Fundamentals of EEG

Technology
Susan R. Rahey, B.Sc., R.E.T., RT (EMG)
Neurophysiology Program Coordinator
Capital Health
Halifax, N.S.
 Objectives
The learner will:
• Review the basic principles of the 10/20
System and differential amplification
• Gain an understanding of the acquisition of
digital EEG waveforms
• Understand the process and utility of digital
calibration
• Appreciate the optimal use of instrument
controls (sensitivity and filters)
• Acquire an awareness of safety issues
 DISCLOSURE FORM
It is the policy of the Canadian Neurological Sciences Federation to insure balance,
independence, objectivity and scientific rigor in all its individually sponsored or jointly sponsored
education programs. Faculty participating in any programs are expected to disclose to the
program audience any real or apparent conflict(s) of interest that may have a direct bearing on the
subject matter of the continuing education program. This pertains to relationships with
pharmaceutical companies, biomedical device manufacturers, or other corporations whose
products or services are related to the subject matter of the presentation topic. The intent of this
policy is not to prevent a speaker with a potential conflict of interest from making a presentation. It
is merely intended that any potential conflict would be identified openly so that the listeners may
form their own judgments about the presentation with the full disclosure of the facts. It remains for
the audience to determine whether the speaker’s outside interests may reflect a possible bias in
either the exposition or the conclusions presented.

Program: 42nd Congress of the Canadian Neurological Sciences Federation

Title of Presentation: Fundamentals of EEG Technology, with an emphasis on digital
techniques
Presenter’s Name: Susan R. Rahey
I have/had a financial interest/arrangement or affiliation with one or more organizations that could be
perceived as a real or apparent conflict of interest in the context of the subject of this presentation.
Affiliation/Financial interest Name of organization(s)
Grant/Research support N/A

Consultant N/A
Speaker’s Bureau N/A
Major stock shareholder N/A
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“Electroencephalography is like a beautiful park
with a sign posted at the entrance:

For Persons With Total Commitment Only”

Ernst Niedermeyer, MD; AJET Vol.24, #2, June 1984, p.72

“The Ten Twenty Electrode System
of the International Federation”
Who?

• Dr. Herbert Jasper, Montreal Neurological

Institute
– The National Hospital, Queen Square
– Dr. F. Gibbs and colleagues in Boston and
Chicago
– Drs. Schwab and Abbott, Massachusetts
General Hospital, Boston
 “The Ten Twenty Electrode System
of the International Federation”
Why?
• “Make more comparable the results
obtained in various laboratories
• Facilitate the communication between
laboratories, in the literature, and with
referring physicians who become familiar
with the localization of EEG abnormalities
in terms of these standard landmarks”
“The Ten Twenty Electrode System
of the International Federation”

How?
• Measured location
• Common nomenclature
• Sequenced measurements
 “The Ten Twenty Electrode System
of the International Federation”

“ Additional electrodes may be placed

between any of these principal standard
positions for especially refined localization
studies”
Additional Localizing Electrodes?

F7
 Additional Localizing Electrodes

• T1/T2 (Silverman)
• Mandibular Notch
• Sphenoidal
• Nasopharyngeal
 Teaching Points

• Use correct nomenclature

• Understand when additional electrodes

are required and where to place them

• Recognize the importance of accurate

head measurement and electrode placement
 Differential Amplifiers
Analog and Digital

• The voltage displayed is the difference

between the two channel inputs

• When there is a voltage difference between

inputs, one electrode will be more negative
or more positive than the other
Differential Amplification: Digital
EEG
The voltage of the displayed waveform
is the algebraic sum of the difference
between input one, minus the
reference, and input two, minus the
reference Input 1 Input 2
(F3 – FCZ) - (C3 – FCZ)
↓
F3 – FCZ
FCZ - C3 – FCZ
FCZ
↓
F3 - C3
 Differential Amplification

For ALL EEG instruments:

• when input 1 is more negative than input 2,

the deflection of the waveform is UP
• when input 2 is more negative than input 1,
the deflection of the waveform is DOWN
 Differential Amplification
Teaching Points:
• Voltage displayed is the difference
between two active electrodes
• In digital EEG, the system reference
does not contribute to the waveforms
displayed in reformatted montages
• Not every upward wave is generated
by a surface negative potential
 Digital EEG Acquisition
• Analog or “paper” recording
– Filters and amplifiers process EEG signals which
drive ink-writing pens
– Electrical signal is continuous and uninterrupted
• Digital EEG Recording
– “Source” signal sampled in time at a rate required to
resolve a particular signal, or waveform, as
determined by engineering theory
– The digital signal is discontinuous
 Digital EEG Acquisition
Analog to Digital Converter
ADC transforms the analog signal to a series of
discrete, discontinuous data points separated by
equal intervals of time.

– Key concepts:
• Sampling rate
• The number of amplitude levels that can be resolved
(bits)
 Sampling Rate
• The rate at which the waveform is
sampled in order to convert it into a
numerical format
– must be at least twice the highest frequency
in the EEG waveforms to be recorded
(Nyquist Theorem).
– Aliasing occurs when a signal is
undersampled.
 Aliasing
• Aliasing occurs when a signal is sampled too slowly to
resolve its frequency content
• The resulting samples form a signal whose frequency is
lower than that of the original signal
 Amplitude Resolution

• The number of amplitude levels is

expressed in terms of “bits”

• A measure of how finely the voltage can be

subdivided when measured.
 Amplitude Resolution

• Too few bits make it more likely that that

relatively large changes can go undetected
and very small amplitude changes can be
overrepresented.

• Minimal Standard in Canada = 12 bits, ie

212 , (or greater) with the ability to resolve
voltage to 0.5µV
Amplitude Resolution
 Monitor Resolution

• The number of pixels in each direction that

can be used to fill in points on the EEG
signal
• Insufficient pixels will have the effect of
mimicking a reduced sampling rate and
displaying incomplete data

Canadian guidelines require 1024 X 768, recommend 1280

X 1024
 Teaching Points
Understand the effects on waveform
display of:

– The features of ADC, including sampling rate

and vertical resolution

– Monitor choice (size AND resolution)

 Calibration
Analog Digital
• A known voltage applied • A known voltage applied across all
simultaneously to all inputs, each inputs to permit accurate
with identical sensitivity and filter amplitude measurement and
settings, to detect instrument display of recorded signals. May
faults or setting errors be manual or automatic
– Electrical and mechanical
baselines
• May be performed daily or weekly
– Sensitivity or at longer intervals, dependent
– Filters on lab and/or national standards
– Time axis alignment
– Pen spacing
• Preexisting calibration file is
– Pen damping attached to each individual
– Noise level recording
– Paper speed
– Performed before and after each
recording
 Advantages of Digital EEG
• Montage reformatting
• Editing channels
• Lots of channels!!
• Off-line manipulation of montages,
filters, sensitivity and time display
(“paper speed”)
 Montage Reformatting
• A single common reference (“system
reference”) is used as the second input
(“G2”) in the differential amplifier for each
channel

• To reformat: the value of the reference is

subtracted from each electrode
 Montage Reformatting
• Activity recorded at the reference is thus “cancelled out”
and cannot contaminate the activity displayed using the
various reformatting montages

Input 1 Input 2
(F3 – FCZ) - (C3 – FCZ)
↓
F3 – FCZ
FCZ - C3 – FCZ
FCZ
↓
F3 - C3

• Virtually limitless options!

 Montage Reformatting

Data in all
channels may be
compromised if
the system
reference is
disrupted or is of
high impedance

Note: Organisation of Societies for Electrophysiological Technology and

Canadian Association of Electroneurophysiology Technologists Guidelines
for Digital EEG Recording
 Digital EEG Instrumentation:
Sensitivity

• Ratio of input voltage to the signal

deflection produced
• Setting with a higher numerical value
means lower amplification
• Can be adjusted on and off-line as
required for clarity
 Digital EEG Instrumentation:
Sensitivity

The sensitivity setting on a Digital EEG is

recorded automatically and is not
annotated and may not be displayed.
Failure to confirm the display sensitivity
may lead to inaccurate interpretation of
results, for example…..
 Digital EEG Instrumentation:
Filters

• Digital and Analog filters establish the

bandwidth of the recording. Digital filters
have no effect on the source data.
• There are three common approaches to
digital filtering:
– FIR (finite impulse response)
– IIR (infinite impulse response)*
– Frequency domain filtering
 Digital EEG Instrumentation:
Filters
• The roll off of a digital filter is determined
by the “order” . Order refers to the number
of points that are averaged by the filter at
any one time
• Do not assume that all filters have the
same order or that the frequency response
curve of a digital EEG filter is identical to
that of an analog filter of the same
magnitude, for example….
higher number = steeper roll-off
 Digital EEG:
Weakness/ Shortcomings

• Compatibility issues
• Physician as technologist
• Blind faith in technology
• Cost!
 Compatibility
• Software is proprietary

• Conversion programs cost money

• Not everyone has access to the same

quality of computer hardware
 Physician as Technologist

The role of the EEGer

has changed from that of
passive recipient of data to
active manipulation of raw data

•choosing montages
•applying filters
•adjusting sensitivity settings
 Blind Faith in Technology

• Not all software programs are equal

• Know your system
• “Turnkey” systems and “traces as
observed” may be good but may not
always be good for you – or the patient
• Computers crash
 Cost
• Storage is cheap

BUT

• Upgrades can cost big money!

Hint: Buy the software warranty and maybe even the hardware
warranty if it’s offered!
 Safety
Electrical Safety:

•Ensure that a proper maintenance schedule is

established and adhered to
•Discuss safety issues with staff
•NEVER ignore the presence of 60 Hz contamination

Infection Control:

•Review laboratory infection control policies in light of institutional

policies
•Never assume that patients are not at risk in your laboratory

Other potential liability issues:

•HV and photic stimulation in pregnancy

•Driving after sleep deprived EEG
 References/ Suggested Readings
• Report of the Committee on Methods of Clinical Examination in
Electroencephalography. EEG Clin. Neurophysiol., 10: pp. 371-375, 1958
• Harner P., Sannit, T. A Review of the International Ten-Twenty System of
Electrode Placement grass Instrument Company 1974
• McLachlan R., Young GB. Minimal Standards for Digital/Quantitative
Electroencephalography in Canada. Can J Neurol. Sci. 26, p. 153, 1999
• Canadian Association of Electroneurophysiology Technologists, Inc.
Minimal Technical Standards 2001
• Tyner F., Knott, J., Mayer, W.B., Fundamentals of EEG Technology.
Volume 1. Basic Concepts and Methods. Raven Press 1983
• Fisch, B. Fisch and Sphelmann’s EEG Primer. Basic Principles of Digital
and Analog EEG. Part A: Technical Background. Elsevier 1999.
• Ebersole J., Pedley, T. Current Practice of Clinical Electroencephalography,
Chapters 3 and 4. Lippincott Williams & Wilkins 2003.
• Epstein C. Digital EEG: Trouble in Paradise? J. Clin. Neurophysiol. 23:
pp.190-193, 2006
• Lagerland, T. Manipulating the Magic of Digital EEG: Montage Reformatting
and Filtering. Am. J. END Technol. 40: pp.121-136, 2000
• Stellate Harmonie Software Reference Manual*