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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Neonatology
Volume 12 - 2024 | doi: 10.3389/fped.2024.1452862

Analysis of electrode performance on amplitude integrated electroencephalography in neonates: Evaluation of a new electrode aCUP-E versus liquid gel electrodes

Provisionally accepted
Ángel Rodríguez-Ballabriga Ángel Rodríguez-Ballabriga 1Albert Fabregat-Sanjuan Albert Fabregat-Sanjuan 1*Agnès Rigo-Vidal Agnès Rigo-Vidal 2Rosa Pàmies-Vilà Rosa Pàmies-Vilà 3Susana Larrosa-Capaces Susana Larrosa-Capaces 2Vanesa Rius-Costa Vanesa Rius-Costa 2Vicenç Pascual-Rubio Vicenç Pascual-Rubio 2
  • 1 University of Rovira i Virgili, Tarragona, Spain
  • 2 Pere Virgili Health Research Institute (IISPV), Tarragona, Catalonia, Spain
  • 3 Universitat Politecnica de Catalunya, Barcelona, Catalonia, Spain

The final, formatted version of the article will be published soon.

    Background: Neonatologists and clinical neurophysiologists face challenges with the current electrodes used for long-duration amplitude-integrated electroencephalography (aEEG) in neonatal intensive care units (NICU), limiting the capacity to diagnose brain damage.The objectives of this study were to develop methods for comparing the performance of different electrodes to be used in aEEG. The comparison was done between a newly designed neonate-specific electrode, aCUP-E, with commercial liquid gel electrodes used in amplitudeintegrated electroencephalography (aEEG). The comparison included impedance stability, electrode survival, recording quality, usability, and satisfaction of NICU staff.Methods: aEEG recordings with bipolar montage was used, with one hemisphere fitted with commercial electrodes and the other with aCUP-E electrodes, alternated among subjects. Continuous impedance and raw EEG data were collected over a minimum of 24 hours, and signal processing was performed using Python and MATLAB.Main results: aCUP-E electrodes demonstrated superior performance, including: Increased impedance stability and electrode survival, enhanced recording quality with fewer artifacts, high correlation in signal capture between electrodes during optimal brain activity segments, higher signal-to-noise ratio (SNR) across varying impedance levels, greater staff satisfaction and ease of use. Moreover, Kaplan-Meier curves indicated a higher survival rate for aCUP-E electrodes over 24 hours compared to commercial electrodes. Impedance variability analysis showed statistically significant stability improvements for aCUP-E. Conclusion: aCUP-E electrodes outperform commercial liquid gel electrodes in impedance stability, electrode survival, and recording quality. These results suggest that aCUP-E electrodes could significantly enhance aEEG utilization in diagnosing and treating neonatal brain conditions in NICUs. Future improvements to the aCUP-E electrode may further reduce artifacts and increase electrode longevity, potentially leading to a significant improvement in neonatal brain monitoring by means of aEEG.

    Keywords: aEEG, impedance, neonates, Electrodes, neonatal intensive care unit

    Received: 21 Jun 2024; Accepted: 20 Sep 2024.

    Copyright: © 2024 Rodríguez-Ballabriga, Fabregat-Sanjuan, Rigo-Vidal, Pàmies-Vilà, Larrosa-Capaces, Rius-Costa and Pascual-Rubio. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Albert Fabregat-Sanjuan, University of Rovira i Virgili, Tarragona, Spain

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.