The frequency domain versus time domain methods for processing of intracranial pressure (ICP) signals

Two methods for analyzing intracranial pressure (ICP) waveforms were compared. The frequency domain (FD) method converts the signal from the time domain to the frequency domain by a fast Fourier transform (FFT), while the time domain (TD) method calculates peak-to-peak value of the pulse waveform directly from the time samples. First, the ICP signal was regenerated from the first harmonic of the FFT and compared against the time domain raw ICP signal. We found that the FD method may underestimate pulse amplitude if there is heart rate variability or a high harmonic distortion. Second, to explore the significance in a larger data set, differences between FD- and TD-derived pulse amplitudes were determined for a total of 50,978 6-s time windows of 79 head injury patients. The mean difference in pulse pressure amplitude was 2.9 mmHg for the 50,978 6-s time windows. Differences between TD- and FD-derived pulse amplitudes were ≥2.0 mmHg in 58.8% of the 50,978 time windows. In about 33% of time windows FD amplitudes were <2 mmHg when TD amplitudes were ≥4 mmHg, and vice versa. Hence, the TD method is superior to the FD method for calculation of pulse amplitudes. Nevertheless, in this material both the TD and FD methods revealed significantly elevated pulse amplitudes in head injury patients with bad outcome (i.e. Glasgow Outcome Score 1–3).