Research Article
Spectral Gini Index for Quantifying the Depth of Consciousness
Kyung-Jin You,
1
Gyu-Jeong Noh,
2,3
and Hyun-Chool Shin
1
1
Department of Electronic Engineering, Soongsil University, Seoul 06978, Republic of Korea
2
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine,
Seoul 05535, Republic of Korea
3
Department of Clinical Pharmacology and herapeutics, Asan Medical Center, University of Ulsan College of Medicine,
Seoul 05535, Republic of Korea
Correspondence should be addressed to Hyun-Chool Shin; shinhc@ssu.ac.kr
Received 14 June 2016; Revised 13 September 2016; Accepted 26 September 2016
Academic Editor: Saeid Sanei
Copyright © 2016 Kyung-Jin You et al. his is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
We propose indices that describe the depth of consciousness (DOC) based on electroencephalograms (EEGs) acquired during
anesthesia. he spectral Gini index (SpG) is a novel index utilizing the inequality in the powers of the EEG spectral components;
a similar index is the binarized spectral Gini index (BSpG), which has low computational complexity. A set of EEG data from 15
subjects was obtained during the induction and recovery periods of general anesthesia with propofol. he eicacy of the indices as
indicators of the DOC was demonstrated by examining Spearman’s correlation coeicients between the indices and the efect-site
concentration of propofol. A higher correlation was observed for SpG and BSpG (0.633 and 0.770, resp., < 0.001) compared to the
conventional indices. hese results show that the proposed indices can achieve a reliable quantiication of the DOC with simpliied
calculations.
1. Introduction
he depth of anesthesia (DOA) must be precisely and appro-
priately controlled according to the surgical procedure and
the patient’s medical condition. For example, inadequate
anesthesia may provoke stress responses of the body such as
hypertension, tachycardia, sweating, lacrimation, increased
skeletal muscle tone, and spontaneous movement [1]. Tachy-
cardia and hypertension can lead to various side efects
such as a cardiovascular event. In contrast, an anesthetic
agent overdose can cause hypotension, which can lead to
hypoperfusion of the heart and brain in susceptible patients.
Owing to the interpatient variability of the dose-response
efect of anesthetic agents, the administration of an adequate
amount of anesthetics and the maintenance of an appropriate
DOA are challenging. herefore, an objective and reliable
method of evaluating the DOA is needed to maintain a stable
level of anesthesia.
General anesthesia (GA) includes two independent com-
ponents: hypnosis and analgesia [2]. Several methods of
measuring the DOA are based on the changes in the
autonomic nervous system, such as the degree of muscle
relaxation, hemodynamics, sweating, and lacrimation [3, 4].
Methods using the heart rate variability relect the changes
in brainstem function [5, 6]. However, these parameters
are poorly correlated with the cerebral cortex functions,
are closely related to consciousness, and constitute poor
indicators of the depth of consciousness (DOC) [7, 8].
Intraoperative awareness can occur without monitoring the
DOC. Intraoperative awareness is the unexpected explicit
recall of sensory perceptions during GA [9] and may occur
in 0.1–0.2% of patients receiving GA [10]. Such awareness
can lead to mental sequelae and posttraumatic syndrome
[11]. herefore, the parameters that monitor the DOC must
focus on the electroencephalogram (EEG), which relects the
action of the cerebral cortex, of the thalamus, and of the
brainstem. Many studies have attempted to develop indices
for a quantitative, immediate, and continuous indicator of the
DOC based on (sub)cortical electrical activities.
Information theoretical approaches, such as the spec-
tral entropy [12–14], permutation entropy (PE) [15], and
approximate entropy (AE) [16] methods, consider that the
irregularity of the EEG change during anesthesia is expressed
Hindawi Publishing Corporation
Computational Intelligence and Neuroscience
Volume 2016, Article ID 2304356, 12 pages
http://dx.doi.org/10.1155/2016/2304356