Featured Publications
Quantitative epileptiform burden and electroencephalography background features predict post-traumatic epilepsy
Chen Y, Li S, Ge W, Jing J, Chen HY, Doherty D, Herman A, Kaleem S, Ding K, Osman G, Swisher CB, Smith C, Maciel CB, Alkhachroum A, Lee JW, Dhakar MB, Gilmore EJ, Sivaraju A, Hirsch LJ, Omay SB, Blumenfeld H, Sheth KN, Struck AF, Edlow BL, Westover MB, Kim JA. Quantitative epileptiform burden and electroencephalography background features predict post-traumatic epilepsy. Journal Of Neurology Neurosurgery & Psychiatry 2022, 94: 245-249. PMID: 36241423, PMCID: PMC9931627, DOI: 10.1136/jnnp-2022-329542.Peer-Reviewed Original ResearchMeSH KeywordsBrain Injuries, TraumaticCase-Control StudiesElectroencephalographyEpilepsy, Post-TraumaticHumansRetrospective StudiesConceptsPost-traumatic epilepsyTraumatic brain injuryCT abnormalitiesElectroencephalography featuresAdmission Glasgow Coma Scale scoreGlasgow Coma Scale scoreRetrospective case-control studyMultivariable logistic regression analysisRisk stratification modelCase-control studyLogistic regression analysisTBI admissionsSevere complicationsFuture trialsBrain injuryCT reportsSeizure diagnosisPredictive valueScale scorePatientsLogistic regressionStratification modelQuantitative electroencephalogramTBI mechanismsRegression analysisAutomated EEG-based prediction of delayed cerebral ischemia after subarachnoid hemorrhage
Zheng WL, Kim JA, Elmer J, Zafar SF, Ghanta M, Moura V, Patel A, Rosenthal E, Westover M. Automated EEG-based prediction of delayed cerebral ischemia after subarachnoid hemorrhage. Clinical Neurophysiology 2022, 143: 97-106. PMID: 36182752, PMCID: PMC9847346, DOI: 10.1016/j.clinph.2022.08.023.Peer-Reviewed Original ResearchMeSH KeywordsBrainBrain IschemiaCerebral InfarctionElectroencephalographyHumansSubarachnoid HemorrhageConceptsMultiple EEG featuresEEG featuresInformative featuresPrediction algorithmSubarachnoid hemorrhageBetter performanceNon-DCI patientsMachineCerebral ischemiaDCI riskAlpha-delta ratioAneurysmal subarachnoid hemorrhageUtility of electroencephalographyReceiver operator curveFeaturesDCI predictionAlgorithmDCI onsetSAH patientsShannon entropyDay 5Whole brainAlpha variabilityPatientsPredictionCombining Transcranial Doppler and EEG Data to Predict Delayed Cerebral Ischemia After Subarachnoid Hemorrhage
Chen HY, Elmer J, Zafar SF, Ghanta M, Moura Junior V, Rosenthal ES, Gilmore EJ, Hirsch LJ, Zaveri HP, Sheth KN, Petersen NH, Westover MB, Kim JA. Combining Transcranial Doppler and EEG Data to Predict Delayed Cerebral Ischemia After Subarachnoid Hemorrhage. Neurology 2021, 98: e459-e469. PMID: 34845057, PMCID: PMC8826465, DOI: 10.1212/wnl.0000000000013126.Peer-Reviewed Original ResearchThe Utility of Quantitative EEG in Detecting Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage
Baang HY, Chen HY, Herman AL, Gilmore EJ, Hirsch LJ, Sheth KN, Petersen NH, Zafar SF, Rosenthal ES, Westover MB, Kim JA. The Utility of Quantitative EEG in Detecting Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage. Journal Of Clinical Neurophysiology 2021, 39: 207-215. PMID: 34510093, PMCID: PMC8901442, DOI: 10.1097/wnp.0000000000000754.Peer-Reviewed Original ResearchDevelopment of Expert-Level Automated Detection of Epileptiform Discharges During Electroencephalogram Interpretation
Jing J, Sun H, Kim JA, Herlopian A, Karakis I, Ng M, Halford JJ, Maus D, Chan F, Dolatshahi M, Muniz C, Chu C, Sacca V, Pathmanathan J, Ge W, Dauwels J, Lam A, Cole AJ, Cash SS, Westover MB. Development of Expert-Level Automated Detection of Epileptiform Discharges During Electroencephalogram Interpretation. JAMA Neurology 2020, 77: 103-108. PMID: 31633740, PMCID: PMC6806668, DOI: 10.1001/jamaneurol.2019.3485.Peer-Reviewed Original ResearchMeSH KeywordsElectroencephalographyEpilepsyHumansNeural Networks, ComputerSensitivity and SpecificitySignal Processing, Computer-AssistedSoftware
2022
Epileptiform activity predicts epileptogenesis in cerebral hemorrhage
Kong THJ, Azeem M, Naeem A, Allen S, Kim JA, Struck AF. Epileptiform activity predicts epileptogenesis in cerebral hemorrhage. Annals Of Clinical And Translational Neurology 2022, 9: 1475-1480. PMID: 36030385, PMCID: PMC9463945, DOI: 10.1002/acn3.51637.Peer-Reviewed Original ResearchMeSH KeywordsCerebral HemorrhageElectroencephalographyEpilepsyHumansRetrospective StudiesSeizuresSubarachnoid HemorrhageConceptsEpileptiform activitySubarachnoid hemorrhageRisk factorsRetrospective case-control studyNontraumatic intraparenchymal hemorrhagesDevelopment of epilepsyCase-control studyS scoresClinical seizuresAcute phaseCerebral hemorrhageIntraparenchymal hemorrhageHemorrhageSeizuresEpilepsyScoresEpileptogenesisPatientsActivityIntraparenchymalMeasuring expertise in identifying interictal epileptiform discharges
Harid NM, Jing J, Hogan J, Nascimento FA, Ouyang A, Zheng W, Ge W, Zafar SF, Kim JA, Alice DL, Herlopian A, Maus D, Karakis I, Ng M, Hong S, Yu Z, Kaplan PW, Cash S, Shafi M, Martz G, Halford JJ, Westover MB. Measuring expertise in identifying interictal epileptiform discharges. Epileptic Disorders 2022, 24: 496-506. PMID: 35770748, PMCID: PMC9340812, DOI: 10.1684/epd.2021.1409.Peer-Reviewed Original Research
2021
Antiseizure Medication Treatment and Outcomes in Patients with Subarachnoid Hemorrhage Undergoing Continuous EEG Monitoring
Zafar SF, Rosenthal ES, Postma EN, Sanches P, Ayub MA, Rajan S, Kim JA, Rubin DB, Lee H, Patel AB, Hsu J, Patorno E, Westover MB. Antiseizure Medication Treatment and Outcomes in Patients with Subarachnoid Hemorrhage Undergoing Continuous EEG Monitoring. Neurocritical Care 2021, 36: 857-867. PMID: 34843082, PMCID: PMC9117405, DOI: 10.1007/s12028-021-01387-x.Peer-Reviewed Original ResearchMeSH KeywordsCohort StudiesElectroencephalographyHumansProspective StudiesRetrospective StudiesSeizuresSubarachnoid HemorrhageTreatment OutcomeConceptsAneurysmal subarachnoid hemorrhageGood functional outcomeAntiseizure medicationsFunctional outcomeContinuous electroencephalographyEpileptiform activityLower likelihoodBetter outcomesAneurysm treatmentRetrospective single-center cohort studySingle-center cohort studyAntiseizure medication (ASM) treatmentElectroencephalographic epileptiform activityResultsNinety-four patientsDay of admissionContinuous EEG monitoringASM treatmentCEEG initiationCohort studyProspective trialHigh-intensity treatmentLow-intensity treatmentMedication treatmentSubarachnoid hemorrhageOutcome measuresElectroencephalographic Abnormalities are Common in COVID‐19 and are Associated with Outcomes
Lin L, Al‐Faraj A, Ayub N, Bravo P, Das S, Ferlini L, Karakis I, Lee JW, Mukerji SS, Newey CR, Pathmanathan J, Abdennadher M, Casassa C, Gaspard N, Goldenholz DM, Gilmore EJ, Jing J, Kim JA, Kimchi EY, Ladha HS, Tobochnik S, Zafar S, Hirsch LJ, Westover MB, Shafi MM. Electroencephalographic Abnormalities are Common in COVID‐19 and are Associated with Outcomes. Annals Of Neurology 2021, 89: 872-883. PMID: 33704826, PMCID: PMC8104061, DOI: 10.1002/ana.26060.Peer-Reviewed Original ResearchMeSH KeywordsAgedCOVID-19ElectroencephalographyFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsSeizuresTreatment OutcomeConceptsNonconvulsive status epilepticusElectrographic seizuresClinical outcomesEpileptiform abnormalitiesRisk factorsPresence of NCSEMultivariate Cox proportional hazards analysisMulticenter retrospective cohort studyCox proportional hazards analysisCOVID-19Retrospective cohort studyClinical risk factorsContinuous electroencephalogram monitoringAdverse clinical outcomesProportional hazards analysisCoronavirus disease 2019Ann NeurolHospital mortalityHospital lengthClinical seizuresCohort studyIndependent predictorsStatus epilepticusEEG findingsElectroencephalographic abnormalitiesElectroencephalography, Hospital Complications, and Longitudinal Outcomes After Subarachnoid Hemorrhage
Lissak IA, Locascio JJ, Zafar SF, Schleicher RL, Patel AB, Leslie-Mazwi T, Stapleton CJ, Koch MJ, Kim JA, Anderson K, Rosand J, Westover MB, Kimberly WT, Rosenthal ES. Electroencephalography, Hospital Complications, and Longitudinal Outcomes After Subarachnoid Hemorrhage. Neurocritical Care 2021, 35: 397-408. PMID: 33483913, PMCID: PMC7822587, DOI: 10.1007/s12028-020-01177-x.Peer-Reviewed Original ResearchMeSH KeywordsBrain IschemiaElectroencephalographyHospitalsHumansProspective StudiesSubarachnoid HemorrhageConceptsHospital-acquired infectionsHospital complicationsEpileptiform abnormalitiesSubarachnoid hemorrhageCerebral ischemiaLongitudinal outcomesContinuous EEGNon-traumatic subarachnoid hemorrhageTime pointsNontraumatic subarachnoid hemorrhageEffects modelCumulative proportional odds modelRankin ScaleProspective studyFunctional outcomeResultsIn totalBaseline severityCEEG monitoringTherapeutic targetComplicationsSustained impairmentMRS assessmentSecondary analysisLongitudinal assessmentMixed effects models
2020
Deep active learning for Interictal Ictal Injury Continuum EEG patterns
Ge W, Jing J, An S, Herlopian A, Ng M, Struck AF, Appavu B, Johnson EL, Osman G, Haider HA, Karakis I, Kim JA, Halford JJ, Dhakar MB, Sarkis RA, Swisher CB, Schmitt S, Lee JW, Tabaeizadeh M, Rodriguez A, Gaspard N, Gilmore E, Herman ST, Kaplan PW, Pathmanathan J, Hong S, Rosenthal ES, Zafar S, Sun J, Westover M. Deep active learning for Interictal Ictal Injury Continuum EEG patterns. Journal Of Neuroscience Methods 2020, 351: 108966. PMID: 33131680, PMCID: PMC8135050, DOI: 10.1016/j.jneumeth.2020.108966.Peer-Reviewed Original ResearchConceptsConvolutional neural networkIll patientsActive learningLarge labeled datasetExpert-level performanceDeep active learningLarge EEG datasetsPseudo-labeled dataUse of ALElectroencephalography patternsPatient careQuery criteriaLabeled datasetLabel spreadingEEG patternsPatientsExpert labelsClass balancingNeural networkAvailable labelsVector representationQueriesInformative examplesAL approachEEG datasetDetecting Seizures and Epileptiform Abnormalities in Acute Brain Injury
Singla S, Garcia GE, Rovenolt GE, Soto AL, Gilmore EJ, Hirsch LJ, Blumenfeld H, Sheth KN, Omay SB, Struck AF, Westover MB, Kim JA. Detecting Seizures and Epileptiform Abnormalities in Acute Brain Injury. Current Neurology And Neuroscience Reports 2020, 20: 42. PMID: 32715371, PMCID: PMC9353690, DOI: 10.1007/s11910-020-01060-4.Peer-Reviewed Original ResearchConceptsIctal-interictal continuumBrain injuryAcute brain injuryBetter clinical outcomesTraumatic brain injuryRecent FindingsCurrent literatureIncreased morbidityClinical outcomesEpileptiform abnormalitiesEEG findingsMortality riskEEG monitoringEpileptiform patternsPrognostic modelSeizuresClinical settingInjuryLogistical barriersElectroencephalogram studyUse of EEGABIPractical barriersEEG analysisEEGMorbidity
2018
Effect of epileptiform abnormality burden on neurologic outcome and antiepileptic drug management after subarachnoid hemorrhage
Zafar SF, Postma EN, Biswal S, Boyle EJ, Bechek S, O'Connor K, Shenoy A, Kim J, Shafi MS, Patel AB, Rosenthal ES, Westover MB. Effect of epileptiform abnormality burden on neurologic outcome and antiepileptic drug management after subarachnoid hemorrhage. Clinical Neurophysiology 2018, 129: 2219-2227. PMID: 30212805, PMCID: PMC6478499, DOI: 10.1016/j.clinph.2018.08.015.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnticonvulsantsElectroencephalographyFemaleGlasgow Outcome ScaleHumansMaleMiddle AgedSeizuresSubarachnoid HemorrhageConceptsAnti-epileptic drugsAneurysmal subarachnoid hemorrhageEpileptiform abnormalitiesWorse outcomesSubarachnoid hemorrhageHigh-grade aSAH patientsEvidence-based treatment protocolsGlasgow Outcome ScoreAntiepileptic drug managementStandard prophylaxisNeurologic outcomeProphylactic protocolASAH patientsOutcome scoresDrug managementHigh burdenRetrospective analysisTreatment protocolOutcome measuresPatientsDaily burdenRhythmic activityFirst dayOutcomesBurdenEpileptiform activity in traumatic brain injury predicts post‐traumatic epilepsy
Kim JA, Boyle EJ, Wu AC, Cole AJ, Staley KJ, Zafar S, Cash SS, Westover MB. Epileptiform activity in traumatic brain injury predicts post‐traumatic epilepsy. Annals Of Neurology 2018, 83: 858-862. PMID: 29537656, PMCID: PMC5912971, DOI: 10.1002/ana.25211.Peer-Reviewed Original Research
2017
Electronic Health Data Predict Outcomes After Aneurysmal Subarachnoid Hemorrhage
Zafar SF, Postma EN, Biswal S, Fleuren L, Boyle EJ, Bechek S, O’Connor K, Shenoy A, Jonnalagadda D, Kim J, Shafi MS, Patel AB, Rosenthal ES, Westover MB. Electronic Health Data Predict Outcomes After Aneurysmal Subarachnoid Hemorrhage. Neurocritical Care 2017, 28: 184-193. PMID: 28983801, PMCID: PMC5886829, DOI: 10.1007/s12028-017-0466-8.Peer-Reviewed Original ResearchConceptsAneurysmal subarachnoid hemorrhageGlasgow Outcome ScaleWhite blood cellsIntracranial pressureAPACHE IIElectronic health dataSubarachnoid hemorrhageBetter outcomesSingle-center retrospective cohort studyDischarge Glasgow Outcome ScaleEarly goal-directed therapyAPACHE II scoreGoal-directed therapyRetrospective cohort studyMean arterial pressureRisk stratification scoresAdmission APACHE IIPredictors of outcomeMultivariate analysis predictorsLogistic regression modelsHealth dataAdmission dayII scoreNeurologic outcomeArterial pressure