Chapter 74:

Biopotentials and
Electrophysiology
Measurement
Teemu Rm
teemu.ramo@nokia.co
m
butler.cc.tut.fi/~malmivuo/bem/bembook/
Agenda
1
st
half
Introduction to biopotentials
Measurement methods
Traditional: ECG, EEG, EMG, EOG
Novell: VCG
2
nd
half
Measurement considerations
Electronics
Electrodes
Practices
Q&A
What are biopotentials
Biopotential: An electric potential that is measured between points in living cells, tissues,
and organisms, and which accompanies all biochemical processes.
Also describes the transfer of information between and within cells
This book focuses strictly on the measurement of potentials
Mechanism behind biopotentials 1/2
Concentration of potassium (K
+
) ions is 30-50
times higher inside as compared to outside
Sodium ion (Na
+
) concentration is 10 times
higher outside the membrane than inside
In resting state the member is permeable only
for potassium ions
Potassium flows outwards leaving an equal
number of negative ions inside
Electrostatic attraction pulls potassium and
chloride ions close to the membrane
Electric field directed inward forms
Electrostatic force vs. diffusional force
Nernst equation:
Goldman-Hodgkin-Katz equation:
mV V
m
100 ... 70
k o
k i
k
k
c
c
F z
RT
V
,
,
ln
Cl i Cl Na i Na K i K
Cl i Cl Na i Na K i K
k
m
c P c P c P
c P c P c P
F z
RT
V
, , ,
, , ,
ln



mV V
m
100 ... 70
Mechanism behind biopotentials 2/2
When membrane stimulation exceeds a threshold
level of about 20 mV, so called action potential
occurs:
1. Sodium and potassium ionic permeabilities of the
membrane change
2. Sodium ion permeability increases very rapidly at first,
allowing sodium ions to flow from outside to inside,
making the inside more positive
3. The more slowly increasing potassium ion
permeability allows potassium ions to flow from inside
to outside, thus returning membrane potential to its
resting value
4. While at rest, the Na-K pump restores the ion
concentrations to their original values
The number of ions flowing through an open
channel >10
6
/sec
Body is an inhomogeneous volume conductor and
these ion fluxes create measurable potentials on
body surface
Electrocardiography (ECG)
Measures galvanically the electric activity of the heart
Well known and traditional, first measurements by
Augustus Waller using capillary electrometer (year 1887)
Very widely used method in clinical environment
Very high diagnostic value
1. Atrial
depolarization
2. Ventricular
depolarization
3. Ventricular repolarization
ECG basics
Amplitude: 1-5 mV
Bandwidth: 0.05-100 Hz
Largest measurement error sources:
Motion artifacts
50/60 Hz powerline interference
Typical applications:
Diagnosis of ischemia
Arrhythmia
Conduction defects
12-Lead ECG measurement
Most widely used ECG measurement setup in clinical environment
Signal is measured non-invasively with 9 electrodes
Lots of measurement data and international reference databases
Well-known measurement and diagnosis practices
This particular method was adopted due to historical reasons, now it is already rather
obsolete
Einthoven leads: I, II & III Goldberger augmented leads: V
R
, V
L
& V
F Precordial leads: V
1
-V
6
Why is 12-lead system obsolete?
Over 90% of the hearts electric activity can be explained
with a dipole source model
Only 3 orthogonal components need to be measured,
which makes 9 of the leads redundant
The remaining percentage, i.e. nondipolar components,
may have some clinical value
This makes 8 truly independent and 4 redundant leads
12-lead system does, to some extend, enhance pattern
recognition and gives the clinician a few more projections
to choose from
but.
If there was no legacy problem with current
systems, 12-lead system wouldve been
discarded ages ago
Electroencephalography (EEG)
Measures the brains electric
activity from the scalp
Measured signal results from
the activity of billions of neurons
Amplitude: 0.001-0.01 mV
Bandwidth: 0.5-40 Hz
Errors:
Thermal RF noise
50/60 Hz power lines
Blink artifacts and similar
Typical applications:
Sleep studies
Seizure detection
Cortical mapping
EEG measurement setup
10-20 Lead system is most
widely clinically accepted
Certain physiological features
are used as reference points
Allow localization of diagnostic
features in the vicinity of the
electrode
Often a readily available wire or
rubber mesh is used
Brain research utilizes even 256
or 512 channel EEG hats
Electromyography (EMG)
Measures the electric activity of active muscle fibers
Electrodes are always connected very close to the muscle
group being measured
Rectified and integrated EMG signal gives rough indication
of the muscle activity
Needle electrodes can be used to measure individual muscle fibers
Amplitude: 1-10 mV
Bandwidth: 20-2000 Hz
Main sources of errors are 50/60 Hz and RF interference
Applications: muscle function, neuromuscular disease, prosthesis
Electrooculography (EOG)
Electric potentials are created as a result of the movement of the eyeballs
Potential varies in proportion to the amplitude of the movement
In many ways a challenging measurement with some clinical value
Amplitude: 0.01-0.1 mV
Bandwidth: DC-10 Hz
Primary sources of error include skin potential and motion
Applications: eye position, sleep state, vestibulo-ocular reflex
Vectorcardiogram (VCG or EVCG)
Instead of displaying the scalar amplitude (ECG
curve) the electric activation front is measured and
displayed as a vector (dipole model, remember?)
It has amplitude and direction
Diagnosis is based on the curve that the point of this
vector draws in 2 or 3 dimensions
The information content of the VCG signal is roughly
the same as 12-lead ECG system. The advantage
comes from the way how this information is
displayed
A normal, scalar ECG curve can be formed from this
vectro representation, although (for practical
reasons) transformation can be quite complicated
Plenty of different types of VCG systems are in use
No legacy problem as such
Short break,
Kahvia ja pullaa!
The biopotential amplifier
Small amplitudes, low frequencies, environmental and biological sources of
interference etc.
Essential requirements for measurement equipment:
High amplification
High differential gain, low common mode gain high CMRR
High input impedance
Low Noise
Stability against temperature and voltage fluctuations
Electrical safety, isolation and defibrillation protection
The Instrumentation Amplifier
Potentially combines the best features desirable for biopotential measurements
High differential gain, low common mode gain, high CMRR, high input resistance
A key design component to almost all biopotential measurements!
Simple and cheap, although high-quality OpAmps with high CMRR should be used
1
2
1
2 1
R
R
G
3
4
2
R
R
G
CMRR fine tuning
Application-specific requirements
ECG amplifier
Lower corner frequency 0.05 Hz, upper 100Hz
Safety and protection: leakage current below safety standard limit of 10 uA
Electrical isolation from the power line and the earth ground
Protection against high defibrillation voltages
EEG amplifier
Gain must deal with microvolt or lower levels of signals
Components must have low thermal and electronic noise @ the front end
Otherwise similar to ECG
EMG amplifier
Slightly enhanced amplifier BW suffices
Post-processing circuits are almost always needed (e.g. rectifier +integrator)
EOG amplifier
High gain with very good low frequency (or even DC) response
DC-drifting electrodes should be selected with great care
Often active DC or drift cancellation or correction circuit may be necessary
Electrical Interference Reduction
Power line interference (50 or 60 Hz) is always around us
Connects capacitively and causes common mode interference
The common mode interference would be completely rejected by the instrumentation
amplifier if the matching would be ideal
Often a clever driven right leg circuit is used to further enhance CMRR
Average of the V
CM
is inverted and driven back to the body via reference electrode
0
R i V
D CM

1
2
0
2 1
R
R
R i
V
D
CM

Filtering
Filtering should be included in the front end of the InstrAmp
Transmitters, motors etc. cause also RF interference
Small inductors
or ferrite beads
in the lead wires
block HF frequency
EM interference
RF filtering with
small capacitors
High-pass filter
to reject DC drifting
Low-pass filtering
at several stages
is recommended to
attenuate residual
RF interference
50 or 60 Hz notch filter
Sometimes it may be desirable to remove the power line interference
Overlaps with the measurement bandwidth
May distort the measurement result and have an affect on the diagnosis!
Option often available with EEG & EOG measuring instruments
Twin T
notch filter
Determines
notch
frequency
Notch
tuning
Artifact reduction
Electrode-skin interface is a major source of artifact
Changes in the junction potential causes slow changes in the baseline
Movement artifacts cause more sudden changes and artifacts
Drifting in the baseline can be detected by discharging the high-pass capacitor in
the amplifier to restore the baseline
Electrical isolation
Electrical isolation limits the possibility of passage of any leakage current from
the instrument in use to the patient
Such passage would be harmful if not fatal!
1. Transformer
Transformers are inherently high frequency
AC devices
Modulation and demodulation needed
2. Optical isolation
Optical signal is modulated in proportion to
the electric signal and transmitted to the
detector
Typically pulse code modulated to
circumvent the inherent nonlinearity of the
LED-phototransistor combination
Defibrillation Protection
Measuring instruments can encounter very high voltages
E.g. 15005000V shocks from defibrillator
Front-end must be designed to withstand these high voltages
1. Resistors in the input
leads limit the current
3. Protection against
much higher voltages
is achieved with
low-pressure gas
discharge tubes
(e.g. neon lamps)
(note: even isolation
components such as
transformers and
optical isolators need
these spark gaps)
Discharge @ ~100V
2. Diodes or Zener diodes
protect against high
voltages
Discharge @ 0.7-15V
Electrodes Basics
High-quality biopotential measurements require
Good amplifier design
Use of good electrodes and their proper placement on the patient
Good laboratory and clinical practices
Electrodes should be chosen according to the application
Basic electrode structure includes:
The body and casing
Electrode made of high-conductivity material
Wire connector
Cavity or similar for electrolytic gel
Adhesive rim
The complexity of electrode design often neglected
Electrodes - Basics
Skin preparation by abrasion or cleansing
Placement close to the source being measured
Placement above bony structures where there is less muscle mass
Distinguishing features of different electrodes:
How secure? The structure and the use of strong but less irritant adhesives
How conductive? Use of noble metals vs. cheaper materials
How prone to artifact? Use of low-junction-potential materials such as Ag-AgCl
If electrolytic gel is used, how is it applied? High conductivity gels can help reduce the junction
potentials and resistance but tend to be more allergenic or irritating
Baseline drift due to the
changes in junction
potential or motion artifacts
Choice of electrodes
Muscle signal
interference
Placement
Electromagnetic
interference
Shielding
Ag-AgCl, Silver-Silver Chloride Electrodes
The most commonly used electrode type
Silver is interfaced with its salt silver-chloride
Choice of materials helps to reduce junction potentials
J unction potentials are the result of the dissimilar electrolytic
interfaces
Electrolytic gel enhances conductivity and also reduces junction
potentials
Typically based on sodium or potassium chloride, concentration in
the order of 0.1 M weak enough to not irritate the skin
The gel is typically soaked into a foam pad or applied directly in
a pocket produced by electrode housing
Relatively low-cost and general purpose electrode
Particularly suited for ambulatory or long term use
Gold Electrodes
Very high conductivity suitable for low-noise meas.
Inertness suitable for reusable electrodes
Body forms cavity which is filled with electrolytic gel
Compared to Ag-AgCL: greater expense, higher
junction potentials and motion artifacts
Often used in EEG, sometimes in EMG
Conductive polymer electrodes
Made out of material that is simultaneously conductive and adhesive
Polymer is made conductive by adding monovalent metallic ions
Aluminum foil allows contact to external instrumentation
No need for gel or other adhesive substance
High resistivity makes unsuitable for low-noise meas.
Not as good connection as with traditional electrodes
Metal or carbon electrodes
Other metals are seldom used as high-quality noble
metal electrodes or low-cost carbon or polymeric
electrodes are so readily available
Historical value. Bulky and awkward to use
Carbon electrodes have high resistivity and are noisier
but they are also flexibleand reusable
Applications in electrical stimulation and impedance plethysmography
Needle electrodes
Obviously invasive electrodes
Used when measurements have to be taken from the organ itself
Small signals such as motor unit potentials can be measured
Needle is often a steel wire with hooked tip
Thats it,
Now for Q&A
SQUID =Superconducting Quantum Interference Device