TY - JOUR A1 - Helland, Vanessa Carolina Figuera A1 - Gapelyuk, Andrej A1 - Suhrbier, Alexander A1 - Riedl, Maik A1 - Penzel, Thomas A1 - Kurths, Jürgen A1 - Wessel, Niels T1 - Investigation of an automatic sleep stage classification by means of multiscorer hypnogram N2 - Objectives: Scoring sleep visually based on polysomnography is an important but time-consuming element of sleep medicine. Where-as computer software assists human experts in the assignment of sleep stages to polysomnogram epochs, their performance is usually insufficient. This study evaluates the possibility to fully automatize sleep staging considering the reliability of the sleep stages available from human expert sleep scorers. Methods: We obtain features from EEG, ECG and respiratory signals of polysomnograms from ten healthy subjects. Using the sleep stages provided by three human experts, we evaluate the performance of linear discriminant analysis on the entire polysomnogram and:only on epochs where the three experts agree in their-sleep stage scoring. Results: We show that in polysomnogram intervals, to which all three scorers assign the same sleep stage, our algorithm achieves 90% accuracy. This high rate of agreement with the human experts is accomplished with only a small set of three frequency features from the EEG. We increase-the performance to 93% by including ECG and respiration features. In contrast, on intervals of ambiguous sleep stage, the sleep stage classification obtained from our algorithm, agrees with the human consensus scorer in approximately 61%. Conclusions: These findings suggest that machine classification is highly consistent with human sleep staging and that error in the algorithm's assignments is rather a problem of lack of well-defined criteria for human experts to judge certain polysomnogram epochs than an insufficiency of computational procedures Y1 - 2010 UR - http://www.schattauer.de/index.php?id=103&L=1 U6 - https://doi.org/10.3414/Me09-02-0052 SN - 0026-1270 ER - TY - JOUR A1 - Wessel, Niels A1 - Voss, Andreas A1 - Kurths, Jürgen A1 - Schirdewan, Alexander A1 - Hnatkova, Katarina A1 - Malik, Marek T1 - Evaluation of renormalised entropy for risk stratification using heart rate variability data N2 - Standard time and frequency parameters of heart rate variability (HRV) describe only linear and periodic behaviour, whereas more complex relationships cannot be recognised. A method that may be capable of assessing more complex properties is the non-linear measure of 'renormalised entropy.' A new concept of the method, RE(AR), has been developed, based on a non-linear renormalisation of autoregressive spectral distributions. To test the hypothesis that renormalised entropy may improve the result of high-risk stratification after myocardial infarction, it is applied to a clinical pilot study (41 subjects) and to prospective data of the St George's Hospital post- infarction database (572 patients). The study shows that the new RE(AR) method is more reproducible and more stable in time than a previously introduced method (p<0.001). Moreover, the results of the study confirm the hypothesis that on average, the survivors have negative values of RE(AR) (-0.11+/-0.18), whereas the non-survivors have positive values (0.03+/-0.22, p<0.01). Further, the study shows that the combination of an HRV triangular index and RE(AR) leads to a better prediction of sudden arrhythmic death than standard measurements of HRV. In summary, the new RE(AR) method is an independent measure in HRV analysis that may be suitable for risk stratification in patients after myocardial infarction. Y1 - 2000 ER - TY - JOUR A1 - Wessel, Niels A1 - Ziehmann, Christine A1 - Kurths, Jürgen A1 - Meyerfeldt, Udo A1 - Schirdewan, Alexander A1 - Voss, Andreas T1 - Short-term forecasting of life-threatening cardiac arrhythmias based on symbolic dynamics and finite-time growth rates N2 - Ventricular tachycardia or fibrillation (VT-VF) as fatal cardiac arrhythmias are the main factors triggering sudden cardiac death. The objective of this study is to find early signs of sustained VT-VF in patients with an implanted cardioverter-defibrillator (ICD). These devices are able to safeguard patients by returning their hearts to a normal rhythm via strong defibrillatory shocks; additionally, they store the 1000 beat-to-beat intervals immediately before the onset of a life-threatening arrhythmia. We study these 1000 beat-to-beat intervals of 17 chronic heart failure ICD patients before the onset of a life-threatening arrhythmia and at a control time, i.e., without a VT-VF event. To characterize these rather short data sets, we calculate heart rate variability parameters from the time and frequency domain, from symbolic dynamics as well as the finite-time growth rates. We find that neither the time nor the frequency domain parameters show significant differences between the VT-VF and the control time series. However, two parameters from symbolic dynamics as well as the finite-time growth rates discriminate significantly both groups. These findings could be of importance in algorithms for next generation ICD's to improve the diagnostics and therapy of VT-VF. Y1 - 2000 ER - TY - JOUR A1 - Wessel, Niels A1 - Voss, Andreas A1 - Malberg, Hagen A1 - Ziehmann, Christine A1 - Voss, Henning U. A1 - Schirdewan, Alexander A1 - Meyerfeldt, Udo A1 - Kurths, Jürgen T1 - Nonlinear analysis of complex phenomena in cardiological data N2 - The main intention of this contribution is to discuss different nonlinear approaches to heart rate and blood pressure variability analysis for a better understanding of the cardiovascular regulation. We investigate measures of complexity which are based on symbolic dynamics, renormalised entropy and the finite time growth rates. The dual sequence method to estimate the baroreflex sensitivity and the maximal correlation method to estimate the nonlinear coupling between time series are employed for analysing bivariate data. The latter appears to be a suitable method to estimate the strength of the nonlinear coupling and the coupling direction. Heart rate and blood pressure data from clinical pilot studies and from very large clinical studies are analysed. We demonstrate that parameters from nonlinear dynamics are useful for risk stratification after myocardial infarction, for the prediction of life-threatening cardiac events even in short time series, and for modelling the relationship between heart rate and blood pressure regulation. These findings could be of importance for clinical diagnostics, in algorithms for risk stratification, and for therapeutic and preventive tools of next generation implantable cardioverter defibrillators. Y1 - 2000 ER - TY - JOUR A1 - Riedl, Maik A1 - van Leeuwen, Peter Jan A1 - Suhrbier, Alexander A1 - Malberg, Hagen A1 - Groenemeyer, Dietrich A1 - Kurths, Jürgen A1 - Wessel, Niels T1 - Testing foetal-maternal heart rate synchronization via model-based analyses N2 - The investigation of foetal reaction to internal and external conditions and stimuli is an important tool in the characterization of the developing neural integration of the foetus. An interesting example of this is the study of the interrelationship between the foetal and the maternal heart rate. Recent studies have shown a certain likelihood of occasional heart rate synchronization between mother and foetus. In the case of respiratory-induced heart rate changes, the comparison with maternal surrogates suggests that the evidence for detected synchronization is largely statistical and does not result from physiological interaction. Rather, they simply reflect a stochastic, temporary stability of two independent oscillators with time-variant frequencies. We reanalysed three datasets from that study for a more local consideration. Epochs of assumed synchronization associated with short-term regulation of the foetal heart rate were selected and compared with synchronization resulting from white noise instead of the foetal signal. Using data-driven modelling analysis, it was possible to identify the consistent influence of the heartbeat duration of maternal beats preceding the foetal beats during epochs of synchronization. These maternal beats occurred approximately one maternal respiratory cycle prior to the affected foetal beat. A similar effect could not be found in the epochs without synchronization. Simulations based on the fitted models led to a higher likelihood of synchronization in the data segments with assumed foetal-maternal interaction than in the segment without such assumed interaction. We conclude that the data-driven model-based analysis can be a useful tool for the identification of synchronization. Y1 - 2009 UR - http://rsta.royalsocietypublishing.org/ U6 - https://doi.org/10.1098/rsta.2008.0277 SN - 1364-503X ER - TY - JOUR A1 - Wessel, Niels A1 - Marwan, Norbert A1 - Meyerfeldt, Udo A1 - Schirdewan, Alexander A1 - Kurths, Jürgen T1 - Recurrence quantification analysis to characterise the heart rate variability before the onset of ventricular tachycardia N2 - Ventricular tachycardia or fibrillation (VT) as fatal cardiac arrhythmias are the main factors triggering sudden cardiac death. The objective of this recurrence quantification analysis approach is to find early signs of sustained VT in patients with an implanted cardioverter-defibrillator (ICD). These devices are able to safeguard patients by returning their hearts to a normal rhythm via strong defibrillatory shocks; additionally, they are able to store at least 1000 beat-to-beat intervals immediately before the onset of a life-threatening arrhythmia. We study the Y1 - 2001 UR - http://link.springer.de/link/service/series/0558/bibs/2199/21990295.htm ER - TY - JOUR A1 - Marwan, Norbert A1 - Wessel, Niels A1 - Meyerfeldt, Udo A1 - Schirdewan, Alexander A1 - Kurths, Jürgen T1 - Recurrence-plot-based measures of complexity and its application to heart-rate-variability data N2 - The knowledge of transitions between regular, laminar or chaotic behavior is essential to understand the underlying mechanisms behind complex systems. While several linear approaches are often insufficient to describe such processes, there are several nonlinear methods which however require rather long time observations. To overcome these difficulties, we propose measures of complexity based on vertical structures in recurrence plots and apply them to the logistic map as well as to heart rate variability data. For the logistic map these measures enable us not only to detect transitions between chaotic and periodic states, but also to identify laminar states, i.e. chaos-chaos transitions. The traditional recurrence quantification analysis fails to detect the latter transitions. Applying our new measures to the heart rate variability data, we are able to detect and quantify the laminar phases before a life-threatening cardiac arrhythmia occurs thereby facilitating a prediction of such an event. Our findings could be of importance for the therapy of malignant cardiac arrhythmias. Y1 - 2002 UR - http://arxiv.org/abs/physics/0201064 ER - TY - JOUR A1 - Bittmann, Frank A1 - Gutschow, Stephan A1 - Luther, Sven A1 - Wessel, Niels A1 - Kurths, Jürgen T1 - On the functional relationship between postural motor balance and performance at school N2 - In integrated medical considerations of the biological human system, both intellectual and motor performances in a similar manner are considered as a result of the function of the nervous system. Consequently, universal minimal dysfunctions of the central nervous system may lead to both intellectual and physical anomalies. Therefore, this study tests the hypothesis that there is a connection between the balance ability as a motor parameter and school success as an intellectual parameter. A postural measuring system based on the force-moment sensor technique was used to record the postural balance regulation of 773 children (circle divide 11 +/- 1 years). The school achievement of each child was determined by school grades. Data analysis was performed by linear as well as by nonlinear time series analyses. There are highly significant differences in balance regulation between good and poor pupils recognized by several linear and nonlinear parameters. Good pupils could be discriminated from pupils with bad results in learning to 80 %. The results support the hypothesis mentioned above. One possible explanation for the poor regulation of balance in bad learners could be a deficit in the neural maturity. In future, further developments will be targeted on higher discrimination levels, possibly in order to predict school success. On the other hand, the effects of special movement exercises on the neural development in childhood will be the focus in our further work Y1 - 2005 ER -