Detecting heterogeneous seizures in newborn infants using triple correlation

We detect seizures in newborn infants using a novel method derived from triple correlation, which integrates spatial and temporal structure in neonatal electroencephalograms (EEGs). Triple correlation natively encompasses analogues to a variety of lower-order approaches (auto-correlation, cross-correlation) in addition to introducing higher-order signals, so we hypothesized that our approach would both effectively detect and differentiate notoriously difficult-to-detect and heterogeneous neonatal seizures. Indeed, our method in its simplest form performs comparably well to a current standard of care, amplitude-integrated EEG (aEEG), and by some measures outperforms aEEG, suggesting at a minimum that a combination of triple correlation and aEEG could produce a more effective first-line bedside detector. Moreover, we find that the triple correlation seizure-signal varies between patients, with 1) differences in dominance of either within or between channel correlations and 2) differing levels of higher order structure. We hope that our approach will provide a fertile field for future work in distinguishing and detecting seizures. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement GAS was funded by the Pritzker Endowment for the Neurosciences. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The source data were from a previously published openly available dataset that can be found at I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The neurologist artifact annotation of the source data is available within our Github repository. All figures can be reproduced using our Github repository in combination with the publicly available source data.