of brain function which may include cessation of involuntary activity necessary to sustain life. It differs from persistent vegetative state, in which the person is alive and some aut ...
in comatose patients * prognosticate in comatose patients (in certain instances) or in newborns with brain injury from various causes around the time of birth * determine whether to wean anti-epileptic medications.


Clinical setting


Epilepsy Monitoring Unit (EMU)

At times, a routine EEG is not sufficient to establish the diagnosis or to determine the best course of action in terms of treatment. In this case, attempts may be made to record an EEG while a seizure is occurring. This is known as an
ictal The postictal state is the altered state of consciousness after an epileptic seizure. It usually lasts between 5 and 30 minutes, but sometimes longer in the case of larger or more severe seizures, and is characterized by drowsiness, confusion, nau ...
recording, as opposed to an interictal recording which refers to the EEG recording between seizures. To obtain an ictal recording, a prolonged EEG is typically performed accompanied by a time-synchronized video and audio recording. This can be done either as an outpatient (at home) or during a hospital admission, preferably to an
Epilepsy Monitoring Unit Epilepsy is a group of non-communicable neurological disorders characterized by recurrent epileptic seizures. Epileptic seizures can vary from brief and nearly undetectable periods to long periods of vigorous shaking due to abnormal electrical ...
(EMU) with nurses and other personnel trained in the care of patients with seizures. Outpatient ambulatory video EEGs typically last one to three days. An admission to an Epilepsy Monitoring Unit typically lasts several days but may last for a week or longer. While in the hospital, seizure medications are usually withdrawn to increase the odds that a seizure will occur during admission. For reasons of safety, medications are not withdrawn during an EEG outside of the hospital. Ambulatory video EEGs, therefore, have the advantage of convenience and are less expensive than a hospital admission, but the disadvantage of a decreased probability of recording a clinical event. Epilepsy monitoring is often considered when patients continue having events despite being on antiseizure medications or if there is concern that the patient's events have an alternate diagnosis, eg:
psychogenic non-epileptic seizures Psychogenic non-epileptic seizures (PNES) are events resembling an epileptic seizure, but without the characteristic electrical discharges associated with epilepsy. PNES fall under the category of disorders known as functional neurological disor ...
, syncope (fainting), sub-cortical movement disorders,
migraine Migraine (, ) is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hou ...
variants, stroke etc. In cases of epileptic seizures, continuous EEG monitoring helps to characterize seizures and localize/lateralize the region of brain from which a seizure originates. This can help identify appropriate non-medication treatment options. In clinical use, EEG traces are visually analyzed by neurologists to look at various features. Increasingly, quantitative analysis of EEG is being used in conjunction with visual analysis. Quantitative analysis displays like power spectrum analysis, alpha-delta ratio, amplitude integrated EEG, spike detection can help quickly identify segments of EEG that need close visual analysis or in some cases be used as surrogates for quick identification of seizures in long term recordings. EEG may be used to monitor the depth of
anesthesia Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), ...
, as an indirect indicator of cerebral perfusion in carotid endarterectomy, or to monitor amobarbital effect during the Wada test.


Intensive Care Unit (ICU)

EEG can also be used in intensive care units for brain function monitoring to monitor for non-convulsive seizures/non-convulsive status epilepticus, to monitor the effect of sedative/anesthesia in patients in medically induced coma (for treatment of refractory seizures or increased intracranial pressure), and to monitor for secondary brain damage in conditions such as
subarachnoid hemorrhage Subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space—the area between the arachnoid membrane and the pia mater surrounding the brain. Symptoms may include a severe headache of rapid onset, vomiting, decreased level of consci ...
(currently a research method). In cases where significant brain injury is suspected, eg after cardiac arrest, EEG can provide some prognostic information. If a patient with epilepsy is being considered for resective surgery, it is often necessary to localize the focus (source) of the epileptic brain activity with a resolution greater than what is provided by scalp EEG. In these cases, neurosurgeons typically implant strips and grids of electrodes or penetrating depth electrodes under the dura mater, through either a craniotomy or a burr hole. The recording of these signals is referred to as electrocorticography (ECoG), subdural EEG (sdEEG), intracranial EEG (icEEG), or stereotactic EEG (sEEG). The signal recorded from ECoG is on a different scale of activity than the brain activity recorded from scalp EEG. Low voltage, high frequency components that cannot be seen easily (or at all) in scalp EEG can be seen clearly in ECoG. Further, smaller electrodes (which cover a smaller parcel of brain surface) allow for better spatial resolution to narrow down the areas critical for seizure onset and propagation. Some clinical sites record from penetrating microelectrodes. EEG is not indicated for diagnosing headache., which cites * Recurring headache is a common pain problem, and this procedure is sometimes used in a search for a diagnosis, but it has no advantage over routine clinical evaluation.


Home ambulatory EEG

Sometimes it is more convenient or clinically necessary to perform ambulatory EEG recordings in the home of the patient. These studies typically have a duration of 24–72 hours.


Research use

EEG, and the related study of ERPs are used extensively in neuroscience, cognitive science,
cognitive psychology Cognitive psychology is the scientific study of mental processes such as attention, language use, memory, perception, problem solving, creativity, and reasoning. Cognitive psychology originated in the 1960s in a break from behaviorism, which ...
,
neurolinguistics Neurolinguistics is the study of neural mechanisms in the human brain that controls the comprehension, production, and acquisition of language. As an interdisciplinary field, neurolinguistics draws methods and theories from fields such as n ...
and psychophysiological research, but also to study human functions such as swallowing. any EEG techniques used in research are not standardised sufficiently for clinical use, and many ERP studies fail to report all of the necessary processing steps for data collection and reduction, limiting the reproducibility and replicability of many studies. But research on mental disabilities, such as auditory processing disorder (APD),
ADD Addition (usually signified by the plus symbol ) is one of the four basic operations of arithmetic, the other three being subtraction, multiplication and division. The addition of two whole numbers results in the total amount or '' sum'' of t ...
, or
ADHD Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inapp ...
, is becoming more widely known and EEGs are used as research and treatment.


Advantages

Several other methods to study brain function exist, including
functional magnetic resonance imaging Functional magnetic resonance imaging or functional MRI (fMRI) measures brain activity by detecting changes associated with blood flow. This technique relies on the fact that cerebral blood flow and neuronal activation are coupled. When an area o ...
(fMRI),
positron emission tomography Positron emission tomography (PET) is a functional imaging technique that uses radioactive substances known as radiotracers to visualize and measure changes in Metabolism, metabolic processes, and in other physiological activities including bl ...
(PET), magnetoencephalography (MEG), nuclear magnetic resonance spectroscopy (NMR or MRS), electrocorticography (ECoG),
single-photon emission computed tomography Single-photon emission computed tomography (SPECT, or less commonly, SPET) is a nuclear medicine tomographic imaging technique using gamma rays. It is very similar to conventional nuclear medicine planar imaging using a gamma camera (that is, ...
(SPECT), near-infrared spectroscopy (NIRS), and event-related optical signal (EROS). Despite the relatively poor spatial sensitivity of EEG, the "one-dimensional signals from localised peripheral regions on the head make it attractive for its simplistic fidelity and has allowed high clinical and basic research throughput". Thus, EEG possesses some advantages over some of those other techniques: * Hardware costs are significantly lower than those of most other techniques * EEG prevents limited availability of technologists to provide immediate care in high traffic hospitals. * EEG only requires a quiet room and briefcase-size equipment, whereas fMRI, SPECT, PET, MRS, or MEG require bulky and immobile equipment. For example, MEG requires equipment consisting of liquid helium-cooled detectors that can be used only in magnetically shielded rooms, altogether costing upwards of several million dollars; and fMRI requires the use of a 1-ton magnet in, again, a shielded room. * EEG can readily have a high temporal resolution, (although sub-millisecond resolution generates less meaningful data), because the two to 32 data streams generated by that number of electrodes is easily stored and processed, whereas 3D spatial technologies provide thousands or millions times as many input data streams, and are thus limited by hardware and software. EEG is commonly recorded at sampling rates between 250 and 2000 Hz in clinical and research settings. * EEG is relatively tolerant of subject movement, unlike most other neuroimaging techniques. There even exist methods for minimizing, and even eliminating movement artifacts in EEG data * EEG is silent, which allows for better study of the responses to auditory stimuli. * EEG does not aggravate claustrophobia, unlike fMRI, PET, MRS, SPECT, and sometimes MEG * EEG does not involve exposure to high-intensity (>1 Tesla) magnetic fields, as in some of the other techniques, especially MRI and MRS. These can cause a variety of undesirable issues with the data, and also prohibit use of these techniques with participants that have metal implants in their body, such as metal-containing pacemakers * EEG does not involve exposure to radioligands, unlike
positron emission tomography Positron emission tomography (PET) is a functional imaging technique that uses radioactive substances known as radiotracers to visualize and measure changes in Metabolism, metabolic processes, and in other physiological activities including bl ...
. * ERP studies can be conducted with relatively simple paradigms, compared with IE block-design fMRI studies * Relatively non-invasive, in contrast to electrocorticography, which requires electrodes to be placed on the actual surface of the brain. EEG also has some characteristics that compare favorably with behavioral testing: * EEG can detect covert processing (i.e., processing that does not require a response) * EEG can be used in subjects who are incapable of making a motor response * Some ERP components can be detected even when the subject is not attending to the stimuli * Unlike other means of studying reaction time, ERPs can elucidate stages of processing (rather than just the result) * the simplicity of EEG readily provides for tracking of brain changes during different phases of life. EEG sleep analysis can indicate significant aspects of the timing of brain development, including evaluating adolescent brain maturation. * In EEG there is a better understanding of what signal is measured as compared to other research techniques, e.g. the BOLD response in MRI.


Disadvantages

* Low spatial resolution on the scalp. fMRI, for example, can directly display areas of the brain that are active, while EEG requires intense interpretation just to hypothesize what areas are activated by a particular response. * Depending on the orientation and location of the dipole causing an EEG change, there may be a false localization due to the inverse problem. * EEG poorly measures neural activity that occurs below the upper layers of the brain (the cortex). * Unlike PET and MRS, cannot identify specific locations in the brain at which various neurotransmitters, drugs, etc. can be found. * Often takes a long time to connect a subject to EEG, as it requires precise placement of dozens of electrodes around the head and the use of various gels, saline solutions, and/or pastes to maintain good conductivity, and a cap is used to keep them in place. While the length of time differs dependent on the specific EEG device used, as a general rule it takes considerably less time to prepare a subject for MEG, fMRI, MRS, and SPECT. * Signal-to-noise ratio is poor, so sophisticated data analysis and relatively large numbers of subjects are needed to extract useful information from EEG.


With other neuroimaging techniques

Simultaneous EEG recordings and fMRI scans have been obtained successfully, though recording both at the same time effectively requires that several technical difficulties be overcome, such as the presence of ballistocardiographic artifact, MRI pulse artifact and the induction of electrical currents in EEG wires that move within the strong magnetic fields of the MRI. While challenging, these have been successfully overcome in a number of studies. MRI's produce detailed images created by generating strong magnetic fields that may induce potentially harmful displacement force and torque. These fields produce potentially harmful radio frequency heating and create image artifacts rendering images useless. Due to these potential risks, only certain medical devices can be used in an MR environment. Similarly, simultaneous recordings with MEG and EEG have also been conducted, which has several advantages over using either technique alone: * EEG requires accurate information about certain aspects of the skull that can only be estimated, such as skull radius, and conductivities of various skull locations. MEG does not have this issue, and a simultaneous analysis allows this to be corrected for. * MEG and EEG both detect activity below the surface of the cortex very poorly, and like EEG, the level of error increases with the depth below the surface of the cortex one attempts to examine. However, the errors are very different between the techniques, and combining them thus allows for correction of some of this noise. * MEG has access to virtually no sources of brain activity below a few centimetres under the cortex. EEG, on the other hand, can receive signals from greater depth, albeit with a high degree of noise. Combining the two makes it easier to determine what in the EEG signal comes from the surface (since MEG is very accurate in examining signals from the surface of the brain), and what comes from deeper in the brain, thus allowing for analysis of deeper brain signals than either EEG or MEG on its own. Recently, a combined EEG/MEG (EMEG) approach has been investigated for the purpose of source reconstruction in epilepsy diagnosis. EEG has also been combined with
positron emission tomography Positron emission tomography (PET) is a functional imaging technique that uses radioactive substances known as radiotracers to visualize and measure changes in Metabolism, metabolic processes, and in other physiological activities including bl ...
. This provides the advantage of allowing researchers to see what EEG signals are associated with different drug actions in the brain. Recent studies using machine learning techniques such as
neural networks A neural network is a network or circuit of biological neurons, or, in a modern sense, an artificial neural network, composed of artificial neurons or nodes. Thus, a neural network is either a biological neural network, made up of biological ...
with statistical temporal features extracted from frontal lobe EEG brainwave data has shown high levels of success in classifying mental states (Relaxed, Neutral, Concentrating), mental emotional states (Negative, Neutral, Positive) and thalamocortical dysrhythmia.


Mechanisms

The brain's electrical charge is maintained by billions of neurons. Neurons are electrically charged (or "polarized") by membrane transport proteins that pump ions across their membranes. Neurons are constantly exchanging ions with the extracellular milieu, for example to maintain resting potential and to propagate action potentials. Ions of similar charge repel each other, and when many ions are pushed out of many neurons at the same time, they can push their neighbours, who push their neighbours, and so on, in a wave. This process is known as volume conduction. When the wave of ions reaches the electrodes on the scalp, they can push or pull electrons on the metal in the electrodes. Since metal conducts the push and pull of electrons easily, the difference in push or pull voltages between any two electrodes can be measured by a voltmeter. Recording these voltages over time gives us the EEG. The electric potential generated by an individual neuron is far too small to be picked up by EEG or MEG. EEG activity therefore always reflects the summation of the synchronous activity of thousands or millions of neurons that have similar spatial orientation. If the cells do not have similar spatial orientation, their ions do not line up and create waves to be detected. Pyramidal neurons of the cortex are thought to produce the most EEG signal because they are well-aligned and fire together. Because voltage field gradients fall off with the square of distance, activity from deep sources is more difficult to detect than currents near the skull. Scalp EEG activity shows oscillations at a variety of frequencies. Several of these oscillations have characteristic frequency ranges, spatial distributions and are associated with different states of brain functioning (e.g., waking and the various sleep stages). These oscillations represent synchronized activity over a network of neurons. The neuronal networks underlying some of these oscillations are understood (e.g., the thalamocortical resonance underlying sleep spindles), while many others are not (e.g., the system that generates the posterior basic rhythm). Research that measures both EEG and neuron spiking finds the relationship between the two is complex, with a combination of EEG power in the
gamma Gamma (uppercase , lowercase ; ''gámma'') is the third letter of the Greek alphabet. In the system of Greek numerals it has a value of 3. In Ancient Greek, the letter gamma represented a voiced velar stop . In Modern Greek, this letter re ...
band and phase in the delta band relating most strongly to neuron spike activity.


Method

In conventional scalp EEG, the recording is obtained by placing electrodes on the scalp with a conductive gel or paste, usually after preparing the scalp area by light abrasion to reduce impedance due to dead skin cells. Many systems typically use electrodes, each of which is attached to an individual wire. Some systems use caps or nets into which electrodes are embedded; this is particularly common when high-density arrays of electrodes are needed. Electrode locations and names are specified by the International 10–20 system for most clinical and research applications (except when high-density arrays are used). This system ensures that the naming of electrodes is consistent across laboratories. In most clinical applications, 19 recording electrodes (plus ground and system reference) are used. A smaller number of electrodes are typically used when recording EEG from neonates. Additional electrodes can be added to the standard set-up when a clinical or research application demands increased spatial resolution for a particular area of the brain. High-density arrays (typically via cap or net) can contain up to 256 electrodes more-or-less evenly spaced around the scalp. Each electrode is connected to one input of a differential amplifier (one amplifier per pair of electrodes); a common system reference electrode is connected to the other input of each differential amplifier. These amplifiers amplify the voltage between the active electrode and the reference (typically 1,000–100,000 times, or 60–100  dB of voltage gain). In analog EEG, the signal is then filtered (next paragraph), and the EEG signal is output as the deflection of pens as paper passes underneath. Most EEG systems these days, however, are digital, and the amplified signal is digitized via an analog-to-digital converter, after being passed through an anti-aliasing filter. Analog-to-digital sampling typically occurs at 256–512 Hz in clinical scalp EEG; sampling rates of up to 20 kHz are used in some research applications. During the recording, a series of activation procedures may be used. These procedures may induce normal or abnormal EEG activity that might not otherwise be seen. These procedures include hyperventilation, photic stimulation (with a strobe light), eye closure, mental activity, sleep and sleep deprivation. During (inpatient) epilepsy monitoring, a patient's typical seizure medications may be withdrawn. The digital EEG signal is stored electronically and can be filtered for display. Typical settings for the high-pass filter and a low-pass filter are 0.5–1  Hz and 35–70 Hz respectively. The high-pass filter typically filters out slow artifact, such as electrogalvanic signals and movement artifact, whereas the low-pass filter filters out high-frequency artifacts, such as electromyographic signals. An additional notch filter is typically used to remove artifact caused by electrical power lines (60 Hz in the United States and 50 Hz in many other countries). The EEG signals can be captured with opensource hardware such as
OpenBCI OpenBCI is an open-source brain–computer interface platform, created by Joel Murphy and Conor Russomanno, after a successful Kickstarter campaign in late 2013. OpenBCI boards can be used to measure and record electrical activity produced by t ...
and the signal can be processed by freely available EEG software such as EEGLAB or the Neurophysiological Biomarker Toolbox. As part of an evaluation for epilepsy surgery, it may be necessary to insert electrodes near the surface of the brain, under the surface of the dura mater. This is accomplished via burr hole or craniotomy. This is referred to variously as "electrocorticography (ECoG)", "intracranial EEG (I-EEG)" or "subdural EEG (SD-EEG)". Depth electrodes may also be placed into brain structures, such as the amygdala or hippocampus, structures, which are common epileptic foci and may not be "seen" clearly by scalp EEG. The electrocorticographic signal is processed in the same manner as digital scalp EEG (above), with a couple of caveats. ECoG is typically recorded at higher sampling rates than scalp EEG because of the requirements of Nyquist theorem – the subdural signal is composed of a higher predominance of higher frequency components. Also, many of the artifacts that affect scalp EEG do not impact ECoG, and therefore display filtering is often not needed. A typical adult human EEG signal is about 10 µV to 100 µV in amplitude when measured from the scalp. Since an EEG voltage signal represents a difference between the voltages at two electrodes, the display of the EEG for the reading encephalographer may be set up in one of several ways. The representation of the EEG channels is referred to as a ''montage.'' ; Sequential montage: Each channel (i.e., waveform) represents the difference between two adjacent electrodes. The entire montage consists of a series of these channels. For example, the channel "Fp1-F3" represents the difference in voltage between the Fp1 electrode and the F3 electrode. The next channel in the montage, "F3-C3", represents the voltage difference between F3 and C3, and so on through the entire array of electrodes. ; Referential montage: Each channel represents the difference between a certain electrode and a designated reference electrode. There is no standard position for this reference; it is, however, at a different position than the "recording" electrodes. Midline positions are often used because they do not amplify the signal in one hemisphere vs. the other, such as Cz, Oz, Pz etc. as online reference. The other popular offline references are: * REST reference: which is an offline computational reference at infinity where the potential is zero. REST (reference electrode standardization technique) takes the equivalent sources inside the brain of any a set of scalp recordings as springboard to link the actual recordings with any an online or offline( average, linked ears etc.) non-zero reference to the new recordings with infinity zero as the standardized reference. * "linked ears": which is a physical or mathematical average of electrodes attached to both earlobes or mastoids. ; Average reference montage: The outputs of all of the amplifiers are summed and averaged, and this averaged signal is used as the common reference for each channel. ; Laplacian montage: Each channel represents the difference between an electrode and a weighted average of the surrounding electrodes. When analog (paper) EEGs are used, the technologist switches between montages during the recording in order to highlight or better characterize certain features of the EEG. With digital EEG, all signals are typically digitized and stored in a particular (usually referential) montage; since any montage can be constructed mathematically from any other, the EEG can be viewed by the electroencephalographer in any display montage that is desired. The EEG is read by a clinical neurophysiologist or neurologist (depending on local custom and law regarding medical specialities), optimally one who has specific training in the interpretation of EEGs for clinical purposes. This is done by visual inspection of the waveforms, called graphoelements. The use of computer signal processing of the EEG – so-called
quantitative electroencephalography Quantitative electroencephalography (qEEG or QEEG) is a field concerned with the numerical analysis of electroencephalography (EEG) data and associated behavioral correlates. Details Techniques used in digital signal analysis are extended to th ...
– is somewhat controversial when used for clinical purposes (although there are many research uses).


Dry EEG electrodes

In the early 1990s Babak Taheri, at University of California, Davis demonstrated the first single and also multichannel dry active electrode arrays using micro-machining. The single channel dry EEG electrode construction and results were published in 1994. The arrayed electrode was also demonstrated to perform well compared to silver/ silver chloride electrodes. The device consisted of four sites of sensors with integrated electronics to reduce noise by impedance matching. The advantages of such electrodes are: (1) no electrolyte used, (2) no skin preparation, (3) significantly reduced sensor size, and (4) compatibility with EEG monitoring systems. The active electrode array is an integrated system made of an array of capacitive sensors with local integrated circuitry housed in a package with batteries to power the circuitry. This level of integration was required to achieve the functional performance obtained by the electrode. The electrode was tested on an electrical test bench and on human subjects in four modalities of EEG activity, namely: (1) spontaneous EEG, (2) sensory event-related potentials, (3) brain stem potentials, and (4) cognitive event-related potentials. The performance of the dry electrode compared favorably with that of the standard wet electrodes in terms of skin preparation, no gel requirements (dry), and higher signal-to-noise ratio. In 1999 researchers at
Case Western Reserve University Case Western Reserve University (CWRU) is a private research university in Cleveland, Ohio. Case Western Reserve was established in 1967, when Western Reserve University, founded in 1826 and named for its location in the Connecticut Western Reser ...
, in Cleveland, Ohio, led by Hunter Peckham, used 64-electrode EEG skullcap to return limited hand movements to quadriplegic Jim Jatich. As Jatich concentrated on simple but opposite concepts like up and down, his beta-rhythm EEG output was analysed using software to identify patterns in the noise. A basic pattern was identified and used to control a switch: Above average activity was set to on, below average off. As well as enabling Jatich to control a computer cursor the signals were also used to drive the nerve controllers embedded in his hands, restoring some movement. In 2018, a functional dry electrode composed of a polydimethylsiloxane
elastomer An elastomer is a polymer with viscoelasticity (i.e. both viscosity and elasticity) and with weak intermolecular forces, generally low Young's modulus and high failure strain compared with other materials. The term, a portmanteau of ''elastic p ...
filled with conductive carbon nanofibers was reported. This research was conducted at the
U.S. Army Research Laboratory The U.S. Army Combat Capabilities Development Command Army Research Laboratory (DEVCOM ARL) is the U.S. Army's foundational research laboratory. ARL is headquartered at the Adelphi Laboratory Center (ALC) in Adelphi, Maryland. Its largest singl ...
. EEG technology often involves applying a gel to the scalp which facilitates strong signal-to-noise ratio. This results in more reproducible and reliable experimental results. Since patients dislike having their hair filled with gel, and the lengthy setup requires trained staff on hand, utilizing EEG outside the laboratory setting can be difficult. Additionally, it has been observed that wet electrode sensors' performance reduces after a span of hours. Therefore, research has been directed to developing dry and semi-dry EEG bioelectronic interfaces. Dry electrode signals depend upon mechanical contact. Therefore, it can be difficult getting a usable signal because of impedance between the skin and the electrode. Some EEG systems attempt to circumvent this issue by applying a saline solution. Others have a semi dry nature and release small amounts of the gel upon contact with the scalp. Another solution uses spring loaded pin setups. These may be uncomfortable. They may also be dangerous if they were used in a situation where a patient could bump their head since they could become lodged after an impact trauma incident. ARL also developed a visualization tool, Customizable Lighting Interface for the Visualization of EEGs or CLIVE, which showed how well two brains are synchronized. Currently, headsets are available incorporating dry electrodes with up to 30 channels. Such designs are able to compensate for some of the signal quality degradation related to high impedances by optimizing pre-amplificatio