# Identifying trace alternant activity in neonatal EEG using an inter-burst detection approach

arXiv: https://arxiv.org/abs/2005.05559 · HTML: https://mlsanity.com/paper/2005.05559/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- First posted on arXiv 12 May 2020.

## Built on by (most cited first, 2 of 2)

- [Scaling convolutional neural networks achieves expert-level seizure detection in neonatal EEG](https://mlsanity.com/paper/2405.09911/) (2024)
- [Expert-level detection of low-voltage intervals in EEG as a robust biomarker of neonatal encephalopathy](https://mlsanity.com/paper/2610.12680/) (2026)

## Abstract (arXiv)

Electroencephalography (EEG) is an important clinical tool for reviewing sleep-wake cycling in neonates in intensive care. Trace alternant (TA)-a characteristic pattern of EEG activity during quiet sleep in term neonates-is defined by alternating periods of short-duration, high-voltage activity (bursts) separated by lower-voltage activity (inter-bursts). This study presents a novel approach for detecting TA activity by first detecting the inter-bursts and then processing the temporal map of the bursts and inter-bursts. EEG recordings from 72 healthy term neonates were used to develop and evaluate performance of 1) an inter-burst detection method which is then used for 2) detection of TA activity. First, multiple amplitude and spectral features were combined using a support vector machine (SVM) to classify bursts from inter-bursts within TA activity, resulting in a median area under the operating characteristic curve (AUC) of 0.95 (95% confidence interval, CI: 0.93 to 0.98). Second, post-processing of the continuous SVM output, the confidence score, was used to produce a TA envelope. This envelope was used to detect TA activity within the continuous EEG with a median AUC of 0.84 (95% CI: 0.80 to 0.88). These results validate how an inter-burst detection approach combined with post processing can be used to classify TA activity. Detecting the presence or absence of TA will help quantify disruption of the clinically important sleep-wake cycle.