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Biomedical subjects

Ronald T Wakai

Publications and source records attributed to Ronald T Wakai.

15 recordsLinked to original sources
PubMed2006

Fetal cardiac repolarization abnormalities.

Abnormal cardiac repolarization renders the heart susceptible to lethal ventricular tachyarrhythmias, increasing the risk of sudden cardiac death in all ages; however, little is known about the incidence and etiology of T-wave abnormalities in utero. In this study, magnetocardiography was used to better define fetal T-wave characteristics, including the QT interval in the normal fetus, and to characterize T-wave abnormalities in the fetus with arrhythmia. The QT interval and T-wave alternans were assessed from magnetocardiographic recordings obtained at 14 to 39 weeks' gestation from 120 fetuses. Of these fetuses, 78 were from uncomplicated pregnancies and 42 had various forms of fetal arrhythmia (supraventricular tachycardia in 14, congenital atrioventricular block in 17, long QT syndrome with Torsades de pointes in 1, ventricular tachycardia in 2, sinus bradycardia in 4, and bradycardia due to blocked premature atrial contractions in 4). Although the corrected QT interval in normal sinus rhythm was accurately described by Bazett's formula, the corrected QT interval in fetal arrhythmia exhibited a systematic deviation at heart rate extremes. The dependence of the QT interval on the RR interval in arrhythmia was approximately described by QT alpha RR0.8. T-wave alternans was detected in 7 fetuses with arrhythmia, often in association with QT prolongation, suboptimal outcome, or fetal demise. The results of our study have demonstrated that QT-interval abnormalities exist and can be detected in fetal patients. The potential importance of T-wave assessment in the fetus with cardiac arrhythmia was evidenced by the high incidence of marked QT prolongation and T-wave alternans in the fetuses with suboptimal outcomes.

Arrhythmias, Cardiac↗
PubMed2006

MEG and EEG source localization in beamspace.

Beamspace methods are applied to EEG/MEG source localization problems in this paper. Beamspace processing involves passing the data through a linear transformation that reduces the data dimension prior to applying a desired statistical signal processing algorithm. This process generally reduces the data requirements of the subsequent algorithm. We present one approach for designing beamspace transformations that are optimized to preserve source activity located within a given region of interest and show that substantial reductions in dimension are obtained with negligible signal loss. Beamspace versions of maximum likelihood dipole fitting, MUSIC, and minimum variance beamforming source localization algorithms are presented. The performance improvement offered by the beamspace approach with limited data is demonstrated by bootstrapping somatosensory data to evaluate the variability of the source location estimates obtained with each algorithm. The quantitative benefits of beamspace processing depend on the algorithm, signal to noise ratio, and amount of data. Dramatic performance improvements are obtained in scenarios with low signal to noise ratio and a small number of independent data samples.

Brain↗
PubMed2006

Linear minimum mean-square error filtering for evoked responses: application to fetal MEG.

This paper describes a linear minimum mean-squared error (LMMSE) approach for designing spatial filters that improve the signal-to-noise ratio (SNR) of multiepoch evoked response data. This approach does not rely on availability of a forward solution and thus is applicable to problems in which a forward solution is not readily available, such as fetal magnetoencephalography (fMEG). The LMMSE criterion leads to a spatial filter that is a function of the autocorrelation matrix of the data and the autocorrelation matrix of the signal. The signal statistics are unknown, so we approximate the signal autocorrelation matrix using the average of the data across epochs. This approximation is reasonable provided the mean of the noise is zero across epochs and the signal mean is significant. An analysis of the error incurred using this approximation is presented. Calculations of SNR for the exact and approximate LMMSE filters and simple averaging for the rank-1 signal case are shown. The effectiveness of the method is demonstrated with simulated evoked response data and fetal MEG data.

Algorithms↗
PubMed2006

Cortical patch basis model for spatially extended neural activity.

A new source model for representing spatially distributed neural activity is presented. The signal of interest is modeled as originating from a patch of cortex and is represented using a set of basis functions. Each cortical patch has its own set of bases, which allows representation of arbitrary source activity within the patch. This is in contrast to previously proposed cortical patch models which assume a specific distribution of activity within the patch. We present a procedure for designing bases that minimize the normalized mean squared representation error, averaged over different activity distributions within the patch. Extension of existing algorithms to the basis function framework is straightforward and is illustrated using linearly constrained minimum variance (LCMV) spatial filtering and maximum-likelihood signal estimation/generalized likelihood ratio test (ML/GLRT). The number of bases chosen for each patch determines a tradeoff between representation accuracy and the ability to differentiate between distinct patches. We propose choosing the minimum number of bases that satisfy a constraint on the normalized mean squared representation accuracy. A mismatch analysis for LCMV and ML/GLRT is presented to show that this is an appropriate strategy for choosing the number of bases. The effectiveness of the patch basis model is demonstrated using real and simulated evoked response data. We show that significant changes in performance occur as the number of basis functions varies, and that very good results are obtained by allowing modest representation error.

Algorithms↗
PubMed2006

Conduction system disease in fetuses evaluated for irregular cardiac rhythm.

OBJECTIVES: To determine the prevalence of 1st and 2nd degree AV block in fetuses with an irregular cardiac rhythm, and to summarize outcome of these pregnancies. BACKGROUND: The diagnosis of irregular cardiac rhythm or 'skipped beats' includes isolated ectopy that resolves spontaneously. Recently, Doppler measurements of the 'mechanical' PR interval have been shown to identify AV conduction disease prenatally. Prenatal therapy of these conduction abnormalities may limit the progression to more advanced disease either in utero or after birth. METHODS: A retrospective review was performed of fetuses evaluated between 1996 and 2004 with the findings of irregular cardiac rhythm. 1st or 2nd degree AV block was diagnosed on Doppler and M-mode recordings, and confirmed using either fetal magnetocardiography (fMCG) or postnatal 12-lead ECG. Dexamethasone was administered to 4 mothers with abnormal fetal AV conduction in the setting of anti-Ro/anti-La antibodies. RESULTS: Of 702 fetuses initially referred for arrhythmia, 306 had an irregular rhythm. Eight (2.6%) had intermittent 1st or 2nd degree AV block confirmed by fMCG and/or postnatal 12-lead ECG. AV block was presumed idiopathic in 2, associated with congenital long QT syndrome in 2 or with clinically unsuspected maternal anti-Ro or anti-La antibodies in 4. During the intrauterine period there was no progression to complete AV block and all were born alive at 34-40 weeks of gestation. CONCLUSION: A small but clinically significant population of fetuses with irregular rhythm will have 1st or 2nd degree AV block. Transplacental therapy may limit the intrauterine progression to more advanced disease.

Antibodies↗
PubMed2004

Giant fetal magnetocardiogram P waves in congenital atrioventricular block: a marker of cardiovascular compensation?

BACKGROUND: Cardiogram signal amplitude is a key index of hypertrophy but has not been investigated extensively in utero. In this study, magnetocardiography was used to assess P and QRS amplitude in normal subjects and subjects with fetal arrhythmia. METHODS AND RESULTS: The study cohort consisted of 68 normal fetuses and 25 with various arrhythmias: 9 reentrant supraventricular tachycardia (SVT), 2 ventricular tachycardia (VT), 2 sinus tachycardia, 2 blocked atrial bigeminy, 2 congenital second-degree atrioventricular (AV) block, and 8 congenital complete AV block. Subjects with congenital AV block, all presenting with bradycardia, showed large QRS amplitude, exceedingly large P-wave amplitude, and long P-wave duration. The 2 subjects with VT, both with poor ventricular function, also exhibited large P waves. SVT was associated with only moderate signal amplitude elevation. CONCLUSIONS: The data imply that AV block in utero is accompanied by hypertrophy, which is more pronounced for the atria than the ventricles. We hypothesize that the hypertrophy results from a compensatory response associated with regulation of cardiac output and is likely to be observable in other arrhythmias and disease states. Magnetocardiography may be more sensitive than fetal echocardiography for detection of atrial hypertrophy in utero.

Bradycardia↗
PubMed2004

Assessment of fetal neurodevelopment via fetal magnetocardiography.

Fetal magnetocardiography (fMCG) offers unique capabilities for assessment of fetal heart rate (FHR) and fetal behavior, which are fundamental aspects of neurodevelopment. The most important attribute of fMCG for FHR monitoring is its high precision, which allows accurate assessment of beat-to-beat fetal heart rate variability (FHRV), including respiratory sinus arrhythmia. Using mathematical indices to assess FHRV, we find that short- and long-term FHRV both increase during gestation but not in the same manner. The largest increases in short-term FHRV occur during the last trimester, while the largest increases in long-term FHRV occur early on, with smaller changes occurring during the last trimester. The fMCG also allows assessment of fetal activity. This results from the high sensitivity of the signal to the position and orientation of the fetal heart. FMCG actograms are therefore specific for fetal trunk movement, which are thought to be more important than isolated extremity movements and other small fetal movements. The ability to assess FHR, FHRV, and fetal trunk movement simultaneously makes fMCG a valuable tool for neurodevelopment research.

Electrocardiography↗
PubMed2004

Maximum-likelihood estimation of low-rank signals for multiepoch MEG/EEG analysis.

A maximum-likelihood-based algorithm is presented for reducing the effects of spatially colored noise in evoked response magneto- and electro-encephalography data. The repeated component of the data, or signal of interest, is modeled as the mean, while the noise is modeled as the Kronecker product of a spatial and a temporal covariance matrix. The temporal covariance matrix is assumed known or estimated prior to the application of the algorithm. The spatial covariance structure is estimated as part of the maximum-likelihood procedure. The mean matrix representing the signal of interest is assumed to be low-rank due to the temporal and spatial structure of the data. The maximum-likelihood estimates of the components of the low-rank signal structure are derived in order to estimate the signal component. The relationship between this approach and principal component analysis (PCA) is explored. In contrast to prestimulus-based whitening followed by PCA, the maximum-likelihood approach does not require signal-free data for noise whitening. Consequently, the maximum-likelihood approach is much more effective with nonstationary noise and produces better quality whitening for a given data record length. The efficacy of this approach is demonstrated using simulated and real MEG data.

Algorithms↗
PubMed2003

Statistical performance analysis of signal variance-based dipole models for MEG/EEG source localization and detection.

A set of dipole fitting algorithms that incorporate different assumptions about the variability of the signal component into their mathematical models is presented and analyzed. Dipole fitting is performed by minimizing the squared error between the selected data model and available data. Dipole models based on moments that have 1) constant amplitude and orientation, 2) variable amplitude and fixed known orientation, 3) variable amplitude and fixed unknown orientation, and 4) variable amplitude and variable orientation are considered. The presence of a dipolar source is determined by comparing the fractional energy explained by the dipole model to a threshold. Source localization is accomplished by searching to find the location that explains the largest fractional signal energy using a dipole model. Expressions for the probability of a false positive decision and probability of correct detection are derived and used to evaluate the effect of variability in the dipole on performance and to address the effects of model mismatch and location errors. Simulated and measured data experiments are presented to illustrate the performance of both detection and localization methods. The results indicate that models which account for variance outperform the constant orientation and magnitude model even when the number of observations is relatively small and the signal of interest contains a very modest variance component.

Action Potentials↗
PubMed2002

Simultaneity of foetal heart rate acceleration and foetal trunk movement determined by foetal magnetocardiogram actocardiography.

We describe a new method of actocardiography, foetal magnetocardiogram (fMCG) actocardiography, which is based on the high sensitivity of the fMCG to foetal trunk movements. We demonstrate the efficacy of the method by applying it to assess the simultaneity of onset of foetal heart rate (FHR) acceleration and foetal trunk movement. The analysis was restricted to events for which the onset of FHR accelerations and foetal movements could be determined accurately, i.e. when FHR was stable and near the average quiescent level just prior to the acceleration. We found that FHR accelerations coincided with or preceded foetal movements nearly all the time. This supports the hypothesis of coordinated control of FHR accelerations and foetal movements more strongly than prior studies, based on other techniques. We also found that beat-to-beat FHR variability often decreased at or near the start of FHR accelerations and that this occurrence was an accurate marker of foetal movement onset, even when foetal movement onset lagged FHR accelerations.

Adolescent↗
PubMed2002

Theta oscillations and human navigation: a magnetoencephalography study.

Magnetoencephalography (MEG) was used to study alpha and theta activity while subjects navigated through a computer-generated virtual reality town. The subjects were first allowed to explore the environment freely. They then had to navigate from a starting point to a destination, knowing that an obstruction would appear at one of several possible locations along the main route and force them to take a detour. Spatiotemporal analysis of the theta and alpha bands were performed (1) prior to the start of navigation, (2) from the start of navigation until the obstruction was encountered, (3) during the time subjects were contemplating a detour and were not navigating, and (4) from the resumption of navigation until the destination was reached. In all subjects, theta power was strongest during the two periods of navigation. The peak frequency of the oscillations was approximately 3.7 Hz. Control studies consisted of a motor task similar to that required for navigation, passive viewing of a tour through the same virtual reality town, and a mental concentration task. No consistent increases in theta power were seen in the MEG during any of the control tasks. The results suggest an association between theta rhythm and the performance of navigational tasks in humans.

Adult↗
PubMed2002

Matched-filter template generation via spatial filtering: application to fetal biomagnetic recordings.

We have developed a two-step procedure for signal processing of fetal biomagnetic recordings that removes cardiac interference and noise. First, a modified matched filter (MF) is applied to remove maternal cardiac interference; then, a simple signal space projection (SSP) is applied to remove noise. The key difference between our MF and a conventional one is that the interference template and the template scaling are derived from a signal that has been spatially filtered to isolate the interference, rather than from the raw signal. Unlike conventional MFs, ours is able to separate maternal and fetal cardiac complexes, even when they have similar morphology and overlap strongly. When followed by a SSP that preserves only the signal subspace, the noise is reduced to a low level.

Electrocardiography↗