Repurposing EEG monitoring of general anaesthesia for building biomarkers of brain ageing: An exploratory study

Abstract

Background: EEG is a common tool for monitoring anaesthetic depth but is rarely reused at large for biomedical research. This study sets out to explore repurposing of EEG during anaesthesia to learn biomarkers of brain ageing. Methods: We focused on brain age estimation as an example. Using machine learning, we reanalysed 4-electrodes EEG of 323 patients under propofol and sevoflurane. We included spatio-spectral features from stable anaesthesia for EEG-based age prediction applying recently published reference methods. Anaesthesia was considered stable when 95% of the total power was below a frequency between 8Hz and 13Hz. Results: We considered moderate-risk patients (ASA <= 2) with propofol anaesthesia to explore predictive EEG signatures. Average alpha-band power (8-13Hz) was informative about age. Yet, state-of-the-art prediction performance was achieved by analysing the entire power spectrum from all electrodes (MAE = 8.2y, R2 = 0.65). Clinical exploration revealed that brain age was systematically linked with intra-operative burst suppression - commonly associated with age-related postoperative cognitive issues. Surprisingly, the brain age was negatively correlated with burst suppression in high-risk patients (ASA = 3), pointing at unknown confounding effects. Secondary analyses revealed that brain-age EEG signatures were specific to propofol anaesthesia, reflected by limited prediction performance under sevoflurane and poor cross-drug generalisation. Conclusions: EEG from general anaesthesia may enable state-of-the-art brain age prediction. Yet, differences between anaesthetic drugs can impact the effectiveness of repurposing EEG from anaesthesia. To unleash the dormant potential of repurposing EEG-monitoring for clinical and health research, collecting larger datasets with precisely documented drug dosage will be key enabling factors.

Competing Interest Statement

D.E. is a full-time employee of F. Hoffmann-La Roche Ltd.

Clinical Trial

NCT03876379

Funding Statement

This work was supported by a 2018 "medecine numerique" (for digital medicine) thesis grant issued by Inserm (French national institute of health and medical research) and Inria (French national research institute for the digital sciences). It was also partly supported by the European Research Council Starting Grant SLAB ERC-StG-676943.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Ethics Advisory Committee (Chairperson Dr Jean Reignier, 48, avenue Claude Vellefaux, Paris, France) gave approval to this work on the 5 January 2016, under the reference CE SRLF 11-356. The SRLF is the French national academic society for anaesthesia and critical care consulted by the department of anaesthesiology at the Lariboisiere hospital (Paris, France).

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Yes

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Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors.

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