Implementation of mobile EEG for resting-state and visual evoked potentials in young children in rural Ethiopia

Children living in low- and middle-income countries (LMIC) are at disproportionately higher risk of neurodevelopmental delays due to exposure to adverse biological and environmental hazards. In infancy, global developmental assessments, such as the Bayley Scales, are insensitive, do not strongly cor...

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Main Authors: Theresa I. Chin, Winko W. An, Kalkidan Yibeltal, Firehiwot Workneh, Stephen Pihl, Sarah K. G. Jensen, Gellila Asmamaw, Nebiyou Fasil, Atsede Teklehaimanot, Krysten North, Sonya V. Troller-Renfree, Charles A. Nelson, Yemane Berhane, Anne CC Lee
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Human Neuroscience
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Online Access:https://www.frontiersin.org/articles/10.3389/fnhum.2025.1552410/full
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author Theresa I. Chin
Theresa I. Chin
Theresa I. Chin
Winko W. An
Winko W. An
Kalkidan Yibeltal
Firehiwot Workneh
Stephen Pihl
Sarah K. G. Jensen
Sarah K. G. Jensen
Gellila Asmamaw
Nebiyou Fasil
Atsede Teklehaimanot
Krysten North
Krysten North
Sonya V. Troller-Renfree
Charles A. Nelson
Charles A. Nelson
Yemane Berhane
Anne CC Lee
Anne CC Lee
Anne CC Lee
author_facet Theresa I. Chin
Theresa I. Chin
Theresa I. Chin
Winko W. An
Winko W. An
Kalkidan Yibeltal
Firehiwot Workneh
Stephen Pihl
Sarah K. G. Jensen
Sarah K. G. Jensen
Gellila Asmamaw
Nebiyou Fasil
Atsede Teklehaimanot
Krysten North
Krysten North
Sonya V. Troller-Renfree
Charles A. Nelson
Charles A. Nelson
Yemane Berhane
Anne CC Lee
Anne CC Lee
Anne CC Lee
author_sort Theresa I. Chin
collection DOAJ
description Children living in low- and middle-income countries (LMIC) are at disproportionately higher risk of neurodevelopmental delays due to exposure to adverse biological and environmental hazards. In infancy, global developmental assessments, such as the Bayley Scales, are insensitive, do not strongly correlate with later cognitive outcomes, and require adaptation for different populations and cultural contexts. Electroencephalography (EEG) objectively measures electrical brain activity and may provide early neural markers predictive of long-term cognitive outcomes. The visual evoked potential (VEP) interrogates the efficiency of visual cortical processing and reflects neural processing speed. Mobile EEG enables the assessment of neural processing in settings where such technologies were historically inaccessible. This paper describes the experiences and lessons learned from implementing mobile EEG and VEP in rural Amhara, Ethiopia as part of the Longitudinal Infant Growth and Development (LIDG) study (NCT06296238). We describe adaptations and strategies to address and optimize data capture (e.g., dry electrode tips to improve scalp contact, tailored protocols, and adequate equipment specifications), environmental challenges (e.g., space constraints, lack of water supply, power outage) and cultural factors (e.g., hair type) unique to the study setting and population. Our formative research underscored the importance of creating awareness among community members (e.g., mothers, fathers, and religious leaders) and local clinicians to improve community engagement and buy-in. Culturally sensitive child behavior management techniques were also critical to ensure EEG completion and high data quality. With community sensitization, we had high consent rates for EEG/VEP (>90%). We completed EEG recordings within an average ± standard deviation of 20 ± 11 minutes. After data processing, approximately 90% and 70% of participants met predefined data quality thresholds for resting EEG and VEP, respectively. Implementing mobile EEG/VEP was feasible and acceptable in rural Ethiopia, with a relatively high proportion of recordings meeting quality standards.
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spelling doaj-art-ff0cfb1643be46b39b09c3b94f05f6c92025-08-20T03:10:56ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612025-06-011910.3389/fnhum.2025.15524101552410Implementation of mobile EEG for resting-state and visual evoked potentials in young children in rural EthiopiaTheresa I. Chin0Theresa I. Chin1Theresa I. Chin2Winko W. An3Winko W. An4Kalkidan Yibeltal5Firehiwot Workneh6Stephen Pihl7Sarah K. G. Jensen8Sarah K. G. Jensen9Gellila Asmamaw10Nebiyou Fasil11Atsede Teklehaimanot12Krysten North13Krysten North14Sonya V. Troller-Renfree15Charles A. Nelson16Charles A. Nelson17Yemane Berhane18Anne CC Lee19Anne CC Lee20Anne CC Lee21Division of Biology and Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United StatesHarvard Medical School, Boston, MA, United StatesDepartment of Pediatrics, Brigham and Women’s Hospital, Boston, MA, United StatesHarvard Medical School, Boston, MA, United StatesBoston Children’s Hospital, Boston, MA, United StatesDepartment of Reproductive Health and Population, Addis Continental Institute of Public Health, Addis Ababa, EthiopiaDepartment of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, EthiopiaBoston Children’s Hospital, Boston, MA, United StatesHarvard Medical School, Boston, MA, United StatesDepartment of Pediatrics, Brigham and Women’s Hospital, Boston, MA, United StatesDepartment of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, EthiopiaDepartment of Global Health and Health Policy, Addis Continental Institute of Public Health, Addis Ababa, EthiopiaCollege of Health Science, Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, EthiopiaHarvard Medical School, Boston, MA, United StatesDepartment of Pediatrics, Brigham and Women’s Hospital, Boston, MA, United StatesDepartment of Human Development, Teachers College, Columbia University, New York, NY, United StatesHarvard Medical School, Boston, MA, United StatesBoston Children’s Hospital, Boston, MA, United StatesDepartment of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, EthiopiaDivision of Biology and Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United StatesHarvard Medical School, Boston, MA, United StatesDepartment of Pediatrics, Brigham and Women’s Hospital, Boston, MA, United StatesChildren living in low- and middle-income countries (LMIC) are at disproportionately higher risk of neurodevelopmental delays due to exposure to adverse biological and environmental hazards. In infancy, global developmental assessments, such as the Bayley Scales, are insensitive, do not strongly correlate with later cognitive outcomes, and require adaptation for different populations and cultural contexts. Electroencephalography (EEG) objectively measures electrical brain activity and may provide early neural markers predictive of long-term cognitive outcomes. The visual evoked potential (VEP) interrogates the efficiency of visual cortical processing and reflects neural processing speed. Mobile EEG enables the assessment of neural processing in settings where such technologies were historically inaccessible. This paper describes the experiences and lessons learned from implementing mobile EEG and VEP in rural Amhara, Ethiopia as part of the Longitudinal Infant Growth and Development (LIDG) study (NCT06296238). We describe adaptations and strategies to address and optimize data capture (e.g., dry electrode tips to improve scalp contact, tailored protocols, and adequate equipment specifications), environmental challenges (e.g., space constraints, lack of water supply, power outage) and cultural factors (e.g., hair type) unique to the study setting and population. Our formative research underscored the importance of creating awareness among community members (e.g., mothers, fathers, and religious leaders) and local clinicians to improve community engagement and buy-in. Culturally sensitive child behavior management techniques were also critical to ensure EEG completion and high data quality. With community sensitization, we had high consent rates for EEG/VEP (>90%). We completed EEG recordings within an average ± standard deviation of 20 ± 11 minutes. After data processing, approximately 90% and 70% of participants met predefined data quality thresholds for resting EEG and VEP, respectively. Implementing mobile EEG/VEP was feasible and acceptable in rural Ethiopia, with a relatively high proportion of recordings meeting quality standards.https://www.frontiersin.org/articles/10.3389/fnhum.2025.1552410/fullelectroencephalography (EEG)neurodevelopmentlow- and middle-income countries (LMIC)nutritionvisual evoked potential (VEP)
spellingShingle Theresa I. Chin
Theresa I. Chin
Theresa I. Chin
Winko W. An
Winko W. An
Kalkidan Yibeltal
Firehiwot Workneh
Stephen Pihl
Sarah K. G. Jensen
Sarah K. G. Jensen
Gellila Asmamaw
Nebiyou Fasil
Atsede Teklehaimanot
Krysten North
Krysten North
Sonya V. Troller-Renfree
Charles A. Nelson
Charles A. Nelson
Yemane Berhane
Anne CC Lee
Anne CC Lee
Anne CC Lee
Implementation of mobile EEG for resting-state and visual evoked potentials in young children in rural Ethiopia
Frontiers in Human Neuroscience
electroencephalography (EEG)
neurodevelopment
low- and middle-income countries (LMIC)
nutrition
visual evoked potential (VEP)
title Implementation of mobile EEG for resting-state and visual evoked potentials in young children in rural Ethiopia
title_full Implementation of mobile EEG for resting-state and visual evoked potentials in young children in rural Ethiopia
title_fullStr Implementation of mobile EEG for resting-state and visual evoked potentials in young children in rural Ethiopia
title_full_unstemmed Implementation of mobile EEG for resting-state and visual evoked potentials in young children in rural Ethiopia
title_short Implementation of mobile EEG for resting-state and visual evoked potentials in young children in rural Ethiopia
title_sort implementation of mobile eeg for resting state and visual evoked potentials in young children in rural ethiopia
topic electroencephalography (EEG)
neurodevelopment
low- and middle-income countries (LMIC)
nutrition
visual evoked potential (VEP)
url https://www.frontiersin.org/articles/10.3389/fnhum.2025.1552410/full
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