Sparse-Denoising Methods for Extracting Desaturation Transients in Cerebral Oxygenation Signals of Preterm Infants

Preterm infants are at high risk of developing brain injury in the first days of life as a consequence of poor cerebral oxygen delivery. Near-infrared spectroscopy (NIRS) is an established technology developed to monitor regional tissue oxygenation. Detailed waveform analysis of the cerebral NIRS signal could improve the clinical utility of this method in accurately predicting brain injury. Frequent transient cerebral oxygen desaturations are commonly observed in extremely preterm infants, yet their clinical significance remains unclear. The aim of this study was to examine and compare the performance of two distinct approaches in isolating and extracting transient deflections within NIRS signals. We optimized three different simultaneous low-pass filtering and total variation denoising (LPF-TVD) methods and compared their performance with a recently proposed method that uses singular-spectrum analysis and the discrete cosine transform (SSA-DCT). Parameters for the LPF-TVD methods were optimized over a grid search using synthetic NIRS-like signals. The SSA-DCT method was modified with a post-processing procedure to increase sparsity in the extracted components. Our analysis, using a synthetic NIRS-like dataset, showed that a LPF-TVD method outperformed the modified SSA-DCT method: median mean-squared error of 0.97 (95% CI: 0.86 to 1.07) was lower for the LPF-TVD method compared to the modified SSA-DCT method of 1.48 (95% CI: 1.33 to 1.63), P<0.001. The dual low-pass filter and total variation denoising methods are considerably more computational efficient, by 3 to 4 orders of magnitude, than the SSA-DCT method. More research is needed to examine the efficacy of these methods in extracting oxygen desaturation in real NIRS signals.Clinical relevance- Early and precise identification of abnormal brain oxygenation in premature infants would enable clinicians to employ therapeutic strategies that seek to prevent brain injury and long-term morbidity in this vulnerable population.