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Updated: May 25, 2026

A Method for Tracking the Time Evolution of Steady-State Evoked Potentials
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Stationarity in neuromonitoring data.

Hans E Heissler1, Kathrin König, Joachim K Krauss

  • 1Klinik für Neurochirurgie 7249, Medizinische Hochschule Hannover, Hannover, Germany. heissler.hans.e@mh-hannover.de

Acta Neurochirurgica. Supplement
|February 14, 2012
PubMed
Summary

Neuromonitoring signals in head-injured patients are often stable due to therapeutic interventions, not disease progression. This effective control-loop limits the analysis of critical pathological changes.

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Area of Science:

  • Neuroscience
  • Critical Care Medicine
  • Biomedical Engineering

Background:

  • Signals reflecting the metabolic and circulatory status of injured central nervous systems are systematically corrupted.
  • Patients are part of a therapeutic control-loop, influencing acquired signals.
  • Signal stationarity is determined by control quality rather than the pathological process.

Purpose of the Study:

  • To verify the control-loop hypothesis in neuromonitoring data from severely head-injured patients.
  • To assess the stationarity of circulatory and metabolic variables under therapeutic control.

Main Methods:

  • Analysis of neuromonitoring data from 12 severely head-injured patients (GCS ≤ 8).
  • Inclusion of circulatory (blood pressure, ICP, CPP) and metabolic (blood gases, SjvO(2), ptiO(2)) variables.

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Last Updated: May 25, 2026

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  • Assessment of 120 time series for stationarity using Wallis & Moore's runs test.

    • Main Results:

    • Non-stationarity was proven in only 23% of time series, violating the control-loop hypothesis.
    • Trends were primarily observed in cerebral perfusion pressure (CPP) and intracranial pressure (ICP).
    • Nine patients exhibited at least one non-stationary time series; one patient showed trends in five variables.

    Conclusions:

    • The limited non-stationarity (approx. 20%) suggests an effective therapeutic control-loop.
    • The analytical benefit of this control-loop appears overestimated.
    • Neuromonitoring may primarily capture short-term, compensated disturbances, reducing information content despite increased sensors.