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EEG_NT Operator Manual B8300033001 Rev. E

Galileo System

Operator Manual

EEG_NT PROGRAM FUNCTIONING SECTION

B8300033001 Rev. E

0051

EDITION:

April 2008

EBNeuro -FLORENCE-

EEG_NT

TABLE OF CONTENTS WARNING INFORMATION ABOUT THE MANUAL VERY IMPORTANT NOTE ON MEDICAL DEVICES UTILIZATION WARNING FOR USAGE OUTSIDE THE EUROPEAN COMMUNITY (EEC)

1 3 5

CHAPTER 1 – ACQUISITION SETTINGS 1.1 SETTING THE ACQUISITION PARAMETERS (PRESET LIBRARIES) 1.1.1 XT24 / XT32 / WB24 / WB 32 AMPLIFIER SETTING 1.1.2 MIZAR (BASIS BE OR SANDMAN DIGITAL) AMPLIFIER SETTING 1.1.3 BE LIGHT AMPLIFIER SETTING 1.1.4 DEFINING THE INPUT LABELS FOR BE AMPLIFIER 1.2 PRESETS - MONTAGE EDITOR 1.2.1 TRACE SENSITIVITY 1.2.2 AVERAGE REFERENCE 1.3 PRESETS - STATES AND MESSAGES (MARKERS) SETTING 1.4 PRESETS - THE FLASH STIMULATOR 1.4.1 EDITING A FLASH PROGRAM 1.4.2 “DOUBLE FLASH” PROGRAMS 1.5 PRESETS - OPTIONS 1.6 VIDEO EEG 1.7 DC CHANNELS CALIBRATION

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CHAPTER 2 - REPORT EDITORS 2.1 2.2 2.2.1 2.3 2.3.1 2.4 2.5

OVERVIEW MODELS CREATING/ EDITING A MODEL BOOKMARKS BOOKMARKS EXAMPLES PREDEFINED SENTENCE S MANAGEMENT WARNING ABOUT REPORT SIZE

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CHAPTER 3 – TRACE ACQUISITION 3.1 OVERVIEW 3.2 CREATING A NEW RECORD FROM THE PMS 3.2.1 FIRST METHOD 3.2.2 SECOND METHOD 3.3 ACQUISITION FRAME 3.3.1 ACQUISITION - UPPER TOOLBAR 3.3.2 ACQUISITION - LOWER TOOLBAR 3.3.3 CALIBRATION / EEG MODE 3.3.4 OHMMETER 3.3.5 REAL TIME PRINTER 3.3.6 FLASH STIMULATOR MANAGEMENT 3.3.7 THE STATE MANAGER 3.38 VERTICAL SPLIT 3.3.9 INSERTING EVENTS DURING THE ACQUISITION 3.3.9.1 Accelerators keys – Spot Messages

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EEG_NT 3.3.9.2 Accelerators keys – States 3.3.9.3 Accelerators keys – Annotations 3.3.9.4 Inserting events from the menu 3.4 ACQUISITION OF A VIDEO EEG TRACE 3.4.1 THE VIDEO WINDOW 3.4.1.1 The video Frame 3.4.1.2 The upper toolbar 3.4.1.3 The lower Status Bar 3.4.2 VIDEO DIGITAL ZOOM 3.5 THE ACQUISTION WINDOW MENU 3.5.1 FILE MENU 3.5.2 TRACES MENU 3.5.3 TOOLS MENU 3.5.4 REPORT MENU 3.5.5 WINDOWS MENU

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CHAPTER 4 – EEG/VIDEO-EEG RECORDING REVIEWER (REPLAY) 4.1 OVERVIEW 4.2 OPENING A DATA FILE FOR REPLAY 4.3 THE REPLAY WINDOW 4.3.1 THE TITLE BAR 4.3.2 THE STATUS BAR 4.4 THE “MAIN” TOOLBAR 4.5 THE “MONTAGE” TOOLBAR 4.6 THE “FILTER” TOOLBAR 4.7 THE NAVIGATOR BAR 4.7.1 INFORMATION ABOUT THE TRACE 4.7.2 THE NAVIGATOR BAR WITH LONG RECORDING 4.7.3 MOVING ACROSS THE TRACE 4.8 THE EVENTS 4.8.1 DISPLAY OF EVENTS ON THE TRACE 4.8.2 EVENTS DISPLAY FILTER 4.8.3 EVENTS LIST - EDITING / SEARCH 4.8.4 ENTERING NEW EVENTS ON THE TRACE DURING REPLAY 4.8.4.1 Inserting a “spot message” or a “annotation” on current page 4.8.4.2 Inserting a “status” or a “selection” on current page 4.8.4.3 Inserting a “status” or a “selection” directly on the navigation bar 4.8.5 SELECTION ON THE TRACE DURING REPLAY 4.8.5.1 Inserting selections on the trace with keyboard 4.8.5.2 Deleting selections on the trace 4.8.5.3 Deleting a single event 4.8.5.4 Deleting ALL the occurrence of an event 4.8.5.5 Deleting ALL the events of a group 4.9 THE MENUS IN THE REPLAY WINDOW 4.9.1 THE FILE MENU 4.9.2 THE TRACES MENU 4.9.3 THE POTENTIAL MAP MENU 4.9.4 THE SPECTRAL MAP MENU 4.9.5 THE SPECTRUM MENU 4.9.6 THE TOOLS MENU 4.9.6.1 User parameter setting 4.9.6.1.1 Graphic 4.9.6.1.2 Batch Print 4.9.6.1.3 Filters 4.9.7 THE REPORT MENU 4.9.8 THE WINDOWS MENU 4.10 THE POTENTIAL MAP WINDOW 4.10.1 INSTANTANEOUS MAP 4.10.1.1 Rotating the Map i-2

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EEG_NT 4.10.1.2 Changing the calculation point on the tracing 4.10.1.3 Changing the color scale 4.10.1.4 Setting the scale range 4.10.2 MEAN MAP 4.11 THE SPECTRAL MAP WINDOW 4.11.1 CONTROLLING THE DISPLAY OF THE SPECTRAL MAP 4.12 THE SPECTRUM WINDOW 4.13 TRACE MEASUREMENTS - ZOOM 4.14 SPLIT WINDOW 4.15 REVIEW OF A VIDEO EEG RECORDING 4.15.1 VIDEO GIGITAL MENU

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CHAPTER 5 - GALILEO NT – SOFTWARE TOOLS 5.1 CSA – COMPRESSED SPECTRAL ARRAY 5.1.1 DESCRIPTION 5.1.2 USING THE CSA 5.1.3 CONFIGURING THE CSA 5.1.3.1 Trace Editor 5.1.3.2 Settings (Analysis Configuration) 5.1.3.3 Layout 5.1.4 SAVING CONFIGURATION 5.2 EEG TREND ANALYSIS 5.2.1 DESCRIPTION 5.2.2 USING THE TREND ANALYSIS 5.2.3 CONFIGURING TREND 5.2.3.1 CSA Traces 5.2.3.2 Special Settings 5.2.3.3 Burst Supression 5.2.4 SAVING CONFIGURATION 5.2.5 READING TREND WINDOW 5.2.5.1 Spectral Graphs 5.2.5.2 Burst Suppression graph 5.2.5.3 Graphic 5.2.5.4 Replay and Print 5.2.5.5 Moving across the TREND graph 5.3 EEG AUDIO REPLAY 5.3.1 DESCRIPTION 5.3.2 USING THE AUDIO PLUG-IN 5.3.2.1 The Main Window 5.3.2.2 The “Peak Viewer” 5.3.3 AUDIO PLUG-IN SETTINGS 5.3.3.1 Threshold Setting 5.3.3.2 Setting 5.4 HRV_NT

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EEG_NT CAPITOLO 6 – GALILEO NT – MONITORING 6.1 INTRODUCTION 6.2 CONFIGURATION 6.2.1 MONITORING CONFIGURATION INSIDE GALILEO PMS 6.2.2 EEG ACQUISITION CONFIGURATION 6.2.2.1 Note on Timed Acquisition Section 6.2.3 EP ACQUISITION CONFIGURATION 6.2.4 USE 6.2.5 HARDWARE CONFIGURATION 6.2.6 ALTERNATE ACQUISITION CONFIGURATION 6.3 ACQUITION MANAGEMENT 6.4 WHAT GETTING FROM THE ALTERNATE ACQUISITION:

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EEG_NT

CHAPTER 1 ACQUISITION SETTINGS 1.1

SETTING THE ACQUISITION PARAMETERS (PRESET LIBRARIES) The collection of all the parameters used to perform an acquisition is called Preset. Users, by creating a list of presets for each type of trace and/or situation, to keep track of , can easily recall the desired one before starting acquisition. This will allow him to find an already set collection of parameters, without, everytime, having to waste time and energy to set again all the values and options– i.e. trace type (EEG, VIDEO-EEG), amplifiers settings, sampling frequency, montages to be used, stimulation programs and so on. In GALILEO NT the user can define as many presets as needed: there is no limit to the number of presets. By the Preset Editor, users can easily check, create, and modify any Preset The Presets editor is invoked by the Configuration Menu, in the Preset tab.

Generally, every kind of data ( as every kind of acquisition) owns its Preset Editor. So, the first thing to do, is to select the recording type of which you want to see/edit the acquisition preset, then click on the Modify Setting button.

Acquisition settings

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EEG_NT The following sections will illustrates the Preset Editor for EEG GALNT (or POLY EEG - VIDEO-EEG) recording. For the other data types, please refer to the related documentation. (for example, for an Evoked Potential recording refer to the Evoked Potential package user manual). Once clicked the Modify Setting button the Preset Editor is invoked.

The list shows the presets already existing in the library, with their name and the type of trace they are linked to. To select a preset in the list to do any action on it simply click on any point of the line containing its name. NOTE Note that each HARDWARE TYPE (i.e. Amplifiers or Head box) has its own preset library.

For this reason, to create a library, the user must first select the amplifier type the preset will refer to. Usually this is not a problem, as a system typically has only one kind of amplifier connected to it (in this case the Hardware Type list contains a single item, and the choice is univocally determined). The situation can exist in more complex systems, where several types of amplifiers are connected to the unit at the same time.

A preset can be deleted (Remove), created (New), renamed (Rename) or modified (Edit). For EEG, VIDEOEEG and POLYEEG data types, a default Preset can be 1-2

Acquisition settings

EEG_NT imposed (Default): the default Preset is the first one that the system will propose as the acquisition starts. The Calibrate button calls the DC Calibration Utility provided by the system. This utility is described in the last section of this chapter (See Para. 1.6 – DC Channels Calibration). Editing a Preset: To analyze in detail the information contained in a preset and/or edit them, select a preset, clicking the line that contains its name, and then click the Edit button.

As shown in the above diagram, the Preset dialog is composed of several sections that will be described in the following pages. At lower level (independent from the active tab) there are three buttons and a drop-down list:

Acquisition settings

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EEG_NT Save & Exit To exit from the Preset Manager, permanently SAVING all the changes made. Cancel To exit WITHOUT saving any changes made Save As To save the current preset with a different name than that one previously given (this is a way to create a NEW preset) Recording type To choose, from the list, the Trace Type to which the preset refers to. NOTE We recommend to first set this parameter, as some of the options available in the different tabs will depend on the selected Trace Type.

For example, the parameters that will control the acquisition of an AVI film during a VIDEO-EEG recording, are ONLY shown if the Trace Type is VIDEOEEG. PRESETS - AMPLIFIERS SETTING The essential part of a Preset is the window where the electrodes to be acquired – among those available in the amplifiers bank – can be selected, and where it is defined how they will work. GALILEO NT tries to minimize any user intervention in these areas, but for the optimal use of the acquisition hardware, GALILEO NT needs some information that the user must provide. In particular, the user must specify: x The storage frequency (traces saved on disk) of the data acquired. x How many, and which inputs have to be acquired among the ones available with the current hardware. x The approximate dynamic of the signals that will be applied to each amplifier. x The “label” to “affix” to each inputs (when applicable). x The Digital Filter to apply to the acquired data when starting the acquisition.

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Acquisition settings

EEG_NT

NOTE GALILEO NT EEG acquisition is made in an “open band” mode sometimes called also “raw data” mode. The analog circuits apply only hardware band pass filters (antialiasing) which are the largest possible in dependence from the physical characteristic of the hardware and from the acquisition sampling rate (which may be actually larger than the storage rate set by the user). Once the signal is converted in numeric form (Analog to Digital conversion) all the processing (filtering) is made by the software on the computer (Digital Filters). The user is free to set these software filter to any value he wants, but he should take in count that the real band of the signal is limited physically by the hardware (generally fixed) filters. This means that the digital filter operates in “series” with the analog hardware band-pass filter. This may be taken in count very carefully when using digital filtering. In particular care must be done when using the High Pass filter (Time Constant) of value comparable (or higher) with the hardware value or the Low Pass filter of value comparable or greater than the hardware value. To see the signal exactly as it is acquired (and so with the only hardware bandpass filter) you can set the digital filter to OFF (or OPEN) position.

The amplifier setting form and procedure may slightly vary depending on the particular hardware (Amplifier) the Setting Manager is relating to. In the next sections any hardware model will be described in detail.

Acquisition settings

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EEG_NT 1.1.1

XT24 / XT32 / WB24 / WB32 AMPLIFIER SETTING

The various options/parameters have the following meaning:

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Input

Is the physical name the system gives to the input. In other words it is the “name” printed near the related socket on the head box. This field is not editable by the user.

Label

Is the “name” that the related input will take when displayed on the screen and in the Montage. For this type of amplifier the label of the input name is not editable.

Status

Set if the electrode (input) will be acquired (On) or not acquired (Off).

Group

The EEG / POLY qualification is provided in order to set which inputs make up the POOL EEG. POOL EEG inputs will be “controlled” in parallel (all together) during acquisition or replay for filtering, gain control or other management.

Acquisition settings

EEG_NT Range

Represents the dynamic range (maximum amplitude of the input signal) that is set on an amplifier. With some amplifier types there is only one choice; with other types there are some different ranges will be available, each one suitable for a specific use. For example for an XT24/32 or WB24/32 amplifier the following range are defined: r 250 PV suitable for a normal EEG signal. r 700 PV suitable for a particularly high EEG signal r 5 mV suitable for a polygraphic signal.

TC / HF / NOTCH

Represents the DIGITAL filtering that will be applied to the input signals during the acquisition when it will be started. (of course the user will always be able to freely modify them in any moment during the recording). The “Open” label means that no digital filtering is performed, and therefore the band of the acquired signal will be the “analog” one, limited only by the anti-aliasing (analog) filters used for the A/D (analog to digital) conversion. See the note at the beginning of “Amplifier Setting” section.

Type / Subtype

The user can define a set of transducers (defining, with an appropriate utility, the name, the dimension of the acquired measure, and the characteristic of the transfer curve). It will then be possible to link any of the transducers in the list previously defined to a DC input. When a channel is linked to a transducer it is possible to display (both during acquisition and during replay) the numerical value of the signal together with its related unit of measure. For more details see the Calibration procedure on section 6.6

SR

Represents the storage rate of data onto disk. The available values and whether this parameter is global or independently selectable for each input depends on the amplifier type (input box) installed on the system, and for which type the preset is being created. Allowable range is 128,…512 samples/second (EEG mode)

Coupling (DC)

Indicates if the related channel is coupled in AC mode or DC mode. DC means that the input accepts DC-coupled signals (i.e. an external oxymeter). For this type of amplifiers this parameter cannot be changed by the user as it represents a physical characteristic of each input. With the XT/WB series of amplifier only the auxiliary inputs AU0…AU31 (amplifier type XT) have this characteristic (input DC coupled). Acquisition settings

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EEG_NT 1.1.2

MIZAR (BASIS BE OR SANDMAN DIGITAL) AMPLIFIER SETTING

The various s parameters have the following meaning:

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Input

Is the physical name given by the system to the input. In other words it is the “name” printed near the related socket on the head box.

Label

Is the “name” that the related input will take when displayed on the screen and in the Montage. To set the label follow the instruction described in Par. 1.1.4..

Status

Whether the electrode (input) will be acquired (on) or not acquired (off).

Group

The EEG / POLY qualification is provided in order for the system to know which inputs make up the POOL EEG. POOL EEG inputs will be “controlled” in parallel (all together) during acquisition or replay for the filtering operations.

Acquisition settings

EEG_NT Range

Represents the dynamic range (maximum amplitude of the input signal) that is set on an amplifier. With some amplifier types there is only one choice; with other types there are some different ranges – each one suitable for its specific use - will be available. The following range are defined: r 4.1 mV All channels r 65.5 mV All channels r 328 mV only channels 25,26,…32 r 410 mV All channels r 655 mV only channels 25,26,…32 r 3.3 V only channels 25,26,…32

TC / HF / NOTCH

Represents the DIGITAL filtering that will be applied to the input signals in acquisition when it will be started. (of course the user will always be able to freely modify them). The “Open” label means that no digital filtering is performed, and therefore the band of the acquired signal will be the “analog” one, limited only by the anti-aliasing (analog) filters used for the A/D (analog to digital) conversion. See the note at the beginning of “Amplifier Setting” section.

Type / Subtype

The user can define a set of transducers (defining, with an appropriate utility, the name, the dimension of the acquired measure, and the characteristic of the transfer curve). It will then be possible to link any of the transducers in the list previously defined to a DC input. When a channel is linked to a transducer it is possible to display (both during acquisition and during replay) to display the numerical value of the signal together with its related unit of measure. For more details see the Calibration procedure in section 6.6

SR

Represents the storage rate of data onto disk. The available values and whether this parameter is global or independently selectable for each input depends on the amplifier type (input box) installed on the system, and for which type the preset is being created. In an EEG recording the allowable range is from 128 samples/s to 8192 samples/s. For an EP acquisition the sampling rate may significantly higher. (See EP NT manual for details)

Acquisition settings

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EEG_NT Coupling (DC)

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Acquisition settings

Indicates if the related channel is coupled in AC mode or DC mode. DC means that the input accepts DC-coupled signals (i.e. an external oxymeter). This status can be set by the user for all the channels. However user must take care of using a DC inputs; Dynamic Range must be chosen appropriately and all the overall acquisition process should be followed with the greatest care.

EEG_NT 1.1.3

BE LIGHT AMPLIFIER SETTING

The various s parameters have the following meaning: Input

Is the physical name given by the system to the input. In other words it is the “name” printed near the related socket on the head box.

Label

Is the “name” that the related input will take when displayed on the screen and in the Montage. To set the label follow the instruction described in Par. 1.1.4.

Status

Whether the electrode (input) will be acquired (on) or not acquired (off).

Group

The EEG / POLY qualification is provided in order for the system to know which inputs make up the POOL EEG. POOL EEG inputs will be “controlled” in parallel (all together) during acquisition or replay for the filtering operations.

Range

Represents the dynamic range (maximum amplitude of the input signal) that is set on an amplifier. With some amplifier types there is only one choice; with other types there are some different ranges – each one suitable for its specific use – will be available. the following range are defined: r 4.1 mV All channels r 65.5 mV 22, 23, 24

Acquisition settings

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EEG_NT

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TC / HF / NOTCH

Represents the DIGITAL filtering that will be applied to the input signals in acquisition when it will be started. (of course the user will always be able to freely modify them). The “Open” label means that no digital filtering is performed, and therefore the band of the acquired signal will be the “analog” one, limited only by the anti-aliasing (analog) filters used for the A/D (analog to digital) conversion. See the note at the beginning of “Amplifier Setting” section.

Type / Subtype

The user can define a set of transducers (defining, with an appropriate utility, the name, the dimension of the acquired measure, and the characteristic of the transfer curve). It will then be possible to link any of the transducers in the list previously defined to a DC input. When a channel is linked to a transducer it is possible to display (both during acquisition and during replay) to display the numerical value of the signal together with its related unit of measure. For more details see the Calibration procedure in section 6.6

SR

Represents the storage rate of data onto disk. The available values and whether this parameter is global or independently selectable for each input depends on the amplifier type (input box) installed on the system, and for which type the preset is being created. In an EEG recording the allowable range is from 128 samples/s to 8192 samples/s. For an EP acquisition the sampling rate may significantly higher. ( See EP NT manual for details)

Coupling (DC)

Indicates if the related channel is coupled in AC mode or DC mode. DC means that the input accepts DC-coupled signals (i.e. an external oxymeter). This status can be set by the user for all the channels. However user must take care of using a DC inputs; Dynamic Range must be chosen appropriately and all the overall acquisition process should be followed with the greatest care.

Acquisition settings

EEG_NT 1.1.4

DEFINING THE INPUT LABELS FOR BE AMPLIFIER To attribute your own label to an input acts as follow: 1. Select the input you want define the label of. 2. Double click on its name or in any part of the highlighted line related to the input under modification. A particular dialog box will be displayed.

3. The table displayed contains all the predefined electrode labels for the 10/10 coordinate system. Click on the predefined label on the table or, if you want define an your own label click on the dots (…) in the upper left corner of the table. In this case you will be asked to type the label you want. NOTE User defined label cannot exceeds the length of 4 characters.

4. In case you want to abort the procedure use the ESC key.

Acquisition settings

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EEG_NT

1.2

PRESETS - MONTAGE EDITOR GALILEO NT keeps a list of user defined montages. There is no limit in the number of montages the list can contain. Montages can be created and edited with the appropriate “editor” that will be shown in the following pages (Montage Editor). This editor can be invoked, in the Preset Manager, from the Montage section, when editing ANY of the presets already existing on the system.

This section contains 2 lists: in the left one (Available montages) are listed all the montages defined in the system for the current hardware model (model the current preset is referring to). In the right (Selected montages) are listed the montage that will be linked to the current preset. The five buttons under the left list allow the user to: x Define a new montage (New) x Edit an existing one (Edit) x Delete a montage from the list (Remove) x Save the selected montage with another name (copy montage) (Save As) x Add the selected montage to the general “Presets Independent” montage library (Add to Library)

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Acquisition settings

EEG_NT

Note that each hardware model (i.e. Amplifiers) has its own Montage Library; this because the number and physical characteristic of the channel that “make” the montage are hardware (amplifiers) dependent. For this reason the Montage Editor is placed inside the Preset Editor: when activating the Montage tab to invoke the Montage Editor you have already declared the Amplifier type you are working with. Moreover, the system maintains a “Presets Independent” Library of Montage that can be used both during the acquisition and replay. This library is an independent collection of montages maintained by the user. There is no relation with the montage list maintained in each hardware model. When, during acquisition or replay, user selects a montage from the Library (activating the “Library” radiobutton on the Montage Option dialog box), the chosen montage is added to the list of montage linked to the trace. Of course the user should be careful when using a montage belonging from the general (hardware model independent) library: may happens that the invoked montage contains some electrodes that are unknown to the current preset (which is as we said before, hardware model depending). It is responsibility of the user to be aware of this situation. To Modify or Delete a montage, its name must compare in the left column (Available Montages). The buttons Add, Add all, Remove, Remove all, showed between the two lists respectively add the selected montage to the ”Selected montages” list, add all the left montages to the ”Selected montages” list, remove the selected montage from the ”Selected montages” list and remove all the montages from the ”Selected montages” list. The Import and Export buttons allow the montage copy to/from drive or folder for importing and/or exporting to other systems. The Startup Montage sets which montage (among those attached to the preset – ”Selected montages”) will be used as “starting montage” at the beginning of the acquisition. NOTE x At least one montage must be attached to the Preset x When use tries to add, in the selected-one list, an available montage (for example PSG) that uses not acquired channels (OFF status in the amplifier list), the system warns him wit the following message

Acquisition settings

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EEG_NT The montage editor (that appears selecting one of the “Available montages” and clicking the Edit button) is shown in the following figure:

The head drawn above contains the “cephalic” electrodes available acquisition hardware (type of amplifier), while the two tabs “Poly” and contain the polygraphic electrodes (those amplifiers that don’t belong standard 10/10 or 10/20 topographical arrangement) and the auxiliary available in the current hardware. NOTA

in the “Aux” to the inputs

For amplifiers with more than 40 channels, above the Poly and Aux tabs, a number of tabs (equal to the number of head boxes needed to configure all the channels) identified by the extension name, will appears near them.

x

A montage is made of a set of traces.

x

The maximum number of derivations in a montage is 128.

x

Each derivation is represented by two electrodes (or inputs) that contribute (with their difference of potential) to the trace.

x

Each derivation is identified in the montage by a difference between two electrodes, and a “label” that typically contains the names of such electrodes.

For example, the F1-F2 derivation is represented by the “F1-F2” label in the acquisition and replay windows. However, when needed, the user can freely assign a label to the derivation (e.g. “oculogram”).

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Acquisition settings

EEG_NT To do this, just double click on the line at the right of the derivation and write the desired name in the “label” field. The new name will replace the label, which by default contains the names of the two electrodes involved in the derivation. Default labels can always be recalled with a single click on the Fill Labels button.

To enter a montage 1. When defining a new montage, select couples of electrodes in sequence, clicking the appropriate buttons. The derivation can be composed by any two electrodes 2. For each pair of clicks on two buttons/electrodes, a new derivation (trace) is inserted in the list. 3. In case of error, select the wrong derivation (clicking on the relevant line in the trace labels column) and delete it (Delete Trace button). It will then possible to insert the derivation (trace) again. 4. To append a derivation to the end of the list - Select the last derivation. Selection is made clicking, on the list, the line containing the derivation - Select in sequence the couples of electrodes forming the new derivation. 5. To add a derivation to the list - Select the derivation before of which you want insert the new one. Select in sequence the couples of electrodes forming the new derivation. 6. Click the Montage Name field and insert the name you want give to the montage. If are editing an existing montage changing its name and saving will generate a new montage. 7. Click the Sensitivity button to set the sensitivity of each trace (see below for further details). 8. Click the Save button to make the modification definitive.

Acquisition settings

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EEG_NT 1.2.1

TRACE SENSITIVITY An important concept in GALILEO NT is that each derivation (trace) during the display has its own sensitivity (expressed in PV/mm). The sensitivity is therefore a derivation (trace) attribute, and has to be managed together with the montage. For this reason the montage editor shows the Sensitivity button, which calls the trace settings dialog:

One or more of even a whole group of derivations can be chosen in the usual way, and then the following parameters can be changed for the selected derivations:

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x

Sensitivity:

x

Type: (EEG, Poly, Service, Different) This attribute is used to define the POOL EEG, that is the group of traces that will be considered “homogeneous”, and on which the sensitivity controls will act as a whole (when in POOL EEG mode – see chapters 3 and 4).

x

Polarity: Trace may be displayed in normal or inverted polarity.

x

Display status: Each derivation can be optionally hidden from the display, though being present in the montage and existing at any effect.

x

Value: This parameter is not used.

x

Colour: Each trace can be characterized by a different colour, so that user can group set of trace by colouring them.

Acquisition settings

Choose the value from the proposed list

EEG_NT NOTA Editing a montage, if user sees some “****” in the Trace Label list, it means that the channels corresponding to this trace are not acquired channels.

1.2.2

AVERAGE REFERENCE An electrode which is often used in montages is the Average Reference (AR): Actually it is not a physical electrode, but a “virtual” one, which assumes the average potential of a set of electrodes chosen by the user. Each montage can define its own average reference electrode. To define the electrodes that will contribute to the average reference (AR) 1. Click the Edit Mean button. The Average Reference edit dialog will appear. The names of the electrodes contributing to the average reference are written in RED, and are shown in the list on the right. 2. Click the electrode/button to toggle their status; the color of the electrode/button label and the names in the list show the current situation. 3. Once the changes are done, click again on the button in the top left corner, whose name is now Close Mean.

In the example above, the virtual electrode AR is computed as (Fp1+ F7 + F3 + C3 + P3 +T5 + O1 + T3 + A1 ) / 9 RF electrode represents the potential of the reference electrode (0 Volts). Acquisition settings

1-19

EEG_NT TM is a virtual electrode whose potential is a little “pulse” generated one time in a second. It is useful only to redirect the montage data to a galvanometric writing system to simulate the “time grid” on the paper. MK represents a virtual electrode on which some “hardware events” are graphically displayed. For example the flash stimulator trigger. If such information is to be graphically shown on the screen, insert the “MK-RF” derivation in the montage.A montage is made up of a set of derivations, also called “traces”.

1-20

Acquisition settings

EEG_NT

1.3

PRESETS - STATES AND MESSAGES (MARKERS) SETTING The form shown below allows user to set the tables with the “instant” (spot) messages and the “states” that will be available in the acquisition Preset. The number of messages and states that can be defined don’t have a limit, except for their label length (not more than 16 characters), and for the first 10 GALILEO NT sets keyboard shortcuts (accelerator keys) to be used during the acquisition. By default, the Preset Editor gives the first ten Spot events/State events respectively the following Short Cuts: Ctrl+1, Ctrl+2, …, Ctrl+0 (Spots) and Shift+1, Shift+2, Shift+0 (States). Moreover 19 keyboard letters (A, .., Z) are available just double clicking on the chosen event to add it a simpler short cut. To close the window opened in this way use the “ESC” key. NOTA If a predefined shortcut (for ex. “A”) is given to an event (for ex. “O.E.” ) in this way, everytime in the same computer, is created a new preset where use define the same event, the system automatically will attribute to it the previously given short cut. In a short: on the same computer since attributing “A” to “O.E.”, every preset containing “O.E.” in the event list will show automatically “A” as its short cut.

All the other messages and states will be selected in the available list, during acquisition, by means of mouse left-click.

To edit a message or a state, select the line containing the appropriate string, then click on the Rename button to change its name, or on the Remove button to delete the selected one.

Acquisition settings

1-21

EEG_NT The Add button adds a message/state to the existing list. The Reset command will erase ALL the messages/states in the list, recovering the default ones (Spot1, Spot2, … and State1, State2,…).

1-22

Acquisition settings

EEG_NT

1.4

PRESETS - THE FLASH STIMULATOR The FLASH section in the Preset Manager, allows the user to create and edit a flash stimulator program. Actually GALILEO NT keeps a list of 8 different programs for flash stimulator management. Each program contains a name (description), a “stimulation rule” (the rule with the flash rate varies in time) and an “energy” (that is the intensity of the single flash stimulus). A program is made of several “steps”: each step contains a starting and a final stimulation rate, and the time needed to pass from the starting to the final rate (relative to that step). A program can contain up to 64 steps. The program is always terminated with one of the two special codes STOP (end of the program) or LOOP N (the program restarts from step N).

For example, the above diagram shows program No. 3, containing three steps. In the first step the stimulation rate will start at 3 flashes/second and in 10 seconds will progressively increase to 18 flashes/second. Then the execution will pass to the next line, where the rate will return to 3 flashes/second, and then (third line) the program will be over (STOP command) and the stimulator will stop in the OFF position. The energy of the single flashes will be LOW. Writing a flash stimulator program, the following points must be kept in mind:

Acquisition settings

1-23

EEG_NT x The initial and final stimulation rates must be integer values between 1 and 50, with the exception, represented by the following point. x An initial frequency of zero means that for the selected time the stimulator will not generate any flash (pause). In this case the final frequency is ignored. x The time (duration) of each step must lie between 1 and 99 seconds x Anything after the STOP or the LOOP n commands will be ignored. Other examples are represented by the following diagrams:

Multi-step ramp with pauses The stimulation rate will change from 3 to 6, 9 and 12. Flashes/second, maintaining each value for 5 seconds, and leaving a 5-seconds pause (lamp off) between each value.

1-24

Acquisition settings

EEG_NT

Continuous undefined ramp (saw-tooth): The rate will grow linearly from 1 to 45 Flashes/second during a 30 seconds interval, and then from 1 to 45 in 30 seconds, and so on, until the user will manually stop the program execution.

Acquisition settings

1-25

EEG_NT 1.4.1

EDITING A FLASH PROGRAM 1. To edit a line, click the cell to be modified. 2. Once the value is entered, the ENTER (or RETURN) key will bring the user to the next cell. 3. On the last step insert (clicking the appropriate buttons) one of the special codes STOP or LOOP.

The meaning of the various field and buttons is as follow:

1-26

Clear line

delete the current line.

Clear All

delete the whole program.

Insert line

inserts a new step between two already existing lines.

Remove line

deletes a step from an existing program.

Description

this field can be used to write a free description about the current flash stimulation program.

Energy

this list allows selection of the flash energy among the available values.

Program #

is used to select one of the eight programs kept in the library.

Acquisition settings

EEG_NT 1.4.2

“DOUBLE FLASH” PROGRAMS A special programming of the flash stimulator is the “double flash” mode used in some clinical study. In this way the stimulator generates a series of “couplet” of flashes. The user can program the frequency of the couplet (time between a couple and the successive) and the delay between the two flashes which forms the couple. The following figures represents an example of such program. To access this type of program select the “Double flash” type in the Type list.

Acquisition settings

1-27

EEG_NT NOTE Remember that “Double Flash” stimulation is possible only with Xenon flash Stimulator.

1-28

Acquisition settings

EEG_NT

1.5

PRESETS - OPTIONS The Options section contains several parameters that influence different aspects of the acquisition process and that cannot be classified in any of the tabs described in the previous sections. This diagram shows this tab in the current release of GALILEO NT (to make a more complete description, we are referring to a preset for a VIDEOEEG data type).

Startup mode

Determines the mode ( CALIBRATION or EEG signal) with which the acquisition will start. And it gives the possibility to choose the default calibration amplitude in the Default Cal Amplitude (ȝV) box.

Ohmmeter

Sets the Ohmmeter threshold. This is only a graphical parameter with no other meaning. During impedance measurement, the electrode whose impedance is greater than the threshold will be highlighted in the ohmmeter display.

Timed Acquisition

It’s possible (Active flag), to create a timed preset, setting its duration in hours and minutes in the TIME ON boxes. This allows, using with this kind of preset, to automatically close acquisition, as soon as the defined duration is reached. Moreover, in MONITORING exam, user can set the number of timed acquisition to make the system automatically carry out. Acquisition settings

1-29

EEG_NT Video EEG

This section is visible only for VIDEOEEG presets. It is used to configure the video frame rate (number of images per second captured by the video device) and the resolution (as the pixel dimension of the video window).

Saturimeter

Here user can select which one of the configured saturimeter wants to be available during acquisition. Choosing the saturimeter in the list, the amplifier section of the Preset editor will be immediately up graded with the 2 DC inputs given by that saturimeter (sat is for saturimeter and HR is for Heart Rate). By default this 2 inputs are in OFF status and with no label to identify the corresponding trace on Galileo NT Viewer. This is the situation generated by the example:

1-30

Acquisition settings

EEG_NT By means of the other Saturimeter box, as shown in the first image, user can also choose if making available the DC Input Box Acquisition device (if correctly configured in the system). This will up grade the Amplifier list with 8 DC inputs (DC1, DC2, …, DC8), that by default are in OFF status and with no label to identify the channel on Galileo NT Viewer. As below:

Acquisition settings

1-31

EEG_NT

1.6

VIDEO EEG With this function we allow the specialized people (INSTALLER user), to configure the acquisition parameters for Video EEG, once the system has recognized (by installation of specific drivers) the available video acquisition devices (video board, web-cam, ...).

With the “OK” button, we access to the “Video EEG settings” window:

1-32

Acquisition settings

EEG_NT This window is composed of three sections “Video”, “Audio” and “General”, where user has to configure: 1. video acquisition device, 2. video and audio compression parameters, 3. duration (in seconds) of the video files.

NOTE It’s mandatory for a sharp synchronization management between video and eeg signals, that video capture device choice is compatible with the chosen device in the dedicated box: “Video device type” (Web cam, DV or PCI card).

Acquisition settings

1-33

EEG_NT

1.7

DC CHANNELS CALIBRATION With this function the user is enabled to perform the calibration of the (eventually) acquired DC channel. Calibration of a DC channel may be necessary to have a correct reading (and display) of the value of a parameter acquired from an external device as for example a pulse-oxymeter. The calibration procedure is possible only on a GALILEO NT station capable of acquiring. In other word the procedure is not enabled in a “replay only” station. To obtain a correct calibration act as follows. 1. Connect the device feeding the signal of interest to the GALILEO NT system. Typically a DC input of the MIZAR Amplifier or an “auxiliary” input will be used, for example AU01. 2. Activate the Configuration / System / Modify Setting mode starting from the menu toolbar of the PMS. 3. Click the Calibrate button. This will open the trace window with all the DC channel displayed on the screen and with the calibration setting window active. (see figure below)

1-34

Acquisition settings

EEG_NT 4. In that active window select the DC channel (DC Channel) to which is connected the sensor and the type of signal (Channel type) the signal you want “calibrate”, insert in the Sensor Name field the name you want call that signal and then click on the Calibration button. 5. In the next window you should acquire the signal of interest in two different “point” to enable the system to calculate the linear calibration factor. In other words you should acquire the input signal in two different point in which the output value is known. This allow the system to calculate the factor for transforming the DC Channel input voltage in the wanted output value.

6. As first step let the system read a known value in the low end of the range of the interested value (this may be due acting on the device feeding the value if this features is present on the device). 7. In the window Channel minimum value wait that the read value stabilize (example 102.34 PV), then click on the left Acquire & Store button and write in the left field Enter physical minimum value the real value of the acquired signal (example 0) 8. As second step let the system read a known value in the high end of the range of the interested value (this may be due acting on the device feeding the value if this features is present on the device). 9. In the window Channel maximum value wait that the read value stabilize (example 102.34 PV), then click on the right Acquire & Store button and write in the right field Enter physical maximum value the real value of the acquired signal (example 100). 10. In the Measure unit field insert the unit of measure of the acquired signal (example %), in the Display offset field insert the physical value you want be represented on the isolelectric of the trace. Check in the Show decimals if you Acquisition settings

1-35

EEG_NT want decimal digits displayed on the number on the screen representing the physical value acquired. 11. Finally press the Calculate button and then the Save and Exit button to terminate the procedure. 12. After doing the procedure close the acquisition and you will return to the PMS window. 13. After this we recommend to try a real acquisition and check that the displayed value are correct. If the values are not correct repeat again the Calibration procedure.

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Acquisition settings

EEG_NT

CHAPTER 2 REPORT EDITORS 2.1

OVERVIEW Patient History (also called Patient Report) and Data Report are two document that GALILEO NT manages, directly basing on one of the following text editor

x Galileo NT internal editor. This is functionally equivalent to a ”subset” of Microsoft WordPad (the standard editor embedded in the various Operative System of the Windows family) x Microsoft Word (an application of the Microsoft Office suite)

The one to be used depend on which is installed in the computer and from the user preference. The current editor is automatically run when the user ask GALILEO NT to open/create a report document (patient History or Data Report). Once the editor is running the user can operate with all the features provided by the program. The only function not more available in both editors (referring to the corresponding functions of the relative editor), is “Save As...”. This is done to avoid users to save documents, instead of in the database, in an not specified folder of the computer. For MS Word this functionality is only hidden, because an accelerator key from keyboard makes the same operation on the document. For details about the use of WordPad or Word please refer to the relative Microsoft documentation.

Report editors

2-1

EEG_NT

2.2

MODELS It is very useful to create one or more “model” of the document below in such a way that all the Patient History or Data Report are formatted in an homogeneous form and reflect the preference of the single user. Further typically the user want to insert in those document some information present in the system (for example the name of the patient), in an automatic way, avoiding to type every time information already inserted. To accomplish this GALILEO NT provides a very flexible method to create and maintain a series of model each of which containing some very useful feature. During the installation of GALILEO NT two particular folder will be created in the GALNT folder

2.2.1

PatTemplate

contains the Patient History model

TrxTemplate

contains the Data Report model.

CREATING/ EDITING A MODEL Model are normal RTF files which can be created or edited ONLY with Microsoft WordPad. NOTE The model MUST be saved in Rich Text Format (RTF).

1. Open an existing model (rtf extension) to modify it or create a new file in the directory mentioned above (depending on if you are editing a Patient History model or a Data Report model). 2. Insert in the document any text and/or image you want to make a document that represent your willing (it is recommended to insert text manually by the keyboard and not, from other text files by the clipboard). 3. Insert in the opportune position the “bookmarks” of the information you want to be inserted automatically by the system when the model will be used to create a real document. Bookmarks are described in the section that immediately follow. 4. Close the document. Remember that the document MUST saved in RTF format.

2-2

Report editors

EEG_NT

2.3

BOOKMARKS To allow the user to automatically insert some information on the report document some standard Bookmark have been defined in the system. When a Bookmark is placed on the document model, when the report is created the bookmark is replaced by its “value” in other word by the information the bookmark is “linked”. NOTE The “translation” of the bookmarks into their effective “value” is made ONLY at the moment of the creation of the report. In other words the bookmark are not dynamic. If a parameter included in a bookmark changes AFTER the moment of the creation of the report the report file will NOT be updated.

In the model a Bookmark is formatted in the following way: < start_code> keyword start_code and stop_code may be one of the following table Start_code

Stop_code

Comment

pat

/pat

Predefined Patient item as in the next table (table 2)

trx

/trx

Predefined Data item as in the next table (table 3)

patstat

/patstat

The item is a Patient Code

trxstat

/trxstat

The item is a Data Code

Table 1 - Bookmark start/stop keywords

Please note that the bookmark can be placed on the model using the text formatting (character type, font, size etc) you want to be applied to the “value”. In order to avoid misalignment when the bookmarks will be replaced in the real document, we suggest to separate, in the model, text from bookmark (when in the same line) by TAB character.

Report editors

2-3

EEG_NT The keyword for tag type “pat” or “trx” are shown in the following table

KEYWORD

Comment

USERPID FIRST NAME LAST NAME BIRTH DATE GENDER HEIGHT WEIGHT STREET CITY COUNTRY ZIP STATE PHONE COMMENTS REC_CREATION_DATE

Patient ID

REC_CREATION_USER REC_MODIFICATION_DATE REC_MODIFICATION_USER REC_ALIAS REC_VERIFIED REP_SIZE REP_MODIFICATION_DATE REP_MODIFICATION_USER

The “Notes” field of the patient Date on which the patient record was created in the archive User who created the patient record in the archive Date of last modification to the patient info User who made the last modification Name of the Archive on which the patient record resides Patient report verification status (Boolean F or T) Patient report size (bytes) Last modification date of the patient history User who made the last modification of the patient history

Table 2 - Patient Item (for tag = pat)

2-4

Report editors

EEG_NT

KEYWORD

Comment

STANDARD_TYPE STANDARD_SUBTYPE FILENAME FILESIZE CUTFILESIZE

Data type Data subtype Filename of data collection Size of the file Selection size (size of the file take in count only the selected part) Time duration of the recording The “Notes” field of the Data Date of recording User who created the recording Last modification date (to recording) User who made the last modification Archive on which the recording resides Data report size (bytes) Date of last modification to the data report User who made the last modification to the data report Review status (Boolean F or T)

DURATION COMMENTS REC_CREATION_DATE REC_CREATION_USER REC_MODIFICATION_DATE REC_MODIFICATION_USER REC_ALIAS REP_SIZE REP_MODIFICATION_DATE REP_MODIFICATIO_USER REP_REVIEWED

Table 3 - Data (trace) Item (for tag = trx)

Report editors

2-5

EEG_NT 2.3.1

BOOKMARKS EXAMPLES 1. Bookmark for the birth date of the patient: BIRTHDATE 2. Bookmark for the recording date of a trace: REC_CREATION_DATE 3. Suppose you have defined the Patient Code “Pathology” and that you want insert the value of the code in the patient history. You will define the following bookmark PATHOLOGY

The following figure shows an example of the model for the Data Report document.

2-6

Report editors

EEG_NT

2.4

PREDEFINED SENTECES MANAGEMENT GALILEO_NT allows the user to automatically insert some predefined sentences on the report document. To configure predefined sentences use the “Sentences” menu: selecting “Configure ”the window shown in the picture below appears. In the window there is a box containing the list of the already existing sentences and three button that permits respective to add a new sentence, to delete or modify an existing one.

“Add” control allows to add a new sentence to the list: digit the sentence in the box and then push “Add” button. To remove an existing sentence , it is necessary to select it from the list and then push the “Remove” control. If the user would like to modify a sentence, it is necessary to select it from the list, to modify the sentence’s text and finally push “Modify” control. Once the user has done one of the previous operations, just click “Save and esc” to save it or “Cancel” to save not. NOTE The digitation of predefined sentences doesn’t contemplate the indent option. If indent is digitated it is automatically removed during the saving operation.

Report editors

2-7

EEG_NT To insert a predefined sentence in the report put the mouse in the chosen point, open “Sentence” menu and select a sentence to insert in the text from the list of available sentences , in which first 30 characters of each sentenceis shown.

2-8

Report editors

EEG_NT

2.5

WARNING ABOUT REPORT SIZE As explained in the user manual of the Patient Management System, the report documents remains always “resident” also when they are actually backed up. This is a great advantage in the daily work, but some consideration should be kept in mind when planning the templates of the reports. You can insert in the template any text you want (formatted in any way the RTF file format allow) and also you can “insert” in the template any “image” as for example the “logo” of your organization: this will make the report very attractive. Take however in mind that “images” are objects that require generally a very large amount of disk space (especially when compared to text). Using templates with one or more images embedded may easily result in a file of more than one Megabyte. Suppose you have a Database with 5000 records (patients + recording) each of them with its own report and you will have more than 5 Gigabytes of space dedicated to the report structure. This may be not a big problem with the disks today installed in any computer but in any case structure of such dimension are generally not efficient in managing. In other word the use of reports of very large dimension may rapidly require the most part of the disk and in the worst case may “saturate” the entire disk capacity. At that point the only chance will be to delete some of the reports from the disk. To avoid such situation the User should carefully plan the report templates taking in count those problems. NOTE We recommend to avoid (or limit to some particular templates) the use of images in the report templates. We recommend to use only text in those documents. Of course you can choose any text “fonts”, colour, and size you prefer to do the better aspect to your reports without incurring in the mentioned problems. Also it must be remembered that if the user needs to transfer the RTF model from one computer to another, he must check that the fonts used in the RTF model are correctly installed in the O.S. of the computer where he wants to transfer the files.

Report editors

2-9

EEG_NT For your notes:

2-10

Report editors

EEG_NT

CHAPTER 3 TRACE ACQUISITION 3.1

OVERVIEW Acquisition is the whole process that leads to the recording on disk of the bioelectrical signal of a certain patient. The following sections will rely only on the acquisition of Electroencephalographic recording (EEG, POLY EEG or VIDEO-EEG). An Acquisition or Recording can be thought of as being divided in two stages: the first one consists of entering the Patient data into the system (or in finding the patient data if already present inside the system), while the second one is the real “capture” of the signal and its storage on disk. The two stages can be started from different points. from the PMS and from the login form when starting GALILEO NT.

Trace acquisition

3-1

EEG_NT

3.2

CREATING A NEW RECORD FROM THE PMS

As described above, a new trace can be created also from the Database manager frame. This can be accomplished in two ways:

3.2.1

FIRST METHOD As explained in the previous section the Acq Wizard can be started from the PMS clicking the Acq Wizard button. For the details of the Acq Wizard see the previous section.

3.2.2

SECOND METHOD Select from the Patient list the patient to which the new recording have to be done. If the Patient does not exist it can be inserted as a new Patient before to proceed). 1. Click the New Data button 2. The system ask for data type

3. Once chosen the type click OK 4. Suppose, as in the example above, the chosen type is EEG GALNT: the EEG manager firstly ask for the Preset to use to start the new recording.

Figure 1: Preset for a Mizar40 head-box configured by PCMCIA set up.

3-2

Trace acquisition

EEG_NT

Figure 2: Preset for a Mizar40 head-box configured by Single Net set up.

Figure 3: Preset for a Be Light head-box configured by Multi Net set up (the head box on the acquisition network is recognized by its clinical name: BE-NET 40026)

5. Note that the default Preset is already proposed in the dialog: so if you simply press ENTER the default preset will be selected and the acquisition will start. 6. Otherwise, if you want a different Preset, open the drop down list, select a preset and click OK. Modify It is possible to modify a Preset before using it: simply clicking the Modify button once choosing the Preset to edit. The “Preset scratch” window will appear; this is similar the Preset Editor window, except for the “Save As” option that in this case is not required.

Trace acquisition

3-3

EEG_NT

NOTE Please note that when modifying a preset from this point the modifications apply ONLY to the current acquisition. In other words the Preset Library is non affected.

Plug-in This button gives the user the possibility to select which of the “Add on” software (set on the system) must be available during acquisition.

Refresh This button, enabled only in Multi Net systems, allows user to make a check of all the configured network acquisition head-boxes available at the acquisition beginning.

3-4

Trace acquisition

EEG_NT

3.3

ACQUISITION FRAME Once the recording of a trace is started, after having entered the required data as explained in the previous section, GALILEO NT opens the trace acquisition window shown below.

The display of the signals immediately starts with the parameters specified in the preset (filters, calibration/use, start-up montage) and with the arrangement of colours/fonts associated with the current user. The acquisition window is composed by the following areas: x One line with the title (the title bar) containing the name of the database on which the trace is being recorded and the patient data. x A line containing the menus (the menu bar). x The upper toolbar (a set of icons and buttons) right under the menu bar. x The lower toolbar under the upper one. x The trace area in the middle. x An area with trace identifiers (montage labels) on the left of the traces area. x A “status” line at the bottom.

All the operations can be performed selecting the corresponding menu items, but the ones used more frequently are also connected to specific buttons in the two toolbars. The toolbars can be moved according to the Windows style, or can be “hidden” on request (menu “Window”). Trace acquisition

3-5

EEG_NT 3.3.1

ACQUISITION - UPPER TOOLBAR

x The three “acquisition mode” buttons (EEG, CALIBRATION, and IMPEDANCE CHECK) are mutually exclusive: only one of them can be active in a certain moment. Selecting a different mode implies the deactivation of the current one. x The FLASH button opens (or closes) the FLASH stimulator management dialog. Details about this are given later on in this section. x In order to remind the user that the signals on the screen are only shown and NOT STORED on disk, the traces window title bar flashes and contains the message “NOT RECORDING”. x Storage on disk can be freely turned on and off as many times as desired, by clicking on the “record” icon (the one with a red circle). x Real time writing (Analog outputs) can be freely turned on and off, clicking on the related button, as many times as desired. Of course this is valid only for system which have a real-time writer (or an Analog output hardware) installed.

3.3.2

ACQUISITION - LOWER TOOLBAR This toolbar shows controls and information about the digital processing and display. It can have two different layouts depending whether it is in POOL EEG or SINGLE TRACE mode. In the POOL EEG mode all the parameters (Sensitivity, Filters) are applied AT THE SAME TIME on all the traces declared as EEG in the current montage. In this case only one Sensitivity value (which is a trace attribute) and one pair of filters are displayed, as all the EEG electrodes will undergo the same filtering.

3-6

Trace acquisition

EEG_NT The POOL EEG mode can be selected at any time clicking on the button shown above, or in the montage labels area, in the space between two labels. The SINGLE TRACE mode allows modification of the display parameters of a single trace (derivation). In this case the sensitivity selected by the user is applied only on the selected trace, whose identifiers appear on the left in the toolbar, and the filters can be selected independently for the two electrodes that make up the derivation. Note that if the second electrode of the derivation is the reference electrode (RF) or the average reference (AR), the toolbar shows only the filters for the first electrode.

In order to select a trace, click on its label on the left of the traces window. In this mode, all the sensitivity changes are performed only on the selected trace shown in a different colour (user-definable). The filters can be managed independently for the negative and positive electrode. Note that the filtering performed on an electrode (for example F8) will be “echoed” on all the derivations that contain that electrode.

Trace acquisition

3-7

EEG_NT

3.3.3

CALIBRATION / EEG MODE

The button switches to CALIBRATION mode. A square wave signal with 1 Hz frequency and a calibrated amplitude that can be selected by the user, is injected at the “entrance” of the processing chain, NOTE For a more detailed explanation about calibration mode of EBNeuro amplifier input signals, please refer to the dedicated section of the corresponding amplifier manuals.

The current montage is automatically substituted by a special monopolar montage made up of as many traces as the number of acquired electrodes, in order to allow the user to view the behaviour of ALL the amplifiers in use. User can therefore evaluate the behaviour of the whole processing chain from the first amplification stages to the presentation on screen. When returning to EEG mode, the user montage selected before the calibration will be automatically restored. To exit from the calibration mode just click on the EEG mode button.

3-8

Trace acquisition

EEG_NT

The button puts the system in the “normal” working condition: the amplifiers input is connected to the electrodes that pick-up the bioelectrical signal on the patient’s body, and the traces shown are the result of the differences of potential as defined by the current montage.

3.3.4

OHMMETER

The measurement of the electrodes contact impedance can be accomplished clicking on the button on the upper toolbar. The system will display the calculated value both in “graphical” form and in “numerical” as showed in the two following figures

Trace acquisition

3-9

EEG_NT

The values are in the range from 1 to 100 KOhm: if the measurement should exceed the upper limit, the value of 100 KOhm will be shown. In the “Impedance Display” table, to any electrodes (cephalic or bipolar) is associated a coloured circle, the colour of which ranges in the chromatic palette on the left of the symbolic head. The circle colour will be near RED when the impedance value overcome the threshold (threshold chosen by the user, or set in the acquisition preset; see Chap. 1); while it will be near GREEN when the impedance value is under the threshold. In the “Impedance List” table the impedance values of all electrodes are shown: for every electrode, if its value overcomes the threshold, a red circle appears in the left column. For the differential bipolar inputs of the XT24/32 and WB24/32 the value shown doesn’t represent the contact impedance of the electrode connected to the patient (in this case there are two electrodes) but how much the positive and the negative electrodes are unbalanced. For the differential inputs of the Basis BE amplifier ( A,B, ...H ) both the value of the positive lead and the negative lead are measured and shown. To close the impedance measurement and return to the normal display, click the x button on the impedance dialog.

3-10

Trace acquisition

EEG_NT 3.3.5

REAL TIME PRINTER

This button manages the start/stop of the real time printing. If correctly set, once printing process starts, thermal paper will be printed out with the speed selected in the relative item under the Trace menu (see after). In particular, the printed pages will present in the upper side the following informations: 1. the sensitivity set in Trace Viewer; 2. the filter values set in the viewer; 3. the Page Speed; 4. the Relative and Absolute Time corresponding either to the first printed second or to the first second of the current page; 5. Event labels inserted in acquisition during real-time printing; Annotation and Spot labels already inserted in the trace, or inserted successively during review. In the lower side there are the following information: 1. the Printing Date 2. the Patient Name 3. the patient date of birth The printed trace area contains the traces displayed as the current montage, but the printer doesn’t accept more than 24 traces. NOTE If one or more traces are filtered with different filter values from the POOL EEG ones, the corresponding value, printed on the upper page, will be the more used one among POOL traces, described with 3 stars (***)

NOTE Real time printing of data acquired with BENET interface and with a sampling rate higher than 512 Hz is not allowed.

Trace acquisition

3-11

EEG_NT 3.3.6

FLASH STIMULATOR MANAGEMENT The FLASH stimulator can be used in 2 different ways: AUTO: in this case the stimulator automatically follows a “program” which can be defined by the user (in the Preset Editor Chapter 1). Such a program will control the stimulation, as the rate of the flashes generated by the lamp can change in time (increase, decrease, hold) with definable speed and times. During the execution of an automatic program the user can at any time “stop” the program keeping the stimulation on (HOLD) or temporarily disabling the stimulation (PAUSE). The user can define eight different programs and can choose at any time which one to execute. How programs are created and modified is described in the section of this manual relative to the presets. MANUAL: the stimulation rate is manually controlled through a potentiometer on the dedicated keyboard, or by the specific graphic component on the software interface of the Flash Stimulator Manager. In each mode, the user can change, as well as the stimulation rate, also the “flash” energy, choosing one of the allowed values for the stimulator installed on the hardware hosting the GALILEO NT software.

The stimulator is controlled through a specific software interface that appears when the user clicks on the stimulator button on the upper toolbar (see images in the previous pages).

Above, the Stimulator Flash window that appears once clicked the stimulator button (compact view). The button under the START button allows the complete view of the window:

Interface description: x The working mode are mutually exclusive and must be chosen in the list on the inferior right side (the user will choose “Manual” for the manual mode, or the name of the program for the automatic mode). Of course only one mode can be active at a certain moment.

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Trace acquisition

EEG_NT x Changing mode will stop an active stimulation. In other words, any stimulation mode always starts with the stimulation turned “OFF”. x Energy and automatic program can be changed ONLY when the stimulation is OFF. x The HOLD and PAUSE keys are enabled only when in AUTO mode, as they have no meaning in the other modes. x In the compact view (available only during stimulation) the working mode is shown (inferior side of the small window) with all parameters of stimulation.

The stimulator can be switched to the “ON” state (flash active), pressing the START button, or to the “OFF (flash inactive) pressing the STOP button (it’s the same button that changes meaning depending on the stimulation state). The frequency is changed with the potentiometer on the dedicated keyboard, or by the graphic potentiometer on the Flash Stimulator window. The frequency selection, in this case, is made or by dragging the indicator with the mouse cursor, or with the key “n” and “p” on the keyboard. The selected value will appear on the left label (during stimulation, the value is continuously up graded , with the corresponding value sent by the stimulation hardware). The energy step can be set or directly dragging the mouse cursor on the “Energy” coloured bar (the selection will be confirmed with a mouse left click), or with the keyboard key “+” and “-“. Energy can be changed also during stimulation.

NOTE There is a limit in Flash stimulation for Frequency versus Energy. In details, the maximum stimulation frequency allowed at the energy maximum value is around 20 – 23 Hz for BE head-boxes.

In the AUTO mode, when the stimulation is ON, the following commands are available: Hold

stops execution of the program holding the current stimulation rate, leaving the stimulation active (the lamp goes on flashing). Pressing HOLD again the normal execution of the program will be resumed.

Pause

similar to the HOLD key, but the lamp will be turned off.

Prev

stops the current program and starts its execution from the PREVIOUS step (see the Preset section for all the details about how a flash program is structured).

Trace acquisition

3-13

EEG_NT Next

stops the current program and starts its execution from the FOLLOWING step (see the Preset section for all the details about how a flash program is structured).

Note that the energy of an automatic program can be changed from the programmed one, but switching to another program the energy will be re-set on the value specified inside that program.

3.3.7

THE STATE MANAGER

From this icon on the acquisition upper toolbar, user accesses to the State Manager. This tool, available only during data recording, allows user to insert, both automatically and manually, a pre-defined state that can be followed also by a generic “Post State”. The available states are those defined in the acquisition preset, user can select the chosen state (for ex. IPERIPNEA), then he can decide if inserting it in an automatic way (checking the “Auto” item) or in a manual way (checking the “Manual” item). In Automatic, he has to set the state duration in the apposite boxes (“State Duration”: minutes and seconds), while, in Manual, the duration of the state will be decided during acquisition by the user himself, opening and closing it by means of “START” and “STOP” buttons. If user needs to insert a Post State after the chosen one, he has only to check the “YES” button on the “Post State” area and to configure its duration in the “P-State duration” boxes, in this case enabled. Checking “NO”, no Post State will be added after the inserted state.

Furthermore, this Stay-On-Top window, displays duration count down (both during automatic state and post state insertion) and gives the following warnings: x

Visual warning: when 30 seconds lack to the end if the state the “Count Down” writing gets yellow coloured.

x

Acoustic warning: when 10 seconds lack to the end if the state the “Count Down” writing gets red coloured and for each of the last 10 seconds a “beep” is given out.

In review, user will see on the trace (and on the navigator bar), not only the black selection relative to the inserted state, but also the Post State one, positioned immediately after the previous. 3-14

Trace acquisition

EEG_NT The automatic state insertion can be closed preventively by means of the “STOP” button. In this case, if a post state is set, the system automatically switches to the post state insertion, that however, can be stopped preventively. During this kind of state/post state insertion, any other way of state inserting is disabled (short cuts, keyboard accelerators, mouse).

User can only insert event on the trace and use the calibration, impedance and EEG mode. Opening the Ohm Meter Window will send immediately the State manager Window on the upper right side of the screen so to do not overlap this 2 applications.

3.3.8

Vertical Split

This controls, that gets active after 20 seconds of data recordings on disk, allows to open a review window for the recording trace. This further window will be automatically tiled vertical to the on-line window. This control gets inactive once launched; not more than 2 EEG window are allowed inside Galileo NT Viewer.

Trace acquisition

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EEG_NT 3.3.9

INSERTING EVENTS DURING THE ACQUISITION In Galileo, event (message, spot, state or annotation) can be freely entered on the trace during the acquisition process, provided that the storage on disk is enabled. Events can be inserted in two different ways: with “accelerator keys” or with a menu, that can be opened with the mouse.

3.3.9.1

Accelerator keys – Spot Messages There are accelerator keys (or combinations of keys on the PC keyboard) for each event defined in the acquisition preset. The attribution of events to accelerator keys is made in the Preset Editor (see Chapter 1). Obviously, accelerators correspond to the spot defined in the acquisition preset. CONTROL+1, CONTROL +2 … CONTROL +0 or A, B, C, …., Z

3.3.9.2

Accelerator keys - States There are accelerator keys (or combinations of keys on the PC keyboard) for each state defined in the acquisition preset. SHIFT+1, SHIFT+2 … SHIFT+0 or A, B, C, …., Z The key starts – at the current acquisition point – the insertion of correspondent state message (as defined in the acquisition preset). The state will remain active until it is turned off, with the same accelerator, or by inserting another state. While the state is active, on the status bar a stopwatch will be displayed, showing the duration and the name of the state. Del

3.3.9.3

Disable the current status (if any enabled).

Accelerator keys – Annotations Ins (or Insert) Opens a small dialog box in which the desired annotation can be entered. Regardless the time needed to type it, the annotation will be inserted exactly in the point corresponding to the moment in which the Ins key has been pressed on the trace window.

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Trace acquisition

EEG_NT

NOTE The “CONTROL+1” notation means that the user must press the “1” key while the CONTROL (or CTRL) key is kept pressed. The “SHIFT+1” notation means that the user must the “1” while the SHIFT key is kept pressed.

3.3.9.4

Inserting events from the menu During the acquisition, double-clicking with the left mouse button on any part of the traces area, a menu will be shown containing all the events defined in the current preset. From the menu it is possible to choose an event that will be inserted in the trace at the point on which the double-click has been performed.

Trace acquisition

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EEG_NT

3.4

ACQUISITION OF A VIDEO EEG TRACE Acquiring a trace with VIDEO EEG means that while trace data is stored in the usual way, the system also records the video information coming from an external camera in order to monitor the behaviour of the patient and its relationships with the trace. During the replay stage the system allows to review the recorded trace and the video information synchronously. In order to start a synchronous trace/video recording, the selected trace type in the preset must be VIDEO-EEG (see chapter about presets).

In this case the system will perform all the operations needed for the video recording together with the trace file. The system will write the video file (which typically has a large size, being a collection of images that – even compressed – take a considerable amount of space on disk) on one of the drives that (during the installation process) have been enabled to store such information. If the system has been configured with more than a drives for this purpose, you will be asked which one is to be used during the acquisition that is going to start. Once chosen the storage drive for the video file (if prompted), the acquisition starts in the usual way, with the difference that the video window will appear on the monitor, showing in real-time the images coming from the camera.

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Trace acquisition

EEG_NT

Video EEG recording is driven only by the “Record” button on the Galileo EEG viewer. Starting storage on disk from this button, will automatically start Video storage.

Trace acquisition

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EEG_NT 3.4.1

THE VIDEO WINDOW Following, a detailed description of the whole Galileo NT Video EEG main window.

3.4.1.1

The Video Frame This frame, according to the resolution size set in the acquisition preset, will show the complete image coming from the video capture device configured for the acquisition.

3.4.1.2

The upper toolbar The state of acquisition appears on the blue title bar ([REC] if the system is storing video data on disk, [PAUSE] if it is not storing video data on disk and [WARNING] if for any reason, the video acquisition system, is loosing frames) next to the indications of relative and absolute time of the recording date. During the whole recording there are only four active buttons on the video toolbar:

1. “Stop Capture” button: to stop only the video acquisition 2. “Zoom Video”: to perform zooming on the image 3. “Normal Size” button: to show the video window with the dimension set in the acquisition preset 4. “Full Screen” button: to extend video window dimension to the monitor size

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Trace acquisition

EEG_NT NOTE To “escape” from the Full Screen visualization, use the “ESC” key or the “Normal Size” button either the “Full Screen” one.

Stopping video acquisition Since the acquisition of both video and trace is very heavy, overall because of the occupation of space on the hard-disk, Galileo NT Video EEG system, allows user to stop video storage, keeping on the EEG acquisition. This is required meanly during long term monitoring of the patient, for example, when patient is quiet and doctors don’t assume video data to be a further information to understand patient state. To stop video capture, there is the “Stop Capture” on the video toolbar, from that moment the video toolbar will be the one shown below:

5. “Start Capture” button: available once stop video recording. It is used to start again video capture. User can restart video recording whenever he wants. This process grants for continuity of synchronization, between video and trace, also after the re-starting of video storage.

3.4.1.3

The lower Status Bar This status bar is normally empty, but for particular configuration, it can show the following information about video capture:

1. Number of captured frames from recording start. 2. Number of loosed (dropped) frames from recording start (normally this number should be 0). 3. Number of seconds from start of recording. 4. Frame rate set in the acquisition preset (depending on the video acquisition device characteristics). 5. Resolution of the video set in the acquisition preset (depending on the video acquisition device characteristics).

Trace acquisition

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EEG_NT 3.4.2

VIDEO DIGITAL ZOOM Exploiting the video image resolution of a VIDEOEEG trace, it is given the user the possibility to perform on it an highly configurable digital zoom, available both in acquisition and in review. This function will be very useful to inspect portions of the video image, to stir inside the same image, searching for important details and to effect the acquisition video focusing on a particular zone of the image; always maintaining the synchronism with the EEG data file.

Through the dedicated icon on the video window toolbar, a further panel (zoom frame) will appear inside the window video, representing the scaled window video. The proportions with which this frame can be sized respect to the window size, is different and goes from 1 (the zoom frame is in 1:1 scale with the video window) to 10 (the zoom frame is in 1:10 scale with the video window). In the figure above the proportional factor between zoom frame and video window is 5.

Inside the zoom frame, a red-edged panel appears, that represents the portion of image indeed displayed. User, at this point can inspect the total image both moving with the cursor inside the zoom frame, and, according to the configurations, exploiting or the mouse pointer click (“Arrows”) or the dragging the mouse pointer on the video window (“Drag and Drop”). For further implementations of the image zoom, dedicated keys can be used; the “Zoom In” through the “+”key (plus) and the “Zoom Out” through the “-” one (minus). The system can subsequently be configured to the same functionalities with the “Pag Up” and “Pag Dn.” keys. NOTE The configuration of the video eeg zoom is of pertinence of the EBNeuro technical personnel or of an experienced user opportunely trained by EBNeuro.

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Trace acquisition

EEG_NT

3.5

3.5.1

3.5.2

THE ACQUISTION WINDOW MENU

FILE MENU

Vertical Split

After 20 seconds of data recording on disk, this control gets active and opens a review window for current data trace. This window tiles vertically the on-line trace, during its acquisition. Once Split Vertical is launched, this control gets inactive (system doesn’t bear more than 2 EEG windows into Galileo NT viewer).

Exit

stops the acquisition, closing the file, and exits from GALILEO NT returning to the Windows desktop.

TRACES MENU

Write On Disk Enables or disables the storage on disk of the acquired data

Analog Output Enables Analog outputs and starts printing on the real-time printer (if some is defined in the system).

Flash Same function as the button (see related section) Trace acquisition

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EEG_NT

State manager Same function as the button (see related section)

Use Same function as the button (see related section)

Calibration Same function as the button (see related section)

Ohmmeter Same function as the button (see related section) Real Time Writer Select the paper speed of the real-time writer

Start next file Enables continuous acquisition on the current file for monitoring exams (not yet implemented). Trace Setting Shows a summary with the traces parameters (sensitivity, status, etc. – see LIBRARIES, Montage Editor for a detailed description of this form)

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Trace acquisition

EEG_NT 3.5.3

TOOLS MENU

Graphic Option Allows the setting of some parameters related to the color palette to be used while transferring images to the Windows clipboard or when an image (i.e. the traces window) is saved on file. Filter Setting Opens the summary table containing the filters on the acquired electrodes for the current trace. The table (see diagram below) also allows editing of the values to be applied. The same operations can be performed with the controls on the processing toolbar, but this view can be useful to have an “overall view”. Montage Option Recalls a dialog box in which a montage can be selected (in the same way as if it was selected from the main toolbar) or the montage editor can be invoked in order to manage the montages (edit existing montages or create new ones). The user can select a montage from the file (On Trace) or picking the a montage from the general montage library (Library) in this last case the montage will become part of the montage linked to the file. (see also chapter 6)

Trace acquisition

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EEG_NT User parameter settings

This window, available both in acquisition and in replay, gives the user (whose name appears on the title bar) the possibility to edit the parameters used to show data on Galileo viewer. These settings goes from the trace area colour to the Batch print setting and the digital filter values. The filter configuration is available only for user INSTALLER. WRITER and READER will be prompted the following window, accessing the “Filters” section:

Setting modification will be saved only by closing this window with the “Save” button, otherwise (“Cancel” button) no modification will be kept. For Filter Settings and map representation, changes will be actualised only next time the same user will open a trace, while any other change will be actualised immediately.

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Trace acquisition

EEG_NT Display: This section is to customize the way of presentation of traces and events or states, on the viewer. Show Events

Enables or disables the display of Events (in a global all/none way)

Show second grid

Enables or disables the display of time grids

Show trace area

Enables or disables the display of frame around the trace area

Show Horizontal scroll bar

Enables or disables the display of scroll bar (under the traces area)

Colours

This section is to customize the colours of some areas of the window and of different kind of channels

EEG Channels

Allows to choose the colour of the traces made of channels described with “EEG” type in the acquisition preset

Polygraphic Channels

Allows to choose the colour of the traces made of channels described with “Poly” type in the acquisition preset

Highlighted Channels

Allows to choose the colour of the traces selected on the viewer (selection is made by means of the mouse cursor on the trace label)

Window background

Allows to choose the colour of the window background (the one around the trace area)

Trace background

Allows to choose the colour of the trace background ( the one where traces are drawn)

Font

Allows the user to customize fonts (and colour) of some text areas on the window (as montage labels, events…).

Label

Allows to choose the colour of montage labels on the window background.

Events

Allows to choose the colour of spot, state and selection name on the trace background.

Trace acquisition

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EEG_NT Show plug-in choose form on replay start This flag allows the user to be prompted or not with the “Available Tools” window opening the trace. Maps - 2D Maps enabled This flag, if checked, makes available the 2-Dimension representation of Potential and Spectral Maps (otherwise 3-Dimension representation is shown). VIDEO-EEG – VEEG Fast-forward speed Sets the speed of video EEG fast forward replay (theoretically, available values range from 1 to 10, but the maximum value of reproduction is strictly conditioned by the computer performances). Batch Print: The background print module needs some information to do its work. To view/modify the parameters that influences the batch printing select this section: the following window will be shown.

You can choose various parameters of the batch print mechanism: -

The font of the montage labels (”Label Font”)

-

The font of the time information displayed along the axis of the page (“Axis Font”)

-

The font used to print the event (“Event Font”)

-

If printing or do not printing the time grid (“Grid”), the sensitivity of each trace (“Sensitivity”),the events (“Events”) and the current montage name (“Acq. Montage”)

-

The time length of the page (”Page Speed”)

-

The EEG trace line width.

If in the trace there are more than one PRINT selection, with different length, the batch print, for every selection, will give the printing of one or more pages, whose 3-28

Trace acquisition

EEG_NT length is given by the “Page Speed” setting. (also if the selection duration is lower than the Page Speed value). Once saved the settings will be valid until modified Filters: This section is dedicated to the Digital Filter configuration (type and values). These filters are available to user when he displays traces on the screen (both in replay and acquisition). As we said before, this configuration is permitted only to INSTALLER user.

Choosing type of low-pass digital filters By checking the “Low pass filters TC” flag, user will choose to display Low-Pass filter value by means of time constant (sec), otherwise these values will be in the frequency domain (Hz). The not available Low-Pass filter list will be greyed as we can see in the figure above for the Low Pass filter list. Editing new value for digital filters User can edit/add filter value simply by mouse clicking on the “N/A” box. Indeed the values that precede the “-----“ are fixed, but from this point on user can add/edit new values. In the window above, user added 1.33 Hz and 1.5 Hz. This operation, next time the same user will open the trace, will result in an up-grading of available LP filter values on the “processing” toolbar of Galileo viewer.

State event manager Shows the State Manager window (see Par. 3.3.7). Trace acquisition

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EEG_NT 3.5.4

REPORT MENU

There are two type of report in GALILEO NT: the Patient Report, called also Patient History which is linked to a patient and the Data Report which is linked to each recording. Both are electronic document managed by system software (typically the internal GALILEO NT editor or Microsoft WORD). For a complete description on how to create your own report template see chapter 7. However, report generation/editing is not available during trace acquisition, since sometimes this operation can hinder data acquisition flow. To avoid this we make report generation available only from database main window.

3.5.5

WINDOW MENU

Contains the typical Windows commands to: x enable or disable (hide) the toolbars x copy the traces page to the Windows clipboard, from where it can then be imported to other documents. x save the traces page (as an image) to a file. x arrange the GALILEO NT windows in the standard modes.

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EEG_NT

CHAPTER 4 EEG/VIDEO-EEG RECORDING REVIEWER (REPLAY) 4.1

OVERVIEW With the terms “replay” or “review” we indicate the “opening” of a data file (acquired since some times) and all the operation the user can perform in order to: x display the acquired data in various form x “browse” in any part of the tracing x “mark” or annotate any significant event on the tracing x select some part of the tracing to do successive elaboration x open or the Data Report or the Patient History to write on any wanted annotation. x print some part of the recording

The following sections treat only of the “EEG” (EEG, VIDEO-EEG) data type. Other data type (example EP, EMG) that the GALILO NT PMS can manage have their own manuals. Please refer to the relative documentation.

EEG/VIDEO-EEG recording reviewer (Replay)

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EEG_NT

4.2

OPENING A DATA FILE FOR REPLAY This operation can be performed both from the Patient List tab and from the Data List tab.

From the Patient List When the Patient List window is activated, the lower part of that window show the recording linked to the current (selected) Patient. To open a recording -

Select the Patient of which you want to examine a recording.

-

Select the wanted recording among the various he can have

-

Click the View Data button or double click in any point of he line containing the selected recording.

From the Data List x Make the Recording you want to examine the current record simply clicking on any point of the line containing it. x Click the View Data button or double click in any point of he line containing the selected recording.

Selection of tools of add-in software Opening the trace (if the system was correctly configured) the “Available Tools” window is shown to the user. Here he can choose which of the post-processing (bought) software making available in replay:

The following pages will illustrate the various feature of GALILEO NT VIEWER.

4-2

EEG/VIDEO-EEG recording reviewer (Replay)

EEG_NT

4.3

THE REPLAY WINDOW The following diagram shows a typical sample of the traces display during the replay of an EEG trace.

The significant elements (that will be described in the following pages) are: x the title bar x the menu bar x the “main” toolbar x the “montage” toolbar x the “filter” toolbar x the “navigator” bar x the traces area x the status line

EEG/VIDEO-EEG recording reviewer (Replay)

4-3

EEG_NT 4.3.1

THE TITLE BAR The Title bar simply show the name of the database where the trace is stored, next to the name of the Patient the recording is related to.

4.3.2

THE STATUS BAR The status bar show some important information about the recording

1. The “absolute” time (time of the day) referred to the first second (the leftmost one) of the displayed page. 2. The “time” duration of the entire recording. 3. The time of the first second displayed (the leftmost one) “relative” to the beginning of the recording (called also the “elapsed” time). 4. The date on which the recording was made. 5. Eventually, if the cursor to scan the trace is present on the replay window, this number represents its time position (hh:mm:ss,msec) relative to the beginning of the current page. Depending on the operation performed, some other information can be showed in the status bar. When applicable, this will described in the following sections.

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EEG/VIDEO-EEG recording reviewer (Replay)

EEG_NT

4.4

THE “MAIN” TOOLBAR

Prints the current page on the system printer

When a recording is opened for reading, GALILEO NT can build four different windows of the acquired data: the traces, the representation as potential maps, as frequency maps and the display in the frequency domain (spectra). The four buttons open each of the four views. The last two may be actually enabled or not depending on the type of license the user has acquired from EBNeuro (and by means of the “Available Tools” Window shown accessing the data trace).

This controls, that gets active after 20 seconds of data recordings on disk, allows to open a review window for opened EEG/VideoEEG trace. This further window will be automatically tiled vertical to the first window. This control gets inactive once launched; not more than 2 EEG window are allowed inside Galileo NT Viewer.

4.5

THE “MONTAGE” TOOLBAR

This toolbar contains some buttons and two drop-down list. The scope of each of them is described below.

Opens the page length (temporal window) selection list.

Opens the montage selection list. EEG/VIDEO-EEG recording reviewer (Replay)

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EEG_NT

NOTE The selection of a montage from those contained in the file can be performed by simply opening the list and selecting the desired montage

The first montage in the list is always the “Acquisition” one: by selecting this montage the system will use exactly the same montages and with the same sequence used during the acquisition. With this mode, moving along the trace, in each point the system will automatically activate the montage that was selected in that point during the acquisition, showing its name in the montage control. In order to show which mode is active, when the “ACQ MONTAGE” mode is selected, the montage names will be shown in the montage control followed by an (A). To disable this mode, just select another montage from the list, and that montage will remain until another is selected with no regards to the montage used during the acquisition.

The four buttons move the displayed portion of the trace one page backwards (). (further details in the following pages)

Enables or disables the automatic replay (further details in the following pages)

Enables/Disables real time printing (when present on the system)

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EEG/VIDEO-EEG recording reviewer (Replay)

EEG_NT

4.6

THE “FILTER” TOOLBAR

The explanation about the processing toolbar is exactly the same as that described in the chapter about ACQUISITION. Please check that section of manual for more details.

EEG/VIDEO-EEG recording reviewer (Replay)

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EEG_NT

4.7

THE NAVIGATOR BAR When “reviewing” a trace, the user needs to quickly move in different directions on the recording, further he needs to know immediately which portions of the recording can be significant as somehow highlighted during the acquisition. The navigation bar and the trace “browsing” controls in GALIEO NT are the answer to these requirements.

4.7.1

INFORMATION ABOUT THE TRACE The navigation bar represents a summary of the trace from the point of view of its length and ALL the annotations (messages, states, notes, system states) that have been inserted during the whole acquisition process. It is represented by a thin red bar whose length represents the WHOLE recording. in cases of recordings shorter than one hour; (the case of longer recordings is discussed further on) and for simplicity only those shorter than one hour will be described for the moment. The red bar can have some “white” zone: this represent the times during which the acquisition was “paused”. Inside the red bar there is a small blue area that represents the position and the length of the displayed page. Above the red bar there are small vertical lines that represent the points where “spot messages” or “annotations” have been inserted into the trace. Still above the red bar there can be areas with different colours (small rectangles) that show the relative position and duration of “user-inserted states” or “system states” like, for example, calibration, impedance test, flash stimulator on, etc. The diagram below represents a typical example.

Moving the mouse pointer over the red bar and on the symbols connected to it, a set of useful information can be obtained. The following diagrams provide some examples of the different situations.

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EEG/VIDEO-EEG recording reviewer (Replay)

EEG_NT

Placing the mouse pointer over any point of the navigator bar, the “tool tip” that automatically appears shows the absolute acquisition time at the point identified by the mouse pointer.

Placing the mouse pointer over any point of the coloured bar of a state, the “tool tip” that automatically appears shows the name of the inserted state and the elapsed acquisition time from the starting of the status to the point identified by the mouse pointer.

If the mouse pointer is placed over a vertical bar representing a message or an annotation, the “tool tip” that automatically appears shows the name of the message inserted at that point and the absolute acquisition time at that point.

EEG/VIDEO-EEG recording reviewer (Replay)

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EEG_NT 4.7.2

THE NAVIGATOR BAR WITH LONG RECORDING The above section described the navigator bar when the recording length is less than one hour. If the recording duration is more than one hour the navigator bar will look as in the figure below:

The navigator is now formed by two “bars”: the upper which represent the entire recording and the lower which is the “zoomed” view of the “current” hour. The information inside the two bars are exactly the same and have the meaning described in the previous section. When double clicking in any point of the upper bar immediately the system select 60 minutes of recording centred on the selected point and displays the lower bar accordingly (from the selected time – 30 minutes to the selected time + 30 minutes); the current page becomes the one related to the time selected with the double click on the upper bar. When “browsing” along the recording (see next section) both the bars are updated with the rule described.

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EEG/VIDEO-EEG recording reviewer (Replay)

EEG_NT The “Two Bars” visualization, can be disabled, with a right-click of the mouse pointer on one of the navigators and just selecting the “One/Two bars” item.

To recover the “Two bars” mode, it’s necessary to do the same thing and select again the “One/Two bars” item.

4.7.3

MOVING ACROSS THE TRACE The navigation bar, besides providing the information described in the previous page, allows the user to move quickly from one point of the trace to another. In particular, if we denote with “DC” the “double click with the left mouse key” operation, we have the following functions: x DC on any point of the navigator bar: the display will immediately move to the point of the recording identified by the position of the mouse. (this is true for both the navigator bars when applicable – see previous sections) x DC on a vertical bar representing a message: the display will immediately move to the point identified by that message, centring on it the current page. x DC on a part of a rectangle representing a state: the display will immediately move to the point identified by that state, centring on it the current page. EEG/VIDEO-EEG recording reviewer (Replay)

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EEG_NT Once the desired point has been reached, the user can move with the “standard” display movement commands that are summarized below.

or key o moves in time one second forward.

or key PgDown moves one page forward (the actual movement in seconds depends on the page length).

or key m moves one second backwards.

or key PgUp moves one page backwards. (the actual movement in seconds depends on the page length). key Home jumps to the beginning of the recording. key End jumps to the end of the recording.

Another way to move on the trace is the “automatic replay”. This modality can be enabled or disabled through the button shown on the left. The ESC key disable immediately the automatic replay mode. Enabling the automatic replay, the system will automatically show the trace page by page, moving forward in time without the need of clicking or pressing any key. The speed at which the pages are shown can be controlled by setting the delay in milliseconds between two pages. This parameter can be modified through an option in the “Trace” menu that will be described later.

During the automatic replay, the movement of the pages can be stopped and restarted from the same point pressing on the spacebar of the keyboard or clicking on the auto replay button.

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EEG_NT

4.8

THE EVENTS In general, “EVENTS” are all the annotations (messages, states, notes) that accompany a trace. An event is described by its type, its position on the trace file, and possibly from its duration. In GALILEO NT the following event types are defined: Message (Spot Message)

This is an event inserted by the user, made up of a short comment (not more than 16 characters, it does not accept null strings). It is defined from its position on the trace and has no duration. As described in the chapter 6, the user can pre-define a set of messages and then “attach” one of them to the trace at a selected point, both during acquisition and replay.

Annotation

This is similar to the “spot” message, but in this case the user can insert at the selected point a real multi-line comment and not only a short string.

State (Status Message)

This is similar to the “spot” message (not more than 16 characters, it does not accept null strings), but it has a duration. The user can select the start and the end points of a certain state. As usual the user can pre-define a State set, in the same way as the “spot” events.

Selection

User can “mark” portions of the trace of arbitrary length, in order to apply to them particular kinds of “processing”. Some examples are the “print” selections for Batch printing (the selected portions will be printed in off-line mode by the appropriate utility) or the “transfer” selections (as User option, during a copy or back-up operation, ONLY the selected areas will be transferred or backed up).

In the section of this manual about the Navigator, it has been described how the events are “graphically” shown to the user. Of course the navigator provides an approximate value of the position of the single events (the resolution depends on the relation between the graphic pixels along the horizontal axis of the monitor and the actual duration of the trace). There is of course a way to know the exact situation of events (how many are present in the trace, and where they are exactly, etc.); this will be described in the following sections.

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EEG_NT 4.8.1

DISPLAY OF EVENTS ON THE TRACE In the previous pages we described how the events are shown on the Navigator bar. The way in which events “falling” in the current page are shown, is explained in the following diagram:

The presence of three “spot” events is shown. NOTE The position of an event is entered with 1 millisecond resolution, and with such resolution the information is stored on the file. The position on the display depends of course from the resolution of the screen.

x

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A spot event is shown by the identifying string (its name), written vertically inside the second in which the event is found.

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EEG_NT x

A state is shown by writing an horizontal line on the display. The line is written on all the seconds in which such a state is active. If more than one state is active in one zone of the tracing more line will be displayed.

x

A selection is shown by writing an horizontal line on the display. The line is written on all the seconds in which such a selection is active. If more than one selections is active in one zone of the tracing more line will be displayed.

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EEG_NT

x

An annotation is not shown writing its content (that can be considerably long) but writing in the corresponding second the “Annotation” string.

To “see” the content “hidden” under that name, just double-click on the “Annotation” string. A dialog box showing the entire annotation will be displayed

From the above dialog box you can: x Modify the text of the annotation : click on the text and modify it as required. x Remove the annotation from the recording : click the Remove button.

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EEG_NT 4.8.2

EVENTS DISPLAY FILTER If the user doesn’t want to view the event labels on the trace viewer (because they confuse the layout or because, for example, he doesn’t want the messages to appear in printed pages), it is possible to completely hide all the events in two ways: a global one to show/hide all the event labels on the EEG layout and an accurate one to show/hide only certain events or a group of them. The first way to hide from the trace viewer all the inserted events, is that of deselecting the “Show Events” item from the “Graphic” section of the “User Settings” tool. This tool can be accessed both from the “Tools” menu and with the right-click of the mouse on the trace window. The most accurate way to hide one or more events from the trace display can be accessed with a right-click of the mouse anywhere on the navigator bar, choosing the Show/Hide item.

A dialog box will appear, with the event display filter:

The Filter section is used to set the type of events to show in the left list. Once selected the type of events, the display status of the whole event list can be modified using the two buttons in the Selection section (green light: event shown; red light: event hidden). Also the status of a single event can be changed, by right-clicking on its name into the list, and selecting the appropriate item.

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EEG_NT 4.8.3

EVENTS LIST - EDITING / SEARCH Selecting the Search/Select option from the event menu, obtained by a rightclick on the navigator area, gives access to a dialog. This shows a summary of the event situation, providing the complete list and allowing the user to perform several operations (Selection and Search dialog).

NOTE This dialog can also be opened by double-clicking on the name of any event on the trace (except annotations, for which the content of the annotation itself is shown).

The list shows the events in chronological order, with temporal position and duration. Of course duration is zero for spots and annotation events. On the right, the Filter section allows to show only certain types of events (“All Events”) or a specific event (“Single Event Type”), that can be repeated several times along the trace. The number of events found in the list (“Number of Events Retrieved”) is shown in the top right section and depends on the event filter settings). An event can be selected from the list by clicking on its name: the line containing the event will be highlighted in blue. The three buttons under the list have the following functions:

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EEG_NT Go ! closes the Search/Select dialog and moves to the display point on the trace, where the selected event is to be found, centring it in the current window. NOTE After this kind of “seek”, the F3 and F4 keys will move the display back to the previous (backward search) or onto the next (forward search) occurrence of the specified event. These commands can also be found in the events menu (rightclick on the navigator area).

Prev Event selects, from the event list, the event with the same name that comes immediately before the selected one, and selects it.

Next Event selects, from the event list, the event with the same name that comes immediately after the selected one, and selects it. The three buttons in the Edit section have the following meaning.

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EEG_NT Edit single Event With this command, the parameters of the selected event can be changed: position, duration (if the event type allows it), or name. This is done by inserting another event from the list or entering a new event type. For the annotations the editing dialog is necessarily different from the one for a spot or state.

Remove Single Events Deletes the selected event (after asking for confirmation) Remove Group of Events The action is performed on a category of events (All Events) or on all the occurrences of the selected type (Single Event Type). Confirmation is required before accomplishing the deletion. In the example on the right, all the occurrences of the “Artefatto” event will be deleted. As deletion is permanent and unrecoverable, we recommend to pay particular attention when performing this operation.

Close This command closes the events Search/Selection dialog.

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EEG_NT 4.8.4

ENTERING NEW EVENTS ON THE TRACE DURING REPLAY In the previous sections we described how to view, modify or delete the events that are already present on the trace during the replay. We still have to understand how the user can enter an event of the selected type in the desired position. The insertion of an event can be done on the current page or directly on the navigation bar. The second method of course doesn’t allow precise setting of the input point (especially with long traces) but is very useful when a long portion of the trace has to be marked; in this case speed and ease are more important than accuracy setting the start and end points. We will consider first the input of a single event on the current page. This can be accomplished with the following procedure.

4.8.4.1

Inserting a “spot message” or “annotation” on current page Holding the CONTROL key on the keyboard, move the mouse pointer to the desired position and click with the left mouse button (the vertical position is not relevant, as the current release of GALILEO NT doesn’t support events linked to a specific trace: the event is simply linked to a time position inside the trace). The spot event input dialog (shown below) will appear.

The blue line shows the point on the trace where the event (that the user will choose in the dialog box) will be inserted. If the user wants to insert a spot event from the list, a new spot event, or an annotation (i.e. all events that have no length) he/she need only select the appropriate radio-button, choose the event from the list, drag with the mouse the cursor on the exact point you will insert the event and press the Insert button. EEG/VIDEO-EEG recording reviewer (Replay)

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EEG_NT The event will be entered, the dialog will be closed and the display (traces area and navigation bar) will be updated with the new event. The next paragraph will explain how to insert a state or a selection, that is events with a non-zero length.

4.8.4.2

Inserting a “status” or a “selection” on current page Holding the SHIFT key on the keyboard, move the mouse pointer to the desired position and click with the left mouse button (the vertical position is not relevant, as the current release of GALILEO NT doesn’t support events linked to a specific line: the event is simply linked to a time position inside the trace). The status/selection event input dialog (shown below) will appear.

To insert a state during the replay, just proceed as if inserting a spot message, and then “grab” the coloured bar that shows the current insertion point and drag it to the end point. The end point can be on the right of the starting point (dragging it forward in time), or on the left of it: in this case the system will adapt to the situation (swapping the start and end points). The highlighted area represents the section in which the state (or selection) will be inserted operating on the dialog controls. The user can insert a state selected from the list, insert a new state, or a “selection” (i.e. a PRINT, TRANSFER or PROCESS mark that will be described later on). The exact start and end time, as well as the duration of the area where the event will be inserted are shown in the dialog box in a numeric way. 4-22

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EEG_NT When the user clicks on Insert, the dialog and the highlighted area disappear, and the selected event is inserted on the trace in the selected position. The Cancel command will abort the operation. If the state to be inserted is longer than one page, the following procedure can be followed: x drag the selection cursor to the end of the page x release the mouse button x holding the CONTROL key, grab the left end of the highlighted area (which stopped approximately one second before the end of the page) and drag it toward the right: the display, together with the highlighted area and the blue bar on the navigator will jump one page forward. The highlighted area will now end on the last second of the current page x repeat the previous two operations as many times as needed (you can check on the navigator the length of the area being selected, by looking at the black line right under the navigation bar – see below) x on the last page, the position of the end point can be corrected (moving it backwards) with the usual “drag and drop” method. NOTE This works also backwards, dragging towards the beginning of the page (towards the montage labels) instead of towards the end of it.

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EEG_NT 4.8.4.3

Inserting a “status” or a “selection” directly on the navigation bar The selection of the point for the insertion of a spot event or the selection of an area for the insertion of an event with a certain duration (states, selections) can be made directly using the navigation bar instead of the traces area of the current page. Considering the resolution in space and time of the navigator, it is obvious that this second method is preferred when an event with duration (state, selection) has to be inserted, and especially if the event is longer than several pages. This can be done in a way similar to the one explained earlier. Start by clicking on the point of the navigation bar where the event should start, then move the mouse pointer on the navigator bar, while holding down the left key of the mouse, until the final point of the event (or selection). Now release the left key of the mouse You will get the following situation: x choose the state or the selection to be inserted x confirm clicking on the Insert button

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EEG_NT As an example the above diagram shows, the insertion of a PRINT selection. The PRINT selection means (as will explained in detail in another section of this manual) that the selected area will be the one printed with the GALILEO NT “offline printing” utility.

4.8.5

SELECTIONS ON THE TRACE DURING REPLAY As described in the previous sections, a “selection” is considered by the system exactly as a state. However, the selections have the purpose to “mark” portions of the trace in order to apply certain operations ONLY to the selected parts. The current release of GALILEO NT allows the use of the following selection types: x PRINT

selection

x TRANSFER selection x PROCESS

selection

PRINT the selected portions will be printed by the ”batch” printing utility TRANSFER the selected portions (and only those) can be transferred during the back-up or copy procedure discharging the other portion of the recording. This is of course an user option. Please see the backup section of this manual for details. EEG/VIDEO-EEG recording reviewer (Replay)

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EEG_NT NOTE When a recording (trace) doesn’t contain any TRANSFER selection, it is automatically considered ALL enabled for the BACKUP (or Transfer)

PROCESS the selected portions will undergo further processing (see for example the spectral map computation). NOTE A trace can contain several types of selections at the same time. On a trace there can be an indefinite number of selections of the same type (i.e. five different portions marked for PRINT).

4.8.5.1

Inserting selections on the trace with keyboard As already explained, a selection is considered as a state, and therefore all the methods described in the previous sections can be used to insert it. However, considering the peculiarity of these kind of events, they can be entered also using another method, that allows selection of the whole page under inspection. Each time a page is selected for the desired type, the system will append it to the global selection map. This method uses the keyboard to mark the whole page for a certain purpose; in particular: P key

selects for PRINT

T key

selects for TRANSFER

R key

selects for PROCESS

Note that with these keys only selection can be performed. Once a page has been added to the selection it cannot be de-selected using these keyboard shortcuts.

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EEG_NT 4.8.5.2

Deleting selections on the trace Selections are events, from any point of view. They will therefore appear in the event list together with all the other events. With reference to the previous example, if the Selection and Search dialog is opened from the event menu the following situation will be presented:

The selection in the previous example is highlighted in the above diagram.

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EEG_NT 4.8.5.3

Deleting a single event 1. Select the event (for ex. TRANSFER) you want remove from the list. 2. Click the Remove Single Events button and confirm.

4.8.5.4

Deleting ALL the occurrence of an event Click the Remove Group of Events button . The following dialog will appear: 1. Check the “Radio button” Single Event Type (see the figure above) 2. Open the drop down list 3. Select the event of which you want remove all occurrence in the recording 4. Click the Yes button

The figure above shows an example regarding the removing of all the occurrence of the PRINT selection. When confirmed, ALL the portions marked for PRINT will be “unmarked”.

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EEG_NT 4.8.5.5

Deleting ALL the events of a group Click the Remove Group of Events button. The following dialog will appear: 1. Check the “Radio button” All Events. 2. Check the box relative to the “group” of events you want to remove. You can choose among Spot Message, Status Message and Selection. 3. Click the Remove button and confirm.

In the example showed above ALL the “selections” (print, transfer, etc.) will be removed from the trace.

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EEG_NT

4.9 4.9.1

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THE MENUS IN THE REPLAY WINDOW THE FILE MENU

Batch Print

Starts background printing process. System will send to the default printer, all the trace pages selected for printing (PRINT selection).

Print

Prints the current page.

Print Preview

Previews the page that will be printed.

Printer Setup

Allow to view/modify some parameters of the current printer or to choose a particular printer when more than one are installed on the system.

Vertical Split

With this command a new window for the same data trace will be opened and automatically tiled in a vertical mode near the first one. This control gets inactive once launched; not more than 2 EEG window are allowed inside Galileo NT Viewer.

Exit

Exits from GALILEO NT replay and returns the control to the Patient Managing System (PMS).

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EEG_NT 4.9.2

THE TRACES MENU

View Traces

Skips to the traces displaying.

Panning

Enables (and disables) the “panning” display.

Real-time monitoring

Allows the trace monitoring during acquisition by updating the reading of the file during its storage on disk.

Automatic Display

Enables (and disables) the automatic page display.

Automatic Display Setting

Allows the user to modify the delay of the automatic page display.

Real Time Writer

Select the paper speed of the real-time writer.

Go To

Offers, at a menu level, all the trace movement commands (one page, one second, forward, backwards…).

Trace Setting

Recalls the trace settings table for review and editing. This table can also be obtained with a double click on any point of the traces area (provided it is not on a message or state name). With the trace settings table, the sensitivity and the polarity of each trace can be changed; the display of one or more traces can also be turned off.

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EEG_NT

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Measure

Enables or disables the measure mode (see 9.12)

Copy Measure to Clipboard

This option is enabled only when in measure mode. Allows measures to be copied to the clipboard, in order to make possible importation to other documents (i.e. reports).

Set Cursors

Enables or disable the vertical cursor along the displayed page. This may be useful displaying the trace together with the Map window.

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EEG_NT 4.9.3

THE POTENTIAL MAP MENU

This menu is related to the Potential Map window. For details about the Potential Map see section 4.10. View Potential Map

Opens and display the Potential Map Window

Instantaneous Map

Displays the “Instantaneous” potential map: the map is computed on a specific time instant (the Cursor control on the Montage toolbar will insert just one cursor on the trace window and it will identify this time instant).

Mean Map

Displays the “Mean” potential map: the map is computed as average among a time interval (the Cursor control on the Montage toolbar will insert two cursor on the trace window, that will identify this time interval).

Set Scale Range

Allow to set up the scale range of colour.

Palette

Allow to set up to colour palette (Gray, Red-Blue or Rainbow).

Interpolation Algorithm

Allow to decide the best fitting algorithm of interpolation (Linear, Quadratic and Cubic).

Show Electrode

Allow to display electrode positions (as small white triangles for 3D representation, or small square for 2D) on the head.

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EEG_NT 4.9.4

THE SPECTRAL MAP MENU

This menu is related to the Spectral Map window. For details about the Spectral Map see section 4.11. View Spectral Map

Displays the spectral map window

Recompute

Re-compute the maps basing on the current parameters.

Computation Option

Allow to modify some calculation parameter.

Number of Views

Et the number of computed and displayed maps (1 … 6)

Lock Maps together

When rotating one map, the other will rotate of the same angle (all view are linked).

Top view, Left view,

Set some predefined point of view (angles).

Palette

Allow to change the colour palette.

Interpolation Algorithm

Allow to decide the best fitting algorithm of interpolation (Linear, Quadratic and Cubic).

Show Electrode

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Allow to display electrode positions (as small white triangles for 3D representation, or small square for 2D) on the head.

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EEG_NT 4.9.5

THE SPECTRUM MENU

View Spectrum

Enables the calculation and the display of the spectral data .For details about the Spectrum window see section 4.12.

Recompute

Restart the computing of the spectral data.

Calculation Option

Allow to modify some calculation parameter.

Number of views

Modify the number of shown spectral data.

Mean

Spectral data are shown in “standard“ way: the frequency along the “X” axis and the Amplitude/Power along the “Y” axis.

Head view

Shows the spectra of all acquired monopolar electrodes (by the 10-10 system), displaying them in correspondence with their position on the scalp.

Select Measure

Allows to set up the measure to be exported o the Windows Clipboard.

Copy Measure to File

Creates two text files (.txt): one for the selected spectral measure computed on all the acquired monopolar channels (“measures.txt”), and another for all the spectral values computed on all the acquired monopolar channels (“spectra.txt”). All of these measures are related to the current temporal window.

Copy Measure to Clipboard

Exports the selected measures to the Windows Clipboard.

Define Bands

Allows to define frequency bands.

Common scale

Shows spectral data with a common scale for all the traces.

Power

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EEG_NT Show Spectral Amplitude data.

Amplitude

4.9.6

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THE TOOLS MENU

Graphic Option

Allows the setting of some parameters regarding the colour palette to be used transferring images to the Windows clipboard or saving an image (i.e. the trace window) to file.

Filter Setting

Opens a summary table with information about the filter settings for the electrodes acquired in the current montage. This table (see diagram below) besides giving an overview of the parameters, also allows change to the filters value. Of course the same operations can be performed with the controls on the processing toolbar, but this view can be useful for a complete overview.

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EEG_NT Montage Option

Recalls a dialog box in which a montage can be selected (in the same way as choosing it from the list on the main toolbar) or edited by calling the montage editor, or allows creation of new montages.

You can select a montage or from the file you are looking or from the system montage library. The radio button in the upper part of the dialog allow this decision. The user can select a montage from the file (On Trace) or picking the a montage from the general montage library (Library) in this last case the montage will become part of the montage linked to the file. (see also chapter 1). User parameters settings

Recalls the dialog-box that manages all user settings (see next section for details).

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EEG_NT 4.9.6.1

User parameter setting

This window, available both in acquisition and in replay, gives the user (whose name appears on the title bar) the possibility to edit the parameters used to show data on Galileo viewer. These settings goes from the trace area colour to the Batch print setting and the digital filter values. The filter configuration is available only for user INSTALLER (SERVICE). WRITER and READER will be prompted the following window, accessing the “Filters” section:

Setting modification will be saved only by closing this window with the “Save” button, otherwise (“Cancel” or “X” button) no modification will be kept. For Filter Settings and map representation changes will be actualised only next time the same user will open a trace, while any other change will be actualised immediately.

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EEG_NT 4.9.6.1.1

Graphic Display This section is to customize the way of presentation of traces and events or states, on the viewer. Show Events

Enables or disables the display of Events (in a global all/none way).

Show second grid

Enables or disables the display of time grids.

Show trace area

Enables or disables the display of frame around the trace area.

Show Horizontal scroll bar

Enables or disables the display of scroll bar (under the traces area).

Colours

This section is to customize the colours of some areas of the window and of different kind of channels.

EEG Channels

Allows to choose the colour of the traces made of channels described with “EEG” type in the acquisition preset.

Polygraphic Channels

Allows to choose the colour of the traces made of channels described with “Poly” type in the acquisition preset.

Highlighted Channels

Allows to choose the colour of the traces selected on the viewer (selection is made by means of the mouse cursor on the trace label).

Window background

Allows to choose the colour of the window background (the one around the trace area).

Trace background

Allows to choose the colour of the trace background (the one where traces are drawn).

Font

Allows the user to customize fonts (and colour) of some text areas on the window (as montage labels, events…).

Label

Allows to choose the colour of montage labels on the window background.

Events

Allows to choose the colour of spot, state and selection name on the trace background.

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EEG_NT Show plug-in choose form on replay start This flag allows the user to be prompted or not with the “Available Tools” window opening the trace. Maps - 2D Maps enabled This flag, if checked, makes available the 2-Dimension representation of Potential and Spectral Maps (otherwise 3-Dimension representation is shown). Maps – Wide range spectra enabled This flag, if checked, makes possible the spectra computation on a band wider than the standard ones:[0,16] and [0,32] Hertz. This further band is the maximum one related to the signal sampling rate (Sr), and it goes from 0 Hz. to Sr/2 Hz. VIDEO-EEG – VEEG Fast-forward speed Sets the speed of video EEG fast forward replay (theoretically, available values range from 1 to 10, but the maximum value of reproduction is strictly conditioned by the computer performances).

4.9.6.1.2

Batch Print The background print module needs some information to do its work. To view/modify the parameters that influences the batch printing select this section: the following window will be shown.

You can choose various parameters of the batch print mechanism:

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-

The font of the montage labels (”Label Font”).

-

The font of the time information displayed along the axis of the page (“Axis Font”).

-

The font used to print the event (“Event Font”).

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EEG_NT -

If printing or do not printing the time grid (“Grid”), the sensitivity of each trace (“Sensitivity”),the events (“Events”) and the current montage name (“Acq. Montage”).

-

The time length of the page (”Page Speed”).

-

The EEG trace line width.

If in the trace there are more than one PRINT selection, with different length, the batch print, for every selection, will give the printing of one or more pages, whose length is given by the “Page Speed” setting. (also if the selection duration is lower than the Page Speed value). Once saved the settings will be valid until modified.

4.9.6.1.3

Filters This section is dedicated to the Digital Filter configuration (type and values). These filters are available to user when he displays traces on the screen (both in replay and acquisition). As we said before, this configuration is permitted only to INSTALLER and MASTER users.

Choosing type of low-pass digital filters By checking the “Low pass filters TC” flag, user will choose to display Low-Pass filter value by means of time constant (sec), otherwise these values will be in the frequency domain (Hz). The not available Low-Pass filter list will be greyed as we can see in the figure above for the Low Pass filter list.

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EEG_NT Editing new value for digital filters User can edit/add filter value simply by mouse clicking on the “N/A” box. Indeed the values that precede the “-----“ are fixed, but from this point on user can add/edit new values. In the window above, user added 1.33 Hz and 1.5 Hz. This operation, next time the same user will open the trace, will result in an up-grading of available LP filter values on the “processing” toolbar of Galileo viewer.

4.9.7

THE REPORT MENU

Contains the commands to open, for editing, the Trace Report and the Patient Report. For detail on the Patient History and Data Report document, please refer to chapter 2.

4.9.8

THE WINDOWS MENU

Contains the standard Windows commands for: x Showing or hiding the toolbars. x Saving the traces view (as image) to a file. x Copying the traces view on the Windows clipboard, from where it can be imported into other documents.

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EEG_NT x Arranging the GALILEO NT windows in the standard way allowed by Windows (Cascade, Tile Horizontal and Vertical). x Showing the windows related to the available tools.

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EEG_NT

4.10

THE POTENTIAL MAP WINDOW The Potential Map window displays the distribution on the scalp of the EEG potential. The Map can refer to a defined point of the tracing (Instantaneous Map) or to the mean value of the EEG signal in a defined interval of the tracing (Mean Map). referred to a defined point (o time interval) of the recording. The distribution of the potential on the scalp is displayed on a 3D representation of a “virtual” head. The potential is displayed in colours following a colour distribution chosen by the user among different “colour scale”. x Calculation are performed on the “monopolar” signal of all the acquired electrode. The distribution of the potential on the scalp is calculated using an interpolation algorithm (linear, quadratic, cubic), and its value is obtained making an average between the potentials of a previously set number of electrodes around itself.

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EEG_NT 4.10.1

INSTANTANEOUS MAP The instantaneous Map can be displayed -

From the Potential Map Menu selecting the Show Potential Map item (the instantaneous mode is the mode activated when the Potential Map display is activated).

-

Clicking on the Potential Map button on the main toolbar.

The figure below shows an example of a Potential Map display.

When the potential Map displayed is not the “instantaneous” but it is the “mean” map”, the Instantaneous map can be recalled from the Potential Map menu or simply clicking the Instantaneous Map button on the Process toolbar.

4.10.1.1

Rotating the Three-dimensional Map The Map is a 3D representation of an “head”. To change the point of view (rotation of the Map) click on any point of the Map Window making that window “active”. Clicking the map windows the map control toolbar appears

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EEG_NT To rotate the head click on it, maintain pressed the left button of the mouse and move the mouse. Depending on the direction you move the mouse the Map will be rotated. There are 5 predefined position that can be invoked simply clicking one of the related button on the map control toolbar.

4.10.1.2

Changing the calculation point on the trace Clicking any point on the right trace window the “focus” is given to this window, so the normal “trace walking” button are enabled on the upper toolbar and from the keyboard. In any moment the map on the left window will reflect the potential distribution in the point marked by the vertical cursor displayed on the trace window. In addition to the “normal” browsing command the system provides the user with two further way to move the cursor across the tracing 1. The user can drag the cursor with the mouse and, when you release the mouse button you’ll see the map updated. 2. The commands CONTROL-o and CONTROL m move the cursor a pixel a time in the related direction and the map is each time updated. Maintaining pressed one of the two key codes you can obtain a “continuous” movement across the tracing with the map continuously updated.

NOTE Entering the first time in the map display the cursor on the trace window is not displayed. You must enable it with the related button on the upper toolbar. You need further to disable it when returning to the normal trace display (without the map window) The same happens when you modify from instantaneous map to mean map.

4.10.1.3

Changing the colour scale There are 3 possible colour scale (Palette). To display them use the Potential Map menu or click the Palette button on the map control toolbar.

The palette window will be displayed. You can select among “Grey”, “Red And Blue” or “Rainbow” colour scale.

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Setting the scale range The scale range of the map display can be manually set or left to the automatic calculation of the system. To select among these possibilities start from the Potential Map menu and activate the Set Scale Range item

Mark the checkbox if you want the automatic calculation, otherwise insert the low and high limit of the range on which distribute the colour of the current palette.

4.10.2

MEAN MAP When the Potential Map display is activated the “Mean Map” mode can be invoked or from the Potential Map menu or clicking the Mean Map button on the map control toolbar

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EEG_NT The various controls acts in the same mode as for the instantaneous map, the only difference is that the potential distribution calculated is the mean value in the time interval defined by the two cursors displayed in the trace window.

To modify the cursor position, clicking and dragging the left (blue) cursor you’ll move both the cursor together (changing the position of the selected interval), while clicking and dragging the right cursor (the red one) you’ll modify the “width” of the selected tracing portion. NOTE Entering the first time in the map display the cursors on the trace window are not displayed. You must enable it with the related button on the upper toolbar. You need further to disable them when returning to the normal trace display (without the map window) The same happens when you modify from instantaneous map to mean map.

NOTE

To print the map you can use the printer button on the upper toolbar. Notice that when doing so you must have the map window ACTIVE, otherwise (with the trace window active) the system will print only the tracing.

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EEG_NT

4.11

THE SPECTRAL MAP WINDOW The Spectral Map window displays the (three-dimensional or bi-dimensional) distribution on the scalp of some “spectral” parameter related to some defined “frequency” bands For example a Map can represent the distribution on the scalp of the “Power” in the “Alpha” frequency band. Up to six different parameter (maps) can be displayed simultaneously. The distribution of the calculated parameter on the scalp is displayed either on a 3D representation of a “virtual” head or on a bi-dimensional bitmap; it’s a coloured representation that follows a colour distribution chosen by user among different “colour scale” (Palette). The three-dimensional map can be rotated in any direction, so to make spectral parameter distribution easier to read. Note that x All the parameter are based on the calculation of the FFT (Fast Fourier Transform) applied to the tracing data. Calculation are performed basing on the current parameter settled with the Calculation Option. x Calculation are performed on the “monopolar” signal of all the acquired electrode. The distribution of the calculated parameter on the scalp is calculated using a “linear interpolation” algorithm. x The signal portion on which the calculations are performed is: - the current page if no selection have been made on the tracing - the selected portion of the tracing with the PROCESS selection code or the selection chosen in the Calculation Option.

On the status bar (above) are displayed the information regarding the calculation mode and the interval time on which the calculation have been performed. The Spectral Map window is activated or from the Spectral Map menu (Show Spectral Map Item) or clicking the Spectral Map button on the main toolbar

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Each of the 6 maps can represent a different band and a different parameter. The setting of the bands and of the parameters may be done with the Bands Setting dialog box (“3D View Manager”) which is invoked double clicking on any head.

For “Spectral data” we intend the Frequency bands used to perform spectral analysis; these bands are customisable by user (see cap. 4.12) in the “Define Bands” item of Spectrum Menu.

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EEG_NT For “Spectral Measures” we intend the spectral parameters whose distribution the system represents on the virtual head, related to the chosen frequency band. And these are: 

Power (Power)



Amp (Amplitude)



PotR (Relative Power)



Mean F (Mean Frequency)



MedF (Median Frequency)



PeakF ( Peak frequency)



Lg(RP) (logarithm of the Relative Power)

Notice that each head has its own independent setting and these settings are stored by the system and remains valid until modified. 4.11.1

CONTROLLING THE DISPLAY OF THE SPECTRAL MAP You can modify the display and the calculation mode of the Spectral Map window. To do this you can act or on the Spectral Map menu on the menu toolbar or on some specialized button on the map control toolbar. The following will illustrate in detail the different possibilities. The figure below shows the Spectral Map menu.

Recompute Re-compute the maps basing on the current parameters.

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EEG_NT Computation Option Allow to modify some calculation parameter.

For specific applications, expert users can set the following computational parameters: x The time duration of the single epochs for FFT (“Time”); x The kind of trace selections to use in computing maps (“Event”), i.e. if using PROCESS selections or other selections corresponding to particular states, etc.; x The overlapping percentage of following epochs. Checking AR and/or CHN the “Configure AR” button will be enabled; clicking on it the above window “Select channels for ...” will appear. Here user can respectively select the channels to do not consider in: average reference definition (AR list) and in the electrode potential evaluation (CHN list). Indeed, AR is selected when user wants to draw a spectral map where all the electrodes are referred to a “virtual electrode” whose value is given by the average of all the electrodes chosen in the AR list; while CHN is selected when user wants to do not consider one or more electrodes (whose value was, for example, corrupted by artefact), in the potential computation for every electrode (remember that this kind of computation is made by interpolation of the mean electrode value with the values of a specific number of electrodes around it).

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EEG_NT Number of views Set the number of maps calculated ( 1 … 6 ).

Lock map together Allows all the maps to rotate in a synchronous way (pressed), or in a independent way (not pressed).

Top view, Left view, …. Set some predefined point of view (angles). In addition to the 5 predefined position above, if you want to rotate the map with the mouse click the map you want rotate, maintain pressed the left button of the mouse and move the mouse: the map will be rotated following the movement of the mouse. When the mouse button will be released the map will be “frozen” in the actual position.

Palette Allow to change the colour palette. Interpolation Algorithm Allow to decide the best fitting algorithm of interpolation (Linear, Quadratic and Cubic).

Show Electrode Allow to display electrode positions (as small white triangles) on the head.

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EEG_NT

4.12

THE SPECTRUM WINDOW The spectrum window displays the “traces” of the current montage in the frequency domain (the frequency band can reach half of the sampling frequency used to acquire the digital signal). For each trace of the montage, the FFT (Fast Fourier Transform) is calculated. Calculation are performed basing on the current parameter settled with the Computation Option. The “spectrum” of each trace is then displayed. The window can display 1,4 or 9 trace spectrum. Further the FFT transform of each acquired electrode can be calculated and displayed (Head view). The signal portion on which the calculations are performed is: -

The current page, if no selection have been made on the tracing

-

The portions of the tracing selected for PROCESS or with other selection code

All the above feature can be controlled by the Spectrum menu or trough some specialised button as detailed in the following paragraph. The Spectrum menu is as in the figure below:

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EEG_NT View Spectrum Enables the calculation and the display of spectral data. Calculation are performed basing on the current parameter settled with the

Recompute Restart the computing of the spectral data, with the new parameters. Calculation Option Allow to modify some calculation parameter (for more informations see the calculation Options of the Spectral map, see § 4.11.1).

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EEG_NT

The calculation is performed on a bandwidth up to 32 o 64 Hz in a particular configuration, this band can reaches the half of the sampling frequency used to acquire the digital signal). The above button select the one or the other band. NOTE in the “User Settings” control user can choose if to extend the spectral analysis band to half the sampling rate set in the acquisition preset.

Number of views Modify the number of spectral data shown. You can choose between 1,4 or 9 spectral diagrams.In any position it is possible to display any of the trace of the current montage. To link a trace to a position double click on the diagram you want assign : the “Spectrum Channel” dialog box will appear through which you can select the trace to assign to that position. The displays reports also the defined measure for each spectrum. When the number of views increases not all the measure will be shown on the screen due to space limitation: in any case all the defined measure will be calculated and (eventually) exported to the clipboard.

The above button allow to see the next or previous group of 1, 4 or 9 spectrum.

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EEG_NT

Mean Display the spectrum of the trace according to the current montage. Spectral data are shown in “standard “ way : the frequency along the “X” axis and the amplitude along the “Y” axis (the number of spectrums shown is that set in the Number of Views voice). Select Measure Allow to set up the measure to be exported o the Windows Clipboard (with this operation user will be able to paste selected data to any electronic paper supporting “.txt” format).

Copy Measure to File Saves on a two different “.txt” files: all the spectral measure available on all the acquired channels, related to the defined frequency bands, and all the spectral values computed on all the acquired channels (following the Spectral Computation options). Two consequent “Save As” dialog boxes will appear.

The “spectra.txt” file will be created first, that contains all the spectral values, then the “measures.txt” file will be created, containing all the spectral available measures for all the acquired (monopolar) channels. These files can be renamed and placed anywhere in “My Computer”.

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EEG_NT Define Bands Allow to define frequency bands where to compute spectral measures.

NOTE The first defined 8 bands are automatically described by software, with 8 different colours 8, so to be well-recognized inside the spectral graphs, as below.

Common scale Shows spectral data with a common scale for all the traces. When this option is not activated each spectrum is displayed with its own “auto ranging” scale (normalized to its maximum value). Power Show Spectral Power data. Amplitude Show Spectral Amplitude data. 4-58

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EEG_NT

Head view Show all the 10-10 electrodes with associated spectrum (see the following figure).

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4.13

TRACE MEASUREMENTS - ZOOM Several kinds of measurements related to the current page can be enabled from the Traces menu, selecting the “Measures” item, as shown in the diagram below:

As can be seen from the diagram, the system makes available different kind of measures on the trace samples. The diagram shows those implemented in the current release of GALILEO NT, while others will be included in the next release. When the selected measures are enabled, clicking on OK will bring the following display.

The measurements shown refer to the point under the vertical cursor. By moving the cursor the values will be updated. To disable this mode and return to the normal display, again use the Trace menu and disable the “Measure” option.

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EEG_NT When measures are active, in the Traces menu an option is enabled, this allows the user to copy the measured values to the Windows clipboard, from where they can be easily transferred into any document that supports the Windows “cut and paste” method. To have a more detailed view of the area of interest GALILEO NT provides the “ZOOM” mechanism. The ZOOM consists on the selection of an area of interest on the trace view an in the display of that area in such a way to blow up that area. The operation starts with the selection, using the mouse - “click and drag”, of the rectangle which identifies the area of interest: Once you release the mouse button during the rectangle selection the zoom window appears:

Now with the n e p keys you can modify the vertical zoom factor (shown in the title bar near the “x”). You can drag and drop the two cursor to make the wanted measure as in the normal measure window (see above).

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EEG_NT Default measure are those displayed in the figure and described below.

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-

Amply (ȝV): single trace amplitude measured in the time moment identified by the left blue cursor;

-

DeltaV (ȝV): for each trace, amplitude difference between the value measured at the time correspondent to the left blue cursor and that to the right red cursor;

-

Average (ȝV): average amplitude measured between the two cursors;

-

Avg Power (uV2): signal average power (as amplitude to the square) computed between the two cursors;

-

Alpha (Hz): frequency (in the Alpha band) where it is measured the higher Alpha band power;

-

Beta (Hz): frequency (in the Beta band) where it is measured the higher Beta band power;

-

Dominant (Hz): frequency (i n the EEG band 0-32 Hz) where it is measured the higher power;

-

PeakDiff (ȝV): difference between the amplitude maximum and the amplitude minimum measured in the time window identified by the 2 cursors (peak to peak value);

-

Freq (1/dT) (Hz): frequency value corresponding to the time interval between the 2 cursors;

-

Avg Ampl (ȝV): average amplitude, this value is twice the squared root of the average power computed between the 2 cursors (so it will be easy to compare it with the PeakDiff value);

-

Rect Area (ȝV *s): normalized amplitude (or rectified area) measured in the interval between the 2 cursors.

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EEG_NT

4.14

SPLIT WINDOW In order to show the user all the informations he can get from reading a trace (spectral and potential maps, spectrums, plug-in software, ...) GALILEO NT makes available a “Split Window” command. It tiles (horizontally, vertically or cascading in the EEG viewer) all the elaboration windows available for the current trace. With the method above, you can open also other trace window: GALILEO NT do not pose particular limit to this mechanism; practical limits are the resource of the computer and the resolution of the monitor. Once opened more than one trace window, with the standard controls of the Operative System it is possible to reduce their dimension and to position them in the desired way. This procedure may be long and tedious. To facilitate the user in this work, GALILEO NT provides two useful command in the “Window” menu

Those command automatically arrange ALL the trace windows opened in an optimal mode. You can “tile” the windows horizontally or vertically.

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EEG_NT To use that command, recall, with the procedure explained above, the Window, select the Window menu from the menu bar and select the “tile” mode you want 8in the example below, we tile 3 different window that show different information about the same range of the trace: Trace, Potential Map and Spectra).

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4.15

REVIEW OF A VIDEO EEG RECORDING The review of a Video EEG recording, in addition to the features of a normal trace, as described in the previous sections, provides a window on which the video information is displayed, and that video and trace can be analysed in a synchronous way.

Traces and video information can be synchronized or independent. When traces and video are synchronized, a blue vertical line will appear on the screen to show the synchronization point: the point of the trace under the blue line shows the activity recorded in the same moment referred by the video image (see picture). The video window has a scroll bar (that represent the whole video recording) and some control buttons. The scroll bar, as stated above, represents the length of the whole video recording. Moving the cursor towards right or left, it is possible to come across all the video recording. Of course such movement will be more or less “smooth” depending on the length of the recording.

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EEG_NT

To move up and down across the video file (with or without the EEG synchronization), user can use both the specific buttons: “Previous Frame” and “Next Frame” (frame by frame), and the “Video End” and “Video Start” buttons (with a specific speed, set at the initial configuration and in an independent way from the EEG display settings).

The other buttons are for (from left to right): x starting the replay of the video (“Play”) x Fast replaying of the video (fast replay speed is set in the user parameter setting window) (“Fast Forward”) x Stopping the replay of the video (“Stop”) x Zooming video image (“Zoom”); x Display the video window with the dimension given by the resolution set in the acquisition preset editor (“Normal View”) x Enabling/disabling the synchronization between traces and video recording (“Lock Mode”) x Disabling /Enabling the audio replay (“Mute”) x Display the video window using the whole monitor area (“Full Screen”); to exit from this way press ESC. The synchronization between trace and video image is reached both by the “Lock Mode” button on the video toolbar, and by the “Set Cursor” button on the EEG viewer toolbar. When the synchronism is enabled and the video replay is started (with the “Play” button), both the video and the trace frame is reproduced in real time (if audio was acquired, and the “Mute” button is not pressed, audio will be reproduced synchronized to video). The synchronization (“Lock Mode”) is kept also moving in the trace with the specific commands: by page, by second and automatic display (Panning display is no enabled in “Lock Mode”). Starting from a “non-synchronous” situation, synchronism can be obtained in two different ways: giving priority to the video (if an interesting point has been found on the video recording) or to the trace recording (if, for example, something interesting has been found reviewing the trace in the ordinary way). Video priority: when – on the video recording – the exact point has been found, just click on the “Lock Mode” button on the video window toolbar. The trace will immediately move to the requested point, and the synchronization marker will be shown on the traces area.

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EEG_NT Trace priority: when a point is found – on the trace recording – to which the video has to be “linked”, just press the “Set Cursor” button on the main toolbar of the traces window. The trace will immediately move to the requested point, the synchronization marker will be shown on the traces area and the “Lock Mode” button on the video toolbar will be pressed. Once the “link” is enabled, it will be constantly maintained until it is explicitly disabled by the user, and therefore video and traces will always be together: moving the video (with the commands and the scroll bar on the video window) or moving the trace (with the standard commands like PgUp, PgDown etc.).

To hide the video window during replay there is the below button on the replay EEG viewer toolbar.

4.15.1

VIDEO DIGITAL ZOOM Exploiting the video image resolution of a VIDEOEEG trace, it is given the user the possibility to perform on it an highly configurable digital zoom, available both in acquisition and in review. This function will be very useful to inspect portions of the video image, to stir inside the same image, searching for important details and to effect the acquisition video focusing on a particular zone of the image; always maintaining the synchronism with the EEG data file.

Through the dedicated icon on the video window toolbar, a further panel (zoom frame) will appear inside the window video, representing the scaled window video. The proportions with which this frame can be sized respect to the window size, is different and goes from 1 (the zoom frame is in 1:1 scale with the video window) to 10 (the zoom frame is in 1:10 scale with the video window). In the figure above the proportional factor between zoom frame and video window is 5.

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EEG_NT

Inside the zoom frame, a red-edged panel appears, that represents the portion of image indeed displayed. User, at this point can inspect the total image both moving with the cursor inside the zoom frame, and, according to the configurations, exploiting or the mouse pointer click (“Arrows”) or the dragging the mouse pointer on the video window (“Drag and Drop”). For further implementations of the image zoom, dedicated keys can be used; the “Zoom In” through the “+”key (plus) and the “Zoom Out” through the “- “ one (minus). The system can subsequently be configured to the same functionalities with the “Pag Up” and “Pag Dn.” keys.

NOTE The configuration of the video eeg zoom is of pertinence of the EBNeuro technical personnel or of an experienced user opportunely trained by EBNeuro.

In Zoom mode Video EEG Play can be always performed, so to restrict video inspection to the enhanced area.

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EEG_NT For your Notes

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EEG_NT

CHAPTER 5 GALILEO NT – SOFTWARE TOOLS 5.1

5.1.1

CSA - COMPRESSED SPECTRAL ARRAY

DESCRIPTION The CSA option is a GALILEO NT plug-in whose purpose is to calculate in real time the spectral analysis of the EEG recording and to show the result as a Compressed Spectral Array graphic (see the figure below). While displaying the Spectral Array the program provides some useful information regarding the most significant parameters of the calculated values. The CSA modality consist in the display in one single graphic of a lot of power spectra stacked one over the other. Each spectrum is related to a defined time interval. The most recent is displayed on the bottom part of the display and the oldest in the upper part of it. Any times a new spectrum is ready the entire “stack” is shifted upward of one position. In other words along the horizontal axis are displayed the “frequencies” while along the vertical axis are represented both the time and the power due to the fact that each spectrum is displayed starting from a vertical position that depends on the time of computation (see the figure).

This modality can be used both during the acquisition and during the replay (with the Automatic Display or the Panning mode); in other word the CSA can be used when using a real time mode display of the EEG signal; it does not work using a page mode display. Galileo NT – SOFTWARE TOOLS

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EEG_NT

Spectra calculation is continuously performed; when a new spectra is ready it will displayed on the first position (the lowest) of the graphic after having shifted the other spectra upward. In this way the total number of spectra displayed remains fixed and correspond to a fixed time interval. The program is able to elaborate an undefined number of traces and to display the spectra for a maximum interval time of 600 seconds. The practical limits is fixed only by the number of spectra that can be “intelligible” on the screen.

5.1.2

Using the CSA The CSA Option can be used both during the acquisition of an EEG tracing and during the replay of this type of trace. To make it available both during acquisition and replay user should be sure to have activated it before opening the trace:

Form the “Window” menu select the “CSA” item as in the following figure

When the CSA is invoked the related window will be opened and automatically “tiled” with the trace window. The first time the CSA is run it will start with a default setting providing only one trace (RF – RF) and a set of standard value for the various parameters (see the following for details). The successive times the CSA will be run it will work with all the parameters set as the last time it was run. 5-2

Galileo NT – SOFTWARE TOOLS

EEG_NT The CSA window is divided in three main areas -

In the upper part a table is shown with the powers (in percentage) of the bands for all the traces displayed

-

In the middle there is the compressed spectral array display of the selected traces

-

In the lower part there is a “status bar” with the value of the current parameter as the time interval on which the calculation is performed (epoch) and the sensitivity of the spectra expressed in PV2/mm.

The table, showing the spectral power values, changes the background colour when a value of power exceed the upper and lower spectral power limits (set by the user in the initial settings). The “warning” colour can be set by the user (see the following sections)

The various functions of the CSA can be handled both from the keyboard or from a pop down menu callable with the right button of the mouse clicking any point in the CSA window. From this menu the user can -

Modify the CSA configuration

-

Increment or decrement the sensitivity of the vertical scale

-

Restart the calculation

-

Print NOTE

The “H” key on the keyboard will recall a simple help window with all the active keyboard shortcut.

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5-3

EEG_NT 5.1.3

CONFIGURING THE CSA To access to the configuration functions of the CSA use the right button of the mouse o press the “O” key on the keyboard. A window will be opened. The window is made by the following tree “tabs”

5.1.3.1

-

Trace Editor (“Traces”)

-

Setting (“Settings”)

-

Layout (“Layout”)

Trace Editor This tab allow the user to set the “trace” on which perform the spectral calculation. The editor is substantially a simplified version of the standard Montage Editor of GALILEO NT (see section 4.2 of this manual). When defining a new trace, select couples of electrodes in sequence, clicking the appropriate buttons. The trace can be composed by any two electrodes. For each pair of clicks on two buttons/electrodes, a new trace is inserted in the list. In case of error, select the wrong derivation (clicking on the relevant line in the trace labels column) and delete it (Delete Trace button). It will then possible to insert the derivation (trace) again.

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EEG_NT 5.1.3.2

Settings (Analysis Configuration)

The following parameters can be set: CSA length

The total time on which the calculation are performed

Max freq.

The maximum frequency of the calculated spectra

Each Spectrum every

The time interval between the calculation of a set of spectra

Notify

Allow to set the maximum and minimum value of the spectral power outside of which a “notification (“or warning”) is displayed. The notification is made colouring the background of the table showing the values with the chosen colours.

Bands

It is possible to configure the bands n which calculate the spectral power. The DELTA band is not modifiable nor erasable. To modify, delete or define new band simply click with the right button of the mouse on the table showing the current band.

Advanced Setting

Allow to set the time interval on which calculate the Fourier Transform. This define the frequency resolution of the calculated spectra. Larger time interval -> higher frequency resolution.

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EEG_NT 5.1.3.3

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Layout

Colors

Define the colour to be used in the display of the various part of the CSA window

Show Numerical Values

Determinate if the table of numerical value will be displayed or not

Spectral array Type

Determinate if the spectral computation will be shown as a Compressed Spectral Array (CSA, as defined in the first paragraph), or as a Density Spectral Array (where the power distribution in the EEG band is shown with a colour scale).

Galileo NT – SOFTWARE TOOLS

EEG_NT 5.1.4

SAVING CONFIGURATIONS If once modified one or more of the parameters described in the previous section the configuration window is closed with the OK button the modified values will be valid only for the current section of CSA. When closing the CSA and opening again the stored value will be used. The button Save as Default allow to save permanently on disk all the parameter in such a way that every time the CSA is run that values will be recalled automatically. The button Save and Load allow to save a set of configuration on disk (giving it a name) and to recall it later. An indefinite number of setting can be saved.

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EEG TREND ANALYSIS

5.1.5

DESCRIPTION The TREND option is a GALILEO NT plug-in that allows a compressed display of long EEG recordings, by means histograms representing Spectral or Amplitude Parameters. This allows, moreover an increase in the informative content of the raw EEG signal and a the instantaneous detection of signal interesting areas. Quantitative analysis of EEG signal is done on the selected traces by means of the elaborations listed below: 1. Automatic computation, by means of FFT analysis, of Spectral Power on user–defined frequency bands, so to show or the Relative Power on a selected band (Alpha trend), or the ratio between the power values of 2 different bands (for. ex. Alpha/Delta ratio); the SEF (Spectral Edge Frequency) related to a user-defined total power percentage and the Total Power on a specific band (mV2). 2. Automatic computation of the signal amplitude suppression (relative to a user–defined threshold value), so to show the percentage of suppressed signal on a specific epoch of analysis and on selected channels. This is useful to value the pharmacological treatment effect on epileptic states and as guide on the pharmacological neuroprotection. The representation of this values is made using histograms. Once configured the software (channels to elaborate, spectral parameters, suppression parameters, …) the Trend Main Window, will process raw EEG data and display the results next to the EEG trace viewer. Every histograms is characterized by the value to represent and by the computation time. The compressed display is obtained since the application produces a value after the analysis of an epoch of EEG data, on which computations are made. The epoch duration is set by user depending on the analysis precision to reach.

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Galileo NT – SOFTWARE TOOLS

EEG_NT 5.1.6

USING THE TREND ANALYSIS The TREND Option can be used both during the acquisition of an EEG trace and during the replay of this type of trace. To make it available both during acquisition and replay user should be sure to have activated it before opening the trace:

From the “Window” menu select the “TREND” item, as in the following figure:

When the TREND is invoked the related window will be opened and automatically “tiled” with the trace window. The first time the TREND is run it will start with a default setting providing only one trace (RF – RF) and a set of standard value for the various parameters (see the following for details). Next times the TREND will be run it will work with all the parameters set last time it was run.

Galileo NT – SOFTWARE TOOLS

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EEG_NT The TREND window is divided in tree main areas

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In the first part (upper) Spectral Trend Graphs are shown. Each one is described with the name of the trace to which computation is referred and with the name of the spectral parameter (Single Trend or Ratio) the graph is displaying;

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In the second part (lower) there is the Suppression Graph for the selected traces, whose name is written above the graph;

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In the lower part there are the buttons that allows user to configure the software, to set graphical parameters and to interact with elaborations.

Galileo NT – SOFTWARE TOOLS

EEG_NT 5.1.7

CONFIGURING TREND To access to the configuration functions of the TREND use the dedicated button (“Setting”) on the lower part of the TREND window.

A window will be opened. The window is made by the following three “tabs”

5.1.7.1

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Trace Editor (“CSA Traces”)

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FFT Setting (“Spectral Settings”)

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Suppression Settings (“Burst Suppression”)

CSA Traces In this section user can insert the montages of traces on which effect computation. Selected traces are shown on the right lists: one (“Traces”) for Spectral Analysis computation and the other (“Burst Suppression”) for the Amplitude Analysis.

Respectively, to select channels for Spectral Analysis, press the “Spectral Montages” flat button and for Amplitude Analysis, press the “Burst. Supp. Montages” flat button, then choose the traces, in the desired montage, with the corresponding button (this montage doesn’t follow necessarily the acquisition one). Below each list will appear the total number of selected traces (not more than 8 for Spectral Trends). Removing a montage from the list is possible by means of the “Delete” button:

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EEG_NT 5.1.7.2

Spectral Settings In this section user defines all the parameters to effect spectral analysis:

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Spectral Setting

User can set the signal frequency band width (from “Max. frequency” to “Min. frequency”), the amplitude, in seconds, of each epoch of analysis (“Each spectrum every (s)”) and the amplitude of FFT epoch, in seconds (“FFT time interval (s)” contains fixed values).

Bands

User can define a set of available frequency bands on which effect analysis. Editing a band is easy: just right clicking with the mouse on a row of the Bands List, will appear a menu with the “Add”, “Delete” and “Modify” items, dedicated to band editing.

Galileo NT – SOFTWARE TOOLS

EEG_NT Select band for

This frame is used to set what kind of parameter to compute for selected traces. There are 2 possibility: “Single Trend” to display/compute relative power in the selected band, or “Ratio” to display/compute the power ratio between two bands, for the selected trace, and “SEF”, to compute the Spectral Edge Frequency, related to a user–defined total power percentage. NOTE

Spectral Edge Frequency: this parameter, that is very used during neurophisiological monitoring, to evaluate anaesthesia depth, describes EEG signal, with a numerical value that represents the frequency under which the P %(percentage) of the selected trace Total Power is contained. Normally the Percentage value used to evaluate SEF is 90 or 95%, but in this case this application allows user to set as percentage (P) any value between 0 and 100. Because of this, user can create also a Median Frequency trend just setting P=50.

Output setting

in this frame user can set if creating, for the selected traces, the Total Power trend, computed on the band specified in the “Single Trend” mode. Obviously, in this case, user has to set correctly the vertical axis dimension, so to not limit it between 0 and 100 as for the Relative Power trend.

To create a “Single Trend/Ratio” analysis, once the kind of parameter has been selected by user, he has to set on which bands effect computation. To do this, user has to select a band on the Band List, and right clicking with the mouse will appear the already seen menu, that present also the “Select for” item. If user chosen to compute Ratio Trend he has now to set which bands considering: that’s why the “Select for” item gives the user the possibility to select the band for “Ratio Den.” (denominator) and “Ratio _Num.” (numerator).

Otherwise, choosing to compute Single Trend user has to set only one band: that’s why the “Select for” item gives him only the possibility to select the band for “Single Trend”. Galileo NT – SOFTWARE TOOLS

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EEG_NT The selected spectral parameter will appear on the right of the “Selected band for” frame (as shown in the previous figure). For the Total Power trend it’s enough to check the “Absolute Power” box in the “Output setting”.

For SEF analysis, once the SEF box in the “Select band for” section, is checked, the “Bands” table is replaced by a “SEF Setting” panel, where the percentage for SEF computation has to be set in numerical value.

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Galileo NT – SOFTWARE TOOLS

EEG_NT 5.1.7.3

Burst Suppression In this section user defines all the parameters to effect amplitude analysis to evaluate the signal suppression:

Elaboration Setting

5.1.8

User can set the amplitude, in seconds, of the single epoch of analysis (“Epoch length (s)”), the time needed to output a value of suppression (“Each value every (s)”), the significant threshold (“Threshold (ȝV)”to value amplitude suppression and the percentage of suppressed samples needed to say that the current time interval is suppressed.

SAVING CONFIGURATION If once modified one or more of the parameters described in the previous sections the configuration window is closed with the OK button the modified values will be valid only for the current section of TREND. When closing the TREND and opening again the stored value will be used. The Default button allows to save permanently on disk all parameter so that, every time the TREND runs, that values will be recalled automatically. The Save and Load buttons allow to save a set of configuration on disk (giving it a name) and to recall it later. An indefinite number of setting can be saved.

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EEG_NT 5.1.9

READING TREND WINDOW Let us give a look to the TREND main window:

5.1.9.1

Spectral Graphs It shows the computed histograms for value of the selected spectral parameter on the examined trace:

In the figure above the Relative Power in the Delta band is shown for the F4-C4 trace: in this case, Vertical Axis represents the percentage value, while the horizontal axis describes the timing of the computation in absolute time. In the Total Power evaluation, for the same band, values will spread along the vertical axis depending on the specific situation. So it is difficult to set preventively, a correct maximum vertical value.

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Galileo NT – SOFTWARE TOOLS

EEG_NT Below the Ratio trend between Alpha and Delta power on the Fp2-F4 trace is shown. In this case the Vertical Axis represents a pure number, with no indication of unit, while the Horizontal one represents the Temporal Window in absolute time.

SEF trend (below) presents, on the Vertical Axis, a frequency bands that goes from 0 Hz to a user-defined frequency whose upper limit is half of the sampling rate.

In the figure above the Ratio value between Alpha band power and Delta band power is shown for the F4-C4 trace: in this case, Vertical Axis represents the absolute value of this ratio, while the horizontal axis describes the timing of the computation in absolute time.

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EEG_NT 5.1.9.2

Burst Suppression graph It shows the computed histograms for the signal suppression evaluations:

In the figure above the Suppression value obtained from computation on C3-T3 and C4-T4 traces: in this case, Vertical Axis represents the percentage value of suppression, while the horizontal axis describes the timing of the computation in absolute time.

5.1.9.3

Graphic This button allows user to define the time-width of the TREND window.

The “Graphic Option” window will be shown:

Temporal Window

User can choose either configuring the TREND window width in MANUAL mode, setting its duration in Minutes or Hours, or in AUTOMATIC mode (only for post processing), here the system dimensions it as the trace recording length.

Set duration

This frame is enabled only if the MANUAL mode is chosen. Here user can choose the window width in Minutes or Hours, checking the corresponding box and setting the desired value.

Spectral Trend Maximum value If user decides to compute for Spectral Ratio Trend, the Vertical Axis, representing a pure number has to be configured. Here the maximum value to represent in the Vertical Axis can be set.

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Galileo NT – SOFTWARE TOOLS

EEG_NT 5.1.9.4

Replay and Print

The “Replay” button enables to open during EEG-EP MONITORING acquisition, a further window, where the previous TREND file is displayed.

The “Print” button send to the computer default printer, the current TREND page to be printed, with information about patient name and recording date.

5.1.9.5

Moving across the TREND graph

1. Previous Page: during post processing, this button enables user to go to the previous TREND page; 2. Next Page: during post processing, this button enables user to go to the next TREND page; 3. Cursor: during Post Processing, enables user to set a red cursor on TREND window so to move across it; 4. Lock: during Post Processing, enables user to lock the TREND window to the Trace one: this allows him to search for a specific or interesting instant on the TREND window and immediately display the corresponding time in the Trace Window.

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EEG_NT

5.2

5.2.1

EEG AUDIO REPLAY

DESCRIPTION The Audio Plug-In option is a GALILEO NT Plug-in that allows to listen, on Personal Computer audio outputs, the signal coming from one or two EEG traces stored with a sampling rate higher than 4096 samples/sec.

The target of this application is to make user able to recognize signal peaks by means of their audio reproduction, without having to scan the whole trace, but just listening to it. In particular it’s dedicated to neurophisiological signal, that present a constant trend with, sometimes, an amplitude peaks. That’s why will be fundamental the use of a threshold.

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Galileo NT – SOFTWARE TOOLS

EEG_NT 5.2.2

USING THE AUDIO PLUG-IN This tool is for both replay and on-line analysis. To make it available user should be sure to have activated it before opening the trace:

Before running this application, the system makes a check about the currently installed Microsoft Direct X version and the trace sampling rate. If everything is good, opening the Galileo NT Trace Viewer, the Audio Plug-In main Window will be shown:

In this way, on the upper left side of Galileo NT Viewer, the minimized main window of this tool appears, with the “Play”, “Stop” ,“EBN Setting” commands and the small button that extends in the main window.

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EEG_NT 5.2.2.1

The Main Window Following, a brief description of the commands displayed in this window:

Auto Start

If checked will means that trace panning and audio outputs have to be run separately.

Channel Audio Setting Left/Right Channel

Available channel list extracted by the acquisition preset, among with choosing the (left /right) channel to listen in the corresponding audio output.

Left/Right Threshold Choosing to set a threshold for one or both channels, will output the audio from the signal only when it overcomes this threshold. Gain

Available Gain list to increase the EEG signal amplitude so to better listen to corresponding output. If Threshold is selected is not possible to set a gain for the signal.

Mute sx/dx

To silence the corresponding output.

No. of Channels:

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Mono

Just one trace can be chosen in the preset channel list, as left channel. This channel can be listened in both audio outputs.

Stereo

Two traces can be chosen in the preset channel list. Each one will be listened from the corresponding audio output.

Progress bar

Displays the time delay between trace panning and audio output.

Galileo NT – SOFTWARE TOOLS

EEG_NT Status bar: Gap

Minimum and maximum delay between trace panning and audio output, in the current session.

Delay

Delay sets in the configuration file, between trace panning and audio output.

S/Sec

Trace sample rate.

To start audio output of the chosen channels, press the Play button. If in replay and with un-checked AutoStart command, to start reproduction user has also to run trace panning from the dedicated menu item. To stop audio output, use the “Stop” button. During reproduction, a further window (“Peak Viewer”) will appear on the screen.

5.2.2.2

The “Peak Viewer” This window appears once Audio Reproduction of chosen channels started. In this window, if correctly set, detected signal peaks are drawn.

Its extended displacement is the following and displays the signal trend. The shown signal is the one checked below (“Show Lf”/”Show Rt”) and whose name appears on the top of the graph; user can also choose if showing or not the signal peaks (“Show Peaks”).

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EEG_NT Further graphical settings are: Xmax[msec]

Here user sets the dimension, in msec of the temporal window to analyse in order to find a peak. System will translate this value from milliseconds to samples (by means of the sampling rate), in according to the graph horizontal axis format.

AutoYMax/AutoYMin Here user decides if automatically scaling the graph vertical axis, depending on the detected peak values or if considering always the same range of variability. In the first case, checking these flags, every msec (Refresh Time) the graph will be redrawn using the maximum and minimum values of the detected peaks (whose values appear on the corresponding boxes); otherwise (un checking these flags), manually user can insert the maximum and/or minimum value between analysed signal trend, searching for peaks.

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Refresh Time[msec]

Time after which the graphs will be re-drawn.

Stop Refresh

This button breaks the graph refreshing process.

Galileo NT – SOFTWARE TOOLS

EEG_NT 5.2.3

AUDIO PLUG-IN SETTINGS The Audio Plug-In settings involve:

5.2.3.1

Threshold Setting Here user can set the threshold values to draw on the “Pick Viewer” during reproduction and to output signal only when its amplitude overcomes this values (“Max Up” and “Max Dw”). Moreover here the horizontal axis dimension is set in msec that are translated in the number of corresponding samples, obviously depending on the sampling rate (“X Axis Msec”).

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EEG_NT 5.2.3.2

Setting Here user can configure: 1. the Gain Values (those available on the main window) 2. the Fast Replay speed (that will allow audio reproduction in a faster way, but that has not been improved yet) 3. the offset between pick and “Peak Viewer” vertical Axis, in percentage of the horizontal sample dimension.

And, moreover, in the “Value” frame, there are written the values obtained during reproduction, for the left and right channel, about their peak trends. This values can be reset by means of the “Reset Value” button.

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Galileo NT – SOFTWARE TOOLS

EEG_NT

5.3

HRV_NT This software tool totally integrated in GalNT allows performing a post-analysis on the polygraphic signals in which it is present at least an ECG derivation. This software enables to extract from the ECG signal some significant parameters of the neuro vegetative system state through the analysis of the cardiac variability, the series of RR intervals (tachogram) but also, if available, the series of the systolic and diastolic values of the arterial pressure (systogram and diastogram). The program provides parameters on the time domain (average, variance, pNN50) and on the frequency domain (power spectral density). In fact, it is possible to calculate the power on the three frequency bands conventionally described in literature as VLF, LF and HF, the relative power of the bands LF and HF and finally the ratio between the powers LF and HF, usually used as indicative parameter of the simpatic - vagal balance. It’s necessary to select in the Patient Management System the acquired data from data list. Then, click on new data button and select HRV exam. The software will try to find among all the channels, one ECG channel and one respiratory channel (these channel types can be set by the user during the preset configuration). If there are not these kind of channels, a new window appears and allows the user to select which channel must be used as ECG channel for the synchronization.

Select the channel and then click on Modify icon. Another window appears and allows the user to select the analysis type (ECG, Respiratory…).

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EEG_NT The analysis of the ECG signal for the QRS complex detection is performed using a new algorithm that is not noise sensitive and it is very precise for the QRS complex detection, with an accurate measure of RR interval. The series of RR intervals is analyzed with the purpose to reveal the presence of possible rhythm alterations or artefacts due to the noise on the native ECG signal; in case these are detected, the algorithm provides, when it’s possible, to a correction of the interested RR intervals in order to minimize the effects of such alterations on the value of the power spectral density. It’s possible to perform an automatic correction of the RR intervals with an algorithm that tries to correct all RR intervals that differ more than a certain percentage (settable, typically 5%) from the mean RR that is dynamically calculated on last N RR intervals:

Once calculated and eventually corrected the series of RR intervals, the analysis can be performed and it furnishes the parameters in the time domain and in the frequency. x Regarding the parameters in the time domain, there are mainly the mean cardiac frequency and the R-R variance. The parameter pNN50 is also calculated and represents the RR intervals percentage that differs from the precedent one more than 50 msecs. This parameter is usually described in literature as one of the most reliable variability indexes in the long period (typically 24 hours) and it provides a global measure of variability. x The value of the power spectral density of the cardiac variability is calculated using both an autoregressive algorithm (AR) and an algorithm based on Fourier transforms. In both cases it is possible to modify all the calculation parameters of the algorithms according to the user necessities or to use the optimal setting suggested by the software. From the spectral density it is calculated the power of the three conventional bands VLF, LF and HF, and it is possible to modify the extremes. The frequency can be expressed in normalized units (cycles for pulsation) or in equivalent Hertz. The frequencies scale in equivalent Hz is obtained, taking into consideration the mean cardiac frequency in the interested interval. From the LF and HF power, the normalized LFn and HFn powers are calculated and also the ratio LF/HF. 5-28

Galileo NT – SOFTWARE TOOLS

EEG_NT

The results are displayed both in graphic form and inside a table. Particularly, the RR intervals are graphically displayed with the possibility to change the temporal scale (horizontal axis) and the amplitude scale (vertical axis). In the same window the power spectrum is visualized with the graphic indication of the conventional three frequency bands. If the analysis includes more than a signals (for example also a signal due to the respiratory activity or to the arterial pressure) the graphic plot shows all the calculated signals and not only the RR intervals, and the spectral chart shows the spectrums related to all these signals. All the calculated parameters, both in time domain and in frequency, are displayed in a table showed together with the signal and spectrum charts.

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EEG_NT Concerning the analysis, there are three different possibilities: 1. The analysis is performed on the whole interval extracted from the trace. 2. The analysis is performed on the current page. 3. The analysis is performed separately on all the pages in order to create a spectrum type CSA (Compressed Spectra Array). The first analysis type is proper for the short recordings where it can be supposed that the patient conditions are static, so it’s possible to retain that the analyzed signal remains the same for all the recording time. The second and third types, instead, are proper for the cases in which or the length or the recording characteristics don't allow to make hypothesis of stationariness and, therefore, it is necessary an analysis for a brief interval. Especially, the last type of analysis allows having an immediate idea of the spectral variations of the signals taken in consideration. The current page corresponds to the spectrum in red on the CSA plot.

It’s possible to print all the obtained results

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Galileo NT – SOFTWARE TOOLS

EEG_NT

6.

6.1

MONITORING: POSSIBLE ALTERNATE AND CONTINUOUS ACQUISITION OF THE EEG SIGNAL AND OF THE EVOKED POTENTIALS

INTRODUCTION Nowadays, the request for neuro-physiological tests within the intensive care unit is more and more increasing. In fact, both the Electroencephalogram and the Evoked Potentials, while allowing a functional assessment of the Central Nervous System, put besides the clinical test, are complementary to the imaging techniques (TC, NMR) and grant a high contribution for the patient diagnosis, prognosis and monitoring. This application was developed to allow the alternate and continuous acquisition of a certain number of EP exams and same number of EEG tests. Every EEG and EP test will last for the time predefined by the user during the configuration and will be repeated as many times as decided by the user when launching the application. It will be anyway possible, according to an appropriate process, to preventively stop both the single test and the monitoring program, so as to allow the user to preventively end the acquisition, as required. This test type will allow the completely and continuously monitoring of the patient brain activity and the assessment of the effect of a possible pharmacological therapy (intensive care monitoring) and of the reaction of this activity to the surgery room.

Galileo NT – Monitoring

6-1

EEG_NT

6.2

6.2.1

CONFIGURATION

MONITORING configuration inside the Galileo PMS This application will be only available when Galileo PMS is preset to such data.

6.2.2

EEG acquisition configuration To configure the EEG GALNT acquisition within a MONITORING test, it is required to define a timed preset.

A timed preset is a preset for carrying out an acquisition that automatically stops when reaching the preset time. The windows Options of the Galileo Preset Manager shows a selection named “Timed acquisition”, where it is possible to assign these characteristics to the involved preset. When selecting the flag “Active”, the “Time ON” (hours and minutes) will be enabled further to the “Number of repetitions” (not required for such an application). Here, the user will input the time (hours and minutes) required for completing the single EEG acquisition session. After completing the preset with this configuration, it can be saved on the system.

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Galileo NT –Monitoring

EEG_NT 6.2.2.1

Note on Timed Acquisition section As above said, it is possible to automatically end an acquisition after a certain time by creating a preset where the timed acquisition is active (dedicated flag) and by setting the ON time to the chosen time (1 hour and 30 minutes in this example).

This preset type is used for an EEG-EP MONITORING acquisition and in this case the single EEG acquisitions will have a length of time same as the preset one. For the EEG MONITORING acquisition, if even the repetition number (dedicated window) is not set, the system will complete one acquisition only for the preset time. On the contrary, if the user also defines the number of repetitions (e.g. 5 as for the following example), launching an EEG MONITORING acquisition will enable the system to automatically obtain, according to the relevant preset, 5 consecutive EEG GALNT traces lasting 1 hour and 30 minutes.

This way allows to exceed the limit for acquisitions longer than 24 hours by simply creating a timed acquisition preset and inputting 24 hours and 00 minutes for the ON time together with the number of repetitions required for the running monitoring (at this time, every acquisition will refer to a full day of patient monitoring) and completing an EEG MONITORING acquisition with such a preset.

Galileo NT – Monitoring

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EEG_NT 6.2.3

EP acquisition configuration To configure the EP EXAM acquisition within a MONITORING test, an EP Trending type time macro should be defined. This macro allows to configure a time acquisition and to build the control trends for Amplitude and latency of the potentials being created as regards the values shown on the initial template which is the reference model. Once the EP Trending has been defined as Test Type, the EEG/EP windows opens where the user can configure (as per the EEG GALNT) the single EP acquisition session time.

NOTE Good practice would require the preset/macro name to indicate the preset acquisition length of time. In fact, the MONITORING EEG-EP program loads ALL the macros available for the selected hardware and does not detect if the macro selected for monitoring is timed or not.

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Galileo NT –Monitoring

EEG_NT 6.2.4

Use After completing all the configuration explained in the previous paragraph, the alternate MONITORING acquisition can be launched by selecting “New data”, selecting “MONITORING”, then “EEG - EP” to state the alternate acquisition program.

By this way, the program main interface is introduced, it consists of: ‰

A section relating to the hardware configuration

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A section relating to the configuration of the acquisition alternation

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A section relating to the acquisition management

The single sections are described here below. Galileo NT – Monitoring

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EEG_NT 6.2.5

Hardware configuration On this section, the user should select both the hardware type to use for the acquisition (please remember that the amplifier used will be the same both for EEG and EP) and the presets for completing the single EEG acquisition session and the EP acquisition session. The software will allow the hardware to select among ALL the amplifiers on the involved system (without distinguishing among systems that can process both EEG and EP and systems dedicated to one or the other method) and the user will be in charge of properly selecting the right acquisition hardware.

6.2.6

Alternate acquisition configuration On this section, the user will establish the acquisition type to use for starting the alternate cycle (EEG or EP) and the number of cycle repetitions (session number). An empty area (“…”) is foreseen at the end of the list for the selection of the repetition number, where the user can write any number which is not listed (of course, the numbers to input must be positive integers lower than 100).

NOTE Because the first EP acquisition requires the user presence, who will be in charge of starting the EP average recording, once defined the template to recognize in the following acquisition sessions, for letting the system work independently as soon as possible, it is a good practice to select the EP acquisition as the initial acquisition.

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Galileo NT –Monitoring

EEG_NT

6.3

ACQUISITION MANAGEMENT

This section includes the controls to start, stop and close the alternate acquisition in advance. The RUN button, after completing all the required setting, starts the acquisition cycle already under the WRITE ON DISK mode (except for the first EP cycle where, before saving the data, the initial template must be set). The PAUSE button allows the temporary acquisition stopping, while the STOP button closes the set monitoring in advance. These two buttons do not immediately stop the acquisition, but ends the cycles (both temporarily and definitively) after completing the running acquisition (i.e. when expiring the set time). To immediately stop the acquisition, it is required to directly operate the current acquisition display. In particular, to stop the acquisition while proceeding with the alternation cycle, directly press the buttons

or the relevant menu controls. To stop the running acquisition in advance and the alternate acquisition program, process foresees the Stop button to be first pressed on the MONITORING interface, then the running acquisition to be stopped by pressing the appropriate button (see above).

To stop the alternate acquisition, before reaching the end foreseen according to the number of sessions preset at the beginning, while waiting for the normal stop of the running acquisition, simply press the Stop button on the MONITORING interface during the running of the acquisition to be ended.

Galileo NT – Monitoring

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EEG_NT

6.4

WHAT GETTING FROM THE ALTERNATE ACQUISITION:

By this type of acquisition (MONITORING – EEG-EP) the following is included in the Galileo PMS patient data list: one MONITORING record including: one EP EXAM (gathering as many EP TRACE as the acquisition sessions) and one EEG GALNT gathering all the collected EEG graphs (both of MONITORING subtype). In particular, the EEG acquisition will be collected within one single gnt file and at the time of the second reading, the various acquisition sessions will be easily identified on the navigation bar and distinguished by the EP graph acquisition ranges (EEG pause white areas).

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Galileo NT –Monitoring