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Lin N, Gao W, Li L, Chen J, Liang Z, Yuan G, Sun H, Liu Q, Chen J, Jin L, Huang Y, Zhou X, Zhang S, Hu P, Dai C, He H, Dong Y, Cui L, Lu Q. vEpiNet: A multimodal interictal epileptiform discharge detection method based on video and electroencephalogram data. Neural Netw 2024; 175:106319. [PMID: 38640698 DOI: 10.1016/j.neunet.2024.106319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/08/2024] [Accepted: 04/11/2024] [Indexed: 04/21/2024]
Abstract
To enhance deep learning-based automated interictal epileptiform discharge (IED) detection, this study proposes a multimodal method, vEpiNet, that leverages video and electroencephalogram (EEG) data. Datasets comprise 24 931 IED (from 484 patients) and 166 094 non-IED 4-second video-EEG segments. The video data is processed by the proposed patient detection method, with frame difference and Simple Keypoints (SKPS) capturing patients' movements. EEG data is processed with EfficientNetV2. The video and EEG features are fused via a multilayer perceptron. We developed a comparative model, termed nEpiNet, to test the effectiveness of the video feature in vEpiNet. The 10-fold cross-validation was used for testing. The 10-fold cross-validation showed high areas under the receiver operating characteristic curve (AUROC) in both models, with a slightly superior AUROC (0.9902) in vEpiNet compared to nEpiNet (0.9878). Moreover, to test the model performance in real-world scenarios, we set a prospective test dataset, containing 215 h of raw video-EEG data from 50 patients. The result shows that the vEpiNet achieves an area under the precision-recall curve (AUPRC) of 0.8623, surpassing nEpiNet's 0.8316. Incorporating video data raises precision from 70% (95% CI, 69.8%-70.2%) to 76.6% (95% CI, 74.9%-78.2%) at 80% sensitivity and reduces false positives by nearly a third, with vEpiNet processing one-hour video-EEG data in 5.7 min on average. Our findings indicate that video data can significantly improve the performance and precision of IED detection, especially in prospective real clinic testing. It suggests that vEpiNet is a clinically viable and effective tool for IED analysis in real-world applications.
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Affiliation(s)
- Nan Lin
- Department of Neurology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Weifang Gao
- Department of Neurology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Lian Li
- NetEase Media Technology Co., Ltd., Beijing, 100084, China
| | - Junhui Chen
- NetEase Media Technology Co., Ltd., Beijing, 100084, China
| | - Zi Liang
- NetEase Media Technology Co., Ltd., Beijing, 100084, China
| | - Gonglin Yuan
- NetEase Media Technology Co., Ltd., Beijing, 100084, China
| | - Heyang Sun
- Department of Neurology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Qing Liu
- Department of Neurology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Jianhua Chen
- Department of Neurology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Liri Jin
- Department of Neurology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Yan Huang
- Department of Neurology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Xiangqin Zhou
- Department of Neurology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Shaobo Zhang
- NetEase Media Technology Co., Ltd., Beijing, 100084, China
| | - Peng Hu
- NetEase Media Technology Co., Ltd., Beijing, 100084, China
| | - Chaoyue Dai
- NetEase Media Technology Co., Ltd., Beijing, 100084, China
| | - Haibo He
- NetEase Media Technology Co., Ltd., Beijing, 100084, China
| | - Yisu Dong
- NetEase Media Technology Co., Ltd., Beijing, 100084, China
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital, Beijing, 100730, China.
| | - Qiang Lu
- Department of Neurology, Peking Union Medical College Hospital, Beijing, 100730, China.
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Huang L, Zhou K, Chen S, Chen Y, Zhang J. Automatic detection of epilepsy from EEGs using a temporal convolutional network with a self-attention layer. Biomed Eng Online 2024; 23:50. [PMID: 38824547 PMCID: PMC11143608 DOI: 10.1186/s12938-024-01244-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/08/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Over 60% of epilepsy patients globally are children, whose early diagnosis and treatment are critical for their development and can substantially reduce the disease's burden on both families and society. Numerous algorithms for automated epilepsy detection from EEGs have been proposed. Yet, the occurrence of epileptic seizures during an EEG exam cannot always be guaranteed in clinical practice. Models that exclusively use seizure EEGs for detection risk artificially enhanced performance metrics. Therefore, there is a pressing need for a universally applicable model that can perform automatic epilepsy detection in a variety of complex real-world scenarios. METHOD To address this problem, we have devised a novel technique employing a temporal convolutional neural network with self-attention (TCN-SA). Our model comprises two primary components: a TCN for extracting time-variant features from EEG signals, followed by a self-attention (SA) layer that assigns importance to these features. By focusing on key features, our model achieves heightened classification accuracy for epilepsy detection. RESULTS The efficacy of our model was validated on a pediatric epilepsy dataset we collected and on the Bonn dataset, attaining accuracies of 95.50% on our dataset, and 97.37% (A v. E), and 93.50% (B vs E), respectively. When compared with other deep learning architectures (temporal convolutional neural network, self-attention network, and standardized convolutional neural network) using the same datasets, our TCN-SA model demonstrated superior performance in the automated detection of epilepsy. CONCLUSION The proven effectiveness of the TCN-SA approach substantiates its potential as a valuable tool for the automated detection of epilepsy, offering significant benefits in diverse and complex real-world clinical settings.
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Affiliation(s)
- Leen Huang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Keying Zhou
- Department of Pediatrics, Shenzhen People's Hospital, Shenzhen, 518020, Guangdong, China
- Department of Pediatrics, Second Clinical Medical College of Jinan University, Shenzhen, 518020, Guangdong, China
- Department of Pediatrics, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, 518020, Guangdong, China
| | - Siyang Chen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China
| | - Yanzhao Chen
- Department of Pediatrics, Shenzhen People's Hospital, Shenzhen, 518020, Guangdong, China
- Department of Pediatrics, Second Clinical Medical College of Jinan University, Shenzhen, 518020, Guangdong, China
- Department of Pediatrics, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, 518020, Guangdong, China
| | - Jinxin Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China.
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Tsereteli A, Okujava N, Malashkhia N, Liluashvili K, de Weerd A. The ENCEVIS algorithm in the EMU and the factors affecting its performance: Our experience. Epilepsy Behav Rep 2024; 26:100656. [PMID: 38495403 PMCID: PMC10937301 DOI: 10.1016/j.ebr.2024.100656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/26/2024] [Accepted: 03/03/2024] [Indexed: 03/19/2024] Open
Abstract
The study's purpose was to assess the seizure detection performance of ENCEVIS 1.7, identify factors that may influence algorithm performance, and explore its potential for implementation and application in long-term video EEG monitoring units. The study included video-EEG recordings containing at least one epileptic seizure. Forty-three recordings, encompassing 112 seizures, were included in the analysis. True positive, false negative, and false positive seizure detections were defined. Factors that may influence algorithm performance were studied. ENCEVIS demonstrated an overall sensitivity of 71.2%, significantly higher (75.1%) in focal compared to generalized seizures (62%). Ictal patterns rhythmicity (rhythmic 59.4 %, arrhythmic 41.7 %), seizure duration (<10 sec 6.3 %, >60 sec. 63.9 % (p < 0.05)) and patient age (<18 years 39.5 %, >18 years 58.1 % (P < 0.05)) influenced ENCEVIS sensitivity. The coexistence of extracerebral signal changes did not influence sensitivity. ENCEVIS with 79.1% accuracy annotates at least one seizure in those recordings containing epileptic seizures. ENCEVIS seizure detection performance was reasonable for generalized/focal to bilateral tonic-clonic seizures and seizures with temporal lobe onset. Rhythmic ictal patterns, longer seizure duration, and adult age positively influenced algorithm performance. ENCEVIS can be a valuable tool for identifying recordings containing seizures and can potentially reduce the workload of neurophysiologists.
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Affiliation(s)
- Aleksandre Tsereteli
- Epilepsy and Sleep Centre, S. Khechinashvili University Hospital (SKUH), Georgia
| | - Natela Okujava
- Epilepsy and Sleep Centre, S. Khechinashvili University Hospital (SKUH), Georgia
- Department of Clinical Neurology, Tbilisi State Medical University (TSMU), Georgia
| | - Nikoloz Malashkhia
- Epilepsy and Sleep Centre, S. Khechinashvili University Hospital (SKUH), Georgia
| | | | - Al de Weerd
- Stichting Epilepsie Instellingen Nederland (SEIN), Zwolle, Netherland
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Abdi-Sargezeh B, Shirani S, Sanei S, Took CC, Geman O, Alarcon G, Valentin A. A review of signal processing and machine learning techniques for interictal epileptiform discharge detection. Comput Biol Med 2024; 168:107782. [PMID: 38070202 DOI: 10.1016/j.compbiomed.2023.107782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 11/15/2023] [Accepted: 11/28/2023] [Indexed: 01/10/2024]
Abstract
Brain interictal epileptiform discharges (IEDs), as one of the hallmarks of epileptic brain, are transient events captured by electroencephalogram (EEG). IEDs are generated by seizure networks, and they occur between seizures (interictal periods). The development of a robust method for IED detection could be highly informative for clinical treatment procedures and epileptic patient management. Since 1972, different machine learning techniques, from template matching to deep learning, have been developed to automatically detect IEDs from scalp EEG (scEEG) and intracranial EEG (iEEG). While the scEEG signals suffer from low information details and high attenuation of IEDs due to the high skull electrical impedance, the iEEG signals recorded using implanted electrodes enjoy higher details and are more suitable for identifying the IEDs. In this review paper, we group IED detection techniques into six categories: (1) template matching, (2) feature representation (mimetic, time-frequency, and nonlinear features), (3) matrix decomposition, (4) tensor factorization, (5) neural networks, and (6) estimation of the iEEG from the concurrent scEEG followed by detection and classification. The methods are compared quantitatively (e.g., in terms of accuracy, sensitivity, and specificity), and their general advantages and limitations are described. Finally, current limitations and possible future research paths related to this field are mentioned.
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Affiliation(s)
- Bahman Abdi-Sargezeh
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; School of Science and Technology, Nottingham Trent University, Nottingham, UK.
| | - Sepehr Shirani
- School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Saeid Sanei
- School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Clive Cheong Took
- Department of Electronic Engineering, Royal Holloway, University of London, London, UK
| | - Oana Geman
- Computer, Electronics and Automation Department, University Stefan cel Mare, Suceava, Romania
| | - Gonzalo Alarcon
- Department of Clinical Neurophysiology, Royal Manchester Children's Hospital, Manchester, UK
| | - Antonio Valentin
- Department of Clinical Neuroscience, King's College London, London, UK
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Khan SU, Jan SU, Koo I. Robust Epileptic Seizure Detection Using Long Short-Term Memory and Feature Fusion of Compressed Time-Frequency EEG Images. SENSORS (BASEL, SWITZERLAND) 2023; 23:9572. [PMID: 38067944 PMCID: PMC10708722 DOI: 10.3390/s23239572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023]
Abstract
Epilepsy is a prevalent neurological disorder with considerable risks, including physical impairment and irreversible brain damage from seizures. Given these challenges, the urgency for prompt and accurate seizure detection cannot be overstated. Traditionally, experts have relied on manual EEG signal analyses for seizure detection, which is labor-intensive and prone to human error. Recognizing this limitation, the rise in deep learning methods has been heralded as a promising avenue, offering more refined diagnostic precision. On the other hand, the prevailing challenge in many models is their constrained emphasis on specific domains, potentially diminishing their robustness and precision in complex real-world environments. This paper presents a novel model that seamlessly integrates the salient features from the time-frequency domain along with pivotal statistical attributes derived from EEG signals. This fusion process involves the integration of essential statistics, including the mean, median, and variance, combined with the rich data from compressed time-frequency (CWT) images processed using autoencoders. This multidimensional feature set provides a robust foundation for subsequent analytic steps. A long short-term memory (LSTM) network, meticulously optimized for the renowned Bonn Epilepsy dataset, was used to enhance the capability of the proposed model. Preliminary evaluations underscore the prowess of the proposed model: a remarkable 100% accuracy in most of the binary classifications, exceeding 95% accuracy in three-class and four-class challenges, and a commendable rate, exceeding 93.5% for the five-class classification.
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Affiliation(s)
- Shafi Ullah Khan
- Department of Electrical Electronic and Computer Engineering, University of Ulsan, Ulsan 44610, Republic of Korea
| | - Sana Ullah Jan
- School of Computing, Edinburgh Napier University, Edinburgh EH10 5DT, UK;
| | - Insoo Koo
- Department of Electrical Electronic and Computer Engineering, University of Ulsan, Ulsan 44610, Republic of Korea
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Greenblatt AS, Beniczky S, Nascimento FA. Pitfalls in scalp EEG: Current obstacles and future directions. Epilepsy Behav 2023; 149:109500. [PMID: 37931388 DOI: 10.1016/j.yebeh.2023.109500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 11/08/2023]
Abstract
Although electroencephalography (EEG) serves a critical role in the evaluation and management of seizure disorders, it is commonly misinterpreted, resulting in avoidable medical, social, and financial burdens to patients and health care systems. Overinterpretation of sharply contoured transient waveforms as being representative of interictal epileptiform abnormalities lies at the core of this problem. However, the magnitude of these errors is amplified by the high prevalence of paroxysmal events exhibited in clinical practice that compel investigation with EEG. Neurology training programs, which vary considerably both in the degree of exposure to EEG and the composition of EEG didactics, have not effectively addressed this widespread issue. Implementation of competency-based curricula in lieu of traditional educational approaches may enhance proficiency in EEG interpretation amongst general neurologists in the absence of formal subspecialty training. Efforts in this regard have led to the development of a systematic, high-fidelity approach to the interpretation of epileptiform discharges that is readily employable across medical centers. Additionally, machine learning techniques hold promise for accelerating accurate and reliable EEG interpretation, particularly in settings where subspecialty interpretive EEG services are not readily available. This review highlights common diagnostic errors in EEG interpretation, limitations in current educational paradigms, and initiatives aimed at resolving these challenges.
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Affiliation(s)
- Adam S Greenblatt
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Sándor Beniczky
- Department of Clinical Neurophysiology, Danish Epilepsy Center, Dianalund and Aarhus University Hospital, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Fábio A Nascimento
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
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Wang X, Wang X, Wang C, Wang Z, Liu X, Lv X, Tang Y. A Two-Stage Automatic System for Detection of Interictal Epileptiform Discharges from Scalp Electroencephalograms. eNeuro 2023; 10:ENEURO.0111-23.2023. [PMID: 37914407 PMCID: PMC10668214 DOI: 10.1523/eneuro.0111-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/22/2023] [Accepted: 09/15/2023] [Indexed: 11/03/2023] Open
Abstract
The objective of this work was to develop a deep learning-based automatic system with reliable performance in detecting interictal epileptiform discharges (IEDs) from scalp electroencephalograms (EEGs). For the present study, 484 raw scalp EEG recordings were included, standardized, and split into 406 for training and 78 for testing. Two neurophysiologists individually annotated the recordings for training in channel-wise manner. Annotations were divided into segments, on which nine deep neural networks (DNNs) were trained for the multiclassification of IED, artifact, and background. The fitted IED detectors were then evaluated on 78 EEG recordings with IED events fully annotated by three experts independently (majority agreement). A two montage-based decision mechanism (TMDM) was designed to determine whether an IED event occurred at a single time instant. Area under the precision-recall curve (AUPRC), as well as false-positive rates, F1 scores, and kappa agreement scores for sensitivity = 0.8 were estimated. In multitype classification, five DNNs provided one-versus-rest AUPRC mean value >0.993 using fivefold cross-validation. In IED detection, the system that had integrated the temporal convolutional network (TCN)-based IED detector and the TMDM rule achieved an AUPRC of 0.811. The false positive was 0.194/min (11.64/h), and the F1 score was 0.745. The agreement score between the system and the experts was 0.905. The proposed framework provides a TCN-based IED detector and a novel two montage-based determining mechanism that combined to make an automatic IED detection system. The system would be useful in aiding clinic EEG interpretation.
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Affiliation(s)
- Xiaoyun Wang
- Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, People's Republic of China
| | - Xing Wang
- Department of Signal Processing Research, Beijing Solar Electronic Technologies Company Ltd, Beijing 100044, People's Republic of China
| | - Chong Wang
- Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, People's Republic of China
| | - Zhongyuan Wang
- Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, People's Republic of China
| | - Xiangyu Liu
- Department of Neurosurgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, People's Republic of China
| | - Xiaoling Lv
- Geriatrics Research Institute of Zhejiang Province, Zhejiang Provincial Key Lab of Geriatrics, Zhejiang Hospital, Hangzhou 310013, People's Republic of China
| | - Ying Tang
- Geriatrics Research Institute of Zhejiang Province, Zhejiang Provincial Key Lab of Geriatrics, Zhejiang Hospital, Hangzhou 310013, People's Republic of China
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Mohammed AH, Cabrerizo M, Pinzon A, Yaylali I, Jayakar P, Adjouadi M. Graph neural networks in EEG spike detection. Artif Intell Med 2023; 145:102663. [PMID: 37925203 DOI: 10.1016/j.artmed.2023.102663] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 06/06/2023] [Accepted: 09/14/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVE This study develops new machine learning architectures that are more adept at detecting interictal epileptiform discharges (IEDs) in scalp EEG. A comparison of results using the average precision (AP) metric is made with the proposed models on two datasets obtained from Baptist Hospital of Miami and Temple University Hospital. METHODS Applying graph neural networks (GNNs) on functional connectivity (FC) maps of different frequency sub-bands to yield a novel architecture we call FC-GNN. Attention mechanism is applied on a complete graph to let the neural network select its important edges, hence bypassing the extraction of features, a model we refer to as CA-GNN. RESULTS On the Baptist Hospital dataset, the results were as follows: Vanilla Self-Attention →0.9029±0.0431, Hierarchical Attention →0.8546±0.0587, Vanilla Visual Geometry Group (VGG) →0.92±0.0618, Satelight →0.9219±0.046, FC-GNN →0.9731±0.0187, and CA-GNN →0.9788±0.0125. In the same order, the results on the Temple University Hospital dataset are 0.9692, 0.9113, 0.97, 0.9575, 0.963, and 0.9879. CONCLUSION Based on the good results they yield, GNNs prove to have a strong potential in detecting epileptogenic activity. SIGNIFICANCE This study opens the door for the discovery of the powerful role played by GNNs in capturing IEDs, which is an essential step for identifying the epileptogenic networks of the affected brain and hence improving the prospects for more accurate 3D source localization.
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Affiliation(s)
- Ahmed Hossam Mohammed
- Department of Electrical and Computer Engineering, Florida International University, 10555 W Flagler St, Miami, 33174, FL, USA.
| | - Mercedes Cabrerizo
- Department of Electrical and Computer Engineering, Florida International University, 10555 W Flagler St, Miami, 33174, FL, USA
| | - Alberto Pinzon
- Epilepsy Center, Baptist Hospital of Miami, 9090 SW 87th Ct Suite201, Miami, 33176, FL, USA
| | - Ilker Yaylali
- Department of Neurology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, 97239, OR, USA
| | - Prasanna Jayakar
- Brain Institute, Nicklaus Children's Hospital, 3100 SW 62nd Ave, Miami, FL 33155, USA
| | - Malek Adjouadi
- Department of Electrical and Computer Engineering, Florida International University, 10555 W Flagler St, Miami, 33174, FL, USA
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da Silva Lourenço C, Tjepkema-Cloostermans MC, van Putten MJAM. Ultrafast review of ambulatory EEGs with deep learning. Clin Neurophysiol 2023; 154:43-48. [PMID: 37541076 DOI: 10.1016/j.clinph.2023.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE Interictal epileptiform discharges (IED) are hallmark biomarkers of epilepsy which are typically detected through visual analysis. Deep learning has shown potential in automating IED detection, which could reduce the burden of visual analysis in clinical practice. This is particularly relevant for ambulatory electroencephalograms (EEGs), as these entail longer review times. METHODS We applied a previously trained neural network to an independent dataset of 100 ambulatory EEGs (average duration 20.6 h). From these, 42 EEGs contained IEDs, 25 were abnormal without IEDs and 33 were normal. The algorithm flagged 2 second epochs that it considered IEDs. The EEGs were provided to an expert, who used NeuroCenter EEG to review the recordings. The expert concluded if each recording contained IEDs, and was timed during the process. RESULTS The conclusion of the reviewer was the same as the EEG report in 97% of the recordings. Three EEGs contained IEDs that were not detected based on the flagged epochs. Review time for the 100 EEGs was approximately 4 h, with half of the recordings taking <2 minutes to review. CONCLUSIONS Our network can be used to reduce time spent on visual analysis in the clinic by 50-75 times with high reliability. SIGNIFICANCE Given the large time reduction potential and high success rate, this algorithm can be used in the clinic to aid in visual analysis.
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Affiliation(s)
- Catarina da Silva Lourenço
- Clinical Neurophysiology, Institute for Technical Medicine, University of Twente, Technical Medical Centre, Enschede, The Netherlands
| | - Marleen C Tjepkema-Cloostermans
- Clinical Neurophysiology, Institute for Technical Medicine, University of Twente, Technical Medical Centre, Enschede, The Netherlands; Department of Neurology and Neurophysiology, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Michel J A M van Putten
- Clinical Neurophysiology, Institute for Technical Medicine, University of Twente, Technical Medical Centre, Enschede, The Netherlands; Department of Neurology and Neurophysiology, Medisch Spectrum Twente, Enschede, The Netherlands.
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Tveit J, Aurlien H, Plis S, Calhoun VD, Tatum WO, Schomer DL, Arntsen V, Cox F, Fahoum F, Gallentine WB, Gardella E, Hahn CD, Husain AM, Kessler S, Kural MA, Nascimento FA, Tankisi H, Ulvin LB, Wennberg R, Beniczky S. Automated Interpretation of Clinical Electroencephalograms Using Artificial Intelligence. JAMA Neurol 2023; 80:805-812. [PMID: 37338864 PMCID: PMC10282956 DOI: 10.1001/jamaneurol.2023.1645] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/23/2023] [Indexed: 06/21/2023]
Abstract
Importance Electroencephalograms (EEGs) are a fundamental evaluation in neurology but require special expertise unavailable in many regions of the world. Artificial intelligence (AI) has a potential for addressing these unmet needs. Previous AI models address only limited aspects of EEG interpretation such as distinguishing abnormal from normal or identifying epileptiform activity. A comprehensive, fully automated interpretation of routine EEG based on AI suitable for clinical practice is needed. Objective To develop and validate an AI model (Standardized Computer-based Organized Reporting of EEG-Artificial Intelligence [SCORE-AI]) with the ability to distinguish abnormal from normal EEG recordings and to classify abnormal EEG recordings into categories relevant for clinical decision-making: epileptiform-focal, epileptiform-generalized, nonepileptiform-focal, and nonepileptiform-diffuse. Design, Setting, and Participants In this multicenter diagnostic accuracy study, a convolutional neural network model, SCORE-AI, was developed and validated using EEGs recorded between 2014 and 2020. Data were analyzed from January 17, 2022, until November 14, 2022. A total of 30 493 recordings of patients referred for EEG were included into the development data set annotated by 17 experts. Patients aged more than 3 months and not critically ill were eligible. The SCORE-AI was validated using 3 independent test data sets: a multicenter data set of 100 representative EEGs evaluated by 11 experts, a single-center data set of 9785 EEGs evaluated by 14 experts, and for benchmarking with previously published AI models, a data set of 60 EEGs with external reference standard. No patients who met eligibility criteria were excluded. Main Outcomes and Measures Diagnostic accuracy, sensitivity, and specificity compared with the experts and the external reference standard of patients' habitual clinical episodes obtained during video-EEG recording. Results The characteristics of the EEG data sets include development data set (N = 30 493; 14 980 men; median age, 25.3 years [95% CI, 1.3-76.2 years]), multicenter test data set (N = 100; 61 men, median age, 25.8 years [95% CI, 4.1-85.5 years]), single-center test data set (N = 9785; 5168 men; median age, 35.4 years [95% CI, 0.6-87.4 years]), and test data set with external reference standard (N = 60; 27 men; median age, 36 years [95% CI, 3-75 years]). The SCORE-AI achieved high accuracy, with an area under the receiver operating characteristic curve between 0.89 and 0.96 for the different categories of EEG abnormalities, and performance similar to human experts. Benchmarking against 3 previously published AI models was limited to comparing detection of epileptiform abnormalities. The accuracy of SCORE-AI (88.3%; 95% CI, 79.2%-94.9%) was significantly higher than the 3 previously published models (P < .001) and similar to human experts. Conclusions and Relevance In this study, SCORE-AI achieved human expert level performance in fully automated interpretation of routine EEGs. Application of SCORE-AI may improve diagnosis and patient care in underserved areas and improve efficiency and consistency in specialized epilepsy centers.
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Affiliation(s)
| | - Harald Aurlien
- Holberg EEG, Bergen, Norway
- Department of Clinical Neurophysiology, Haukeland University Hospital, Bergen, Norway
| | - Sergey Plis
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta
| | - Vince D. Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta
| | | | - Donald L. Schomer
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Vibeke Arntsen
- Department of Neurology and Clinical Neurophysiology, St Olavs Hospital, Trondheim University Hospital, Norway
| | - Fieke Cox
- Department of Clinical Neurophysiology, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, the Netherlands
| | - Firas Fahoum
- Department of Neurology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - William B. Gallentine
- Department of Neurology and Pediatrics, Stanford University Lucile Packard Children’s Hospital, Palo Alto, California
| | - Elena Gardella
- Department of Clinical Neurophysiology, Danish Epilepsy Centre, Dianalund, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Cecil D. Hahn
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Aatif M. Husain
- Department of Neurology, Duke University Medical Center, Durham, North Carolina
- Neurodiagnostic Center, Veterans Affairs Medical Center, Durham, North Carolina
| | - Sudha Kessler
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Mustafa Aykut Kural
- Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Fábio A. Nascimento
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Hatice Tankisi
- Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Line B. Ulvin
- Department of Neurology, Oslo University Hospital, Norway
| | - Richard Wennberg
- Division of Neurology, Department of Medicine, Krembil Brain Institute, University Health Network, Toronto Western Hospital, University of Toronto, Toronto, Canada
| | - Sándor Beniczky
- Department of Clinical Neurophysiology, Danish Epilepsy Centre, Dianalund, Denmark
- Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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11
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Roy B, Malviya L, Kumar R, Mal S, Kumar A, Bhowmik T, Hu JW. Hybrid Deep Learning Approach for Stress Detection Using Decomposed EEG Signals. Diagnostics (Basel) 2023; 13:diagnostics13111936. [PMID: 37296788 DOI: 10.3390/diagnostics13111936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/14/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
Stress has an impact, not only on a person's physical health, but also on the ability to perform at the workplace in daily life. The well-established relation between psychological stress and its pathogeneses highlights the need for detecting psychological stress early, in order to prevent disease advancement and to save human lives. Electroencephalography (EEG) signal recording tools are widely used to collect these psychological signals/brain rhythms in the form of electric waves. The aim of the current research was to apply automatic feature extraction to decomposed multichannel EEG recordings, in order to efficiently detect psychological stress. The traditional deep learning techniques, namely the convolution neural network (CNN), long short-term memory (LSTM), bidirectional long short-term memory (BiLSTM), gated recurrent unit (GRU) and recurrent neural network (RNN) models, have been frequently used for stress detection. A hybrid combination of these techniques may provide improved performance, and can handle long-term dependencies in non-linear brain signals. Therefore, this study proposed an integration of deep learning models, called DWT-based CNN, BiLSTM, and two layers of a GRU network, to extract features and classify stress levels. Discrete wavelet transform (DWT) analysis was used to remove the non-linearity and non-stationarity from multi-channel (14 channel) EEG recordings, and to decompose them into different frequency bands. The decomposed signals were utilized for automatic feature extraction using the CNN, and the stress levels were classified using BiLSTM and two layers of GRU. This study compared five combinations of the CNN, LSTM, BiLSTM, GRU and RNN models with the proposed model. The proposed hybrid model performed better in classification accuracy compared to the other models. Therefore, hybrid combinations are appropriate for the clinical intervention and prevention of mental and physical problems.
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Affiliation(s)
- Bishwajit Roy
- Department of Computer Science Engineering-AI & ML, Siliguri Institute of Technology, Siliguri 734009, India
| | - Lokesh Malviya
- School of Computing Science and Engineering, Vellore Institute of Technology Bhopal University, Bhopal 466114, India
| | - Radhikesh Kumar
- Department of Computer Science and Engineering, National Institute of Technology, Patna 800001, India
| | - Sandip Mal
- School of Computing Science and Engineering, Vellore Institute of Technology Bhopal University, Bhopal 466114, India
| | - Amrendra Kumar
- Department of Civil Engineering, Roorkee Institute of Technology, Roorkee 247667, India
| | - Tanmay Bhowmik
- Department of Computer Science and Engineering, Pandit Deendayal Energy University, Gandhinagar 382426, India
| | - Jong Wan Hu
- Department of Civil and Environmental Engineering, Incheon National University, Incheon 22022, Republic of Korea
- Incheon Disaster Prevention Research Center, Incheon National University, Incheon 22022, Republic of Korea
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12
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van Nifterick AM, Mulder D, Duineveld DJ, Diachenko M, Scheltens P, Stam CJ, van Kesteren RE, Linkenkaer-Hansen K, Hillebrand A, Gouw AA. Resting-state oscillations reveal disturbed excitation-inhibition ratio in Alzheimer's disease patients. Sci Rep 2023; 13:7419. [PMID: 37150756 PMCID: PMC10164744 DOI: 10.1038/s41598-023-33973-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/21/2023] [Indexed: 05/09/2023] Open
Abstract
An early disruption of neuronal excitation-inhibition (E-I) balance in preclinical animal models of Alzheimer's disease (AD) has been frequently reported, but is difficult to measure directly and non-invasively in humans. Here, we examined known and novel neurophysiological measures sensitive to E-I in patients across the AD continuum. Resting-state magnetoencephalography (MEG) data of 86 amyloid-biomarker-confirmed subjects across the AD continuum (17 patients diagnosed with subjective cognitive decline, 18 with mild cognitive impairment (MCI) and 51 with dementia due to probable AD (AD dementia)), 46 healthy elderly and 20 young control subjects were reconstructed to source-space. E-I balance was investigated by detrended fluctuation analysis (DFA), a functional E/I (fE/I) algorithm, and the aperiodic exponent of the power spectrum. We found a disrupted E-I ratio in AD dementia patients specifically, by a lower DFA, and a shift towards higher excitation, by a higher fE/I and a lower aperiodic exponent. Healthy subjects showed lower fE/I ratios (< 1.0) than reported in previous literature, not explained by age or choice of an arbitrary threshold parameter, which warrants caution in interpretation of fE/I results. Correlation analyses showed that a lower DFA (E-I imbalance) and a lower aperiodic exponent (more excitation) was associated with a worse cognitive score in AD dementia patients. In contrast, a higher DFA in the hippocampi of MCI patients was associated with a worse cognitive score. This MEG-study showed E-I imbalance, likely due to increased excitation, in AD dementia, but not in early stage AD patients. To accurately determine the direction of shift in E-I balance, validations of the currently used markers and additional in vivo markers of E-I are required.
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Affiliation(s)
- Anne M van Nifterick
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands.
- Clinical Neurophysiology and MEG Center, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Systems and Network Neurosciences, Amsterdam, The Netherlands.
| | - Danique Mulder
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Clinical Neurophysiology and MEG Center, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | - Denise J Duineveld
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Clinical Neurophysiology and MEG Center, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | - Marina Diachenko
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Systems and Network Neurosciences, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Cornelis J Stam
- Clinical Neurophysiology and MEG Center, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Systems and Network Neurosciences, Amsterdam, The Netherlands
| | - Ronald E van Kesteren
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
| | - Klaus Linkenkaer-Hansen
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Systems and Network Neurosciences, Amsterdam, The Netherlands
| | - Arjan Hillebrand
- Clinical Neurophysiology and MEG Center, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Systems and Network Neurosciences, Amsterdam, The Netherlands
| | - Alida A Gouw
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Clinical Neurophysiology and MEG Center, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
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13
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Chung YG, Lee WJ, Na SM, Kim H, Hwang H, Yun CH, Kim KJ. Deep learning-based automated detection and multiclass classification of focal interictal epileptiform discharges in scalp electroencephalograms. Sci Rep 2023; 13:6755. [PMID: 37185941 PMCID: PMC10130023 DOI: 10.1038/s41598-023-33906-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 04/20/2023] [Indexed: 05/17/2023] Open
Abstract
Detection and spatial distribution analyses of interictal epileptiform discharges (IEDs) are important for diagnosing, classifying, and treating focal epilepsy. This study proposes deep learning-based models to detect focal IEDs in electroencephalography (EEG) recordings of the frontal, temporal, and occipital scalp regions. This study included 38 patients with frontal (n = 15), temporal (n = 13), and occipital (n = 10) IEDs and 232 controls without IEDs from a single tertiary center. All the EEG recordings were segmented into 1.5-s epochs and fed into 1- or 2-dimensional convolutional neural networks to construct binary classification models to detect IEDs in each focal region and multiclass classification models to categorize IEDs into frontal, temporal, and occipital regions. The binary classification models exhibited accuracies of 79.3-86.4%, 93.3-94.2%, and 95.5-97.2% for frontal, temporal, and occipital IEDs, respectively. The three- and four-class models exhibited accuracies of 87.0-88.7% and 74.6-74.9%, respectively, with temporal, occipital, and non-IEDs F1-scores of 89.9-92.3%, 84.9-90.6%, and 84.3-86.0%; and 86.6-86.7%, 86.8-87.2%, and 67.8-69.2% for the three- and four-class (frontal, 50.3-58.2%) models, respectively. The deep learning-based models could help enhance EEG interpretation. Although they performed well, the resolution of region-specific focal IED misinterpretations and further model improvement are needed.
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Affiliation(s)
- Yoon Gi Chung
- Division of Pediatric Neurology, Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Republic of Korea
| | - Woo-Jin Lee
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Republic of Korea
| | - Sung Min Na
- Division of Pediatric Neurology, Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Republic of Korea
| | - Hunmin Kim
- Division of Pediatric Neurology, Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Republic of Korea.
| | - Hee Hwang
- Division of Pediatric Neurology, Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Republic of Korea
- Kakao Healthcare, Seongnam-si, Republic of Korea
| | - Chang-Ho Yun
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Republic of Korea
| | - Ki Joong Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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14
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Hillebrand A, Holmes N, Sijsma N, O'Neill GC, Tierney TM, Liberton N, Stam AH, van Klink N, Stam CJ, Bowtell R, Brookes MJ, Barnes GR. Non-invasive measurements of ictal and interictal epileptiform activity using optically pumped magnetometers. Sci Rep 2023; 13:4623. [PMID: 36944674 PMCID: PMC10030968 DOI: 10.1038/s41598-023-31111-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/06/2023] [Indexed: 03/23/2023] Open
Abstract
Magneto- and electroencephalography (MEG/EEG) are important techniques for the diagnosis and pre-surgical evaluation of epilepsy. Yet, in current cryogen-based MEG systems the sensors are offset from the scalp, which limits the signal-to-noise ratio (SNR) and thereby the sensitivity to activity from deep structures such as the hippocampus. This effect is amplified in children, for whom adult-sized fixed-helmet systems are typically too big. Moreover, ictal recordings with fixed-helmet systems are problematic because of limited movement tolerance and/or logistical considerations. Optically Pumped Magnetometers (OPMs) can be placed directly on the scalp, thereby improving SNR and enabling recordings during seizures. We aimed to demonstrate the performance of OPMs in a clinical population. Seven patients with challenging cases of epilepsy underwent MEG recordings using a 12-channel OPM-system and a 306-channel cryogen-based whole-head system: three adults with known deep or weak (low SNR) sources of interictal epileptiform discharges (IEDs), along with three children with focal epilepsy and one adult with frequent seizures. The consistency of the recorded IEDs across the two systems was assessed. In one patient the OPMs detected IEDs that were not found with the SQUID-system, and in two patients no IEDs were found with either system. For the other patients the OPM data were remarkably consistent with the data from the cryogenic system, noting that these were recorded in different sessions, with comparable SNRs and IED-yields overall. Importantly, the wearability of OPMs enabled the recording of seizure activity in a patient with hyperkinetic movements during the seizure. The observed ictal onset and semiology were in agreement with previous video- and stereo-EEG recordings. The relatively affordable technology, in combination with reduced running and maintenance costs, means that OPM-based MEG could be used more widely than current MEG systems, and may become an affordable alternative to scalp EEG, with the potential benefits of increased spatial accuracy, reduced sensitivity to volume conduction/field spread, and increased sensitivity to deep sources. Wearable MEG thus provides an unprecedented opportunity for epilepsy, and given its patient-friendliness, we envisage that it will not only be used for presurgical evaluation of epilepsy patients, but also for diagnosis after a first seizure.
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Affiliation(s)
- Arjan Hillebrand
- Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands.
- Brain Imaging, Amsterdam Neuroscience, Amsterdam, The Netherlands.
- Systems and Network Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands.
| | - Niall Holmes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Ndedi Sijsma
- Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - George C O'Neill
- Wellcome Centre for Human Neuroimaging, Department of Imaging Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3AR, UK
| | - Tim M Tierney
- Wellcome Centre for Human Neuroimaging, Department of Imaging Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3AR, UK
| | - Niels Liberton
- Department of Medical Technology, 3D Innovation Lab, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anine H Stam
- Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - Nicole van Klink
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
- Brain Imaging, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Neurodegeneration, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Richard Bowtell
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Matthew J Brookes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Gareth R Barnes
- Wellcome Centre for Human Neuroimaging, Department of Imaging Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3AR, UK
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15
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Boßelmann CM, Leu C, Lal D. Are AI language models such as ChatGPT ready to improve the care of individuals with epilepsy? Epilepsia 2023; 64:1195-1199. [PMID: 36869421 DOI: 10.1111/epi.17570] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 03/05/2023]
Affiliation(s)
- Christian M Boßelmann
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.,Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Costin Leu
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.,Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK
| | - Dennis Lal
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.,Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.,Stanley Center for Psychiatric Research, Broad Institute of Harvard and M.I.T., Cambridge, Massachusetts, USA.,Cologne Center for Genomics (CCG), University of Cologne, Cologne, Delaware, USA
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16
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Sun S, Wang H. Clocking Epilepsies: A Chronomodulated Strategy-Based Therapy for Rhythmic Seizures. Int J Mol Sci 2023; 24:ijms24044223. [PMID: 36835631 PMCID: PMC9962262 DOI: 10.3390/ijms24044223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023] Open
Abstract
Epilepsy is a neurological disorder characterized by hypersynchronous recurrent neuronal activities and seizures, as well as loss of muscular control and sometimes awareness. Clinically, seizures have been reported to display daily variations. Conversely, circadian misalignment and circadian clock gene variants contribute to epileptic pathogenesis. Elucidation of the genetic bases of epilepsy is of great importance because the genetic variability of the patients affects the efficacies of antiepileptic drugs (AEDs). For this narrative review, we compiled 661 epilepsy-related genes from the PHGKB and OMIM databases and classified them into 3 groups: driver genes, passenger genes, and undetermined genes. We discuss the potential roles of some epilepsy driver genes based on GO and KEGG analyses, the circadian rhythmicity of human and animal epilepsies, and the mutual effects between epilepsy and sleep. We review the advantages and challenges of rodents and zebrafish as animal models for epileptic studies. Finally, we posit chronomodulated strategy-based chronotherapy for rhythmic epilepsies, integrating several lines of investigation for unraveling circadian mechanisms underpinning epileptogenesis, chronopharmacokinetic and chronopharmacodynamic examinations of AEDs, as well as mathematical/computational modeling to help develop time-of-day-specific AED dosing schedules for rhythmic epilepsy patients.
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Affiliation(s)
- Sha Sun
- Center for Circadian Clocks, Soochow University, Suzhou 215123, China
- School of Biology and Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou 215123, China
| | - Han Wang
- Center for Circadian Clocks, Soochow University, Suzhou 215123, China
- School of Biology and Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou 215123, China
- Correspondence: or ; Tel.: +86-186-0512-8971
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17
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Nhu D, Janmohamed M, Shakhatreh L, Gonen O, Perucca P, Gilligan A, Kwan P, O'Brien TJ, Tan CW, Kuhlmann L. Automated Interictal Epileptiform Discharge Detection from Scalp EEG Using Scalable Time-series Classification Approaches. Int J Neural Syst 2023; 33:2350001. [PMID: 36599664 DOI: 10.1142/s0129065723500016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Deep learning for automated interictal epileptiform discharge (IED) detection has been topical with many published papers in recent years. All existing works viewed EEG signals as time-series and developed specific models for IED classification; however, general time-series classification (TSC) methods were not considered. Moreover, none of these methods were evaluated on any public datasets, making direct comparisons challenging. This paper explored two state-of-the-art convolutional-based TSC algorithms, InceptionTime and Minirocket, on IED detection. We fine-tuned and cross-evaluated them on a public (Temple University Events - TUEV) and two private datasets and provided ready metrics for benchmarking future work. We observed that the optimal parameters correlated with the clinical duration of an IED and achieved the best area under precision-recall curve (AUPRC) of 0.98 and F1 of 0.80 on the private datasets, respectively. The AUPRC and F1 on the TUEV dataset were 0.99 and 0.97, respectively. While algorithms trained on the private sets maintained their performance when tested on the TUEV data, those trained on TUEV could not generalize well to the private data. These results emerge from differences in the class distributions across datasets and indicate a need for public datasets with a better diversity of IED waveforms, background activities and artifacts to facilitate standardization and benchmarking of algorithms.
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Affiliation(s)
- D Nhu
- Department of Data Science and Artificial Intelligence, Faculty of Information Technology, Monash University, Melbourne, VIC, Australia
| | - M Janmohamed
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - L Shakhatreh
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - O Gonen
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - P Perucca
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia.,Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Melbourne, VIC, Australia.,Epilepsy Research Center, Department of Medicine (Austin Health), The University of Melbourne, Melbourne, VIC, Australia
| | - A Gilligan
- Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Melbourne, VIC, Australia.,Neurosciences Clinical Institute, Epworth Healthcare, Melbourne, VIC, Australia
| | - P Kwan
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - T J O'Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - C W Tan
- Department of Data Science and Artificial Intelligence, Faculty of Information Technology, Monash University, Melbourne, VIC, Australia
| | - L Kuhlmann
- Department of Data Science and Artificial Intelligence, Faculty of Information Technology, Monash University, Melbourne, VIC, Australia
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18
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Zhang L, Wang X, Jiang J, Xiao N, Guo J, Zhuang K, Li L, Yu H, Wu T, Zheng M, Chen D. Automatic interictal epileptiform discharge (IED) detection based on convolutional neural network (CNN). Front Mol Biosci 2023; 10:1146606. [PMID: 37091867 PMCID: PMC10119410 DOI: 10.3389/fmolb.2023.1146606] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/28/2023] [Indexed: 04/25/2023] Open
Abstract
Clinical diagnosis of epilepsy significantly relies on identifying interictal epileptiform discharge (IED) in electroencephalogram (EEG). IED is generally interpreted manually, and the related process is very time-consuming. Meanwhile, the process is expert-biased, which can easily lead to missed diagnosis and misdiagnosis. In recent years, with the development of deep learning, related algorithms have been used in automatic EEG analysis, but there are still few attempts in IED detection. This study uses the currently most popular convolutional neural network (CNN) framework for EEG analysis for automatic IED detection. The research topic is transferred into a 4-labels classification problem. The algorithm is validated on the long-term EEG of 11 pediatric patients with epilepsy. The computational results confirm that the CNN-based model can obtain high classification accuracy, up to 87%. The study may provide a reference for the future application of deep learning in automatic IED detection.
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Affiliation(s)
- Ling Zhang
- School of Innovation and Entrepreneurship, Hubei University of Science and Technology, Xianning, China
- School of Biomedical Engineering and Medical Imaging, Xianning Medical College, Hubei University of Science and Technology, Xianning, China
| | - Xiaolu Wang
- Department of Clinical Neuroelectrophysiology, Wuhan Children’s Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Jiang
- Department of Clinical Neuroelectrophysiology, Wuhan Children’s Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Duo Chen, ; Jun Jiang, ; Naian Xiao,
| | - Naian Xiao
- Department of Neurology, The Third Hospital of Xiamen, Xiamen, China
- Department of Neurology and Geriatrics, Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, China
- *Correspondence: Duo Chen, ; Jun Jiang, ; Naian Xiao,
| | - Jiayang Guo
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China
- Department of Hematology, School of Medicine, Xiamen University, Xiamen, China
| | - Kailong Zhuang
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China
- Department of Hematology, School of Medicine, Xiamen University, Xiamen, China
| | - Ling Li
- School of Biomedical Engineering and Medical Imaging, Xianning Medical College, Hubei University of Science and Technology, Xianning, China
| | - Houqiang Yu
- School of Biomedical Engineering and Medical Imaging, Xianning Medical College, Hubei University of Science and Technology, Xianning, China
| | - Tong Wu
- School of Biomedical Engineering and Medical Imaging, Xianning Medical College, Hubei University of Science and Technology, Xianning, China
| | - Ming Zheng
- School of Biomedical Engineering and Medical Imaging, Xianning Medical College, Hubei University of Science and Technology, Xianning, China
| | - Duo Chen
- School of Artificial Intelligence and Information Technology, Nanjing University of Chinese Medicine, Nanjing, China
- *Correspondence: Duo Chen, ; Jun Jiang, ; Naian Xiao,
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RNN and BiLSTM Fusion for Accurate Automatic Epileptic Seizure Diagnosis Using EEG Signals. LIFE (BASEL, SWITZERLAND) 2022; 12:life12121946. [PMID: 36556313 PMCID: PMC9784456 DOI: 10.3390/life12121946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022]
Abstract
Epilepsy is a common neurological condition. The effects of epilepsy are not restricted to seizures alone. They comprise a wide spectrum of problems that might impair and reduce quality of life. Even with medication, 30% of epilepsy patients still have recurring seizures. An epileptic seizure is caused by significant neuronal electrical activity, which affects brain activity. EEG shows these changes as high-amplitude spiky and sluggish waves. Recognizing seizures on an electroencephalogram (EEG) manually by a professional neurologist is a time-consuming and labor-intensive process, hence an efficient automated approach is necessary for the identification of epileptic seizure. One technique to increase the speed and accuracy with which a diagnosis of epileptic seizures could be made is by utilizing computer-aided diagnosis systems that are built on deep neural networks, or DNN. This study introduces a fusion of recurrent neural networks (RNNs) and bi-directional long short-term memories (BiLSTMs) for automatic epileptic seizure identification via EEG signal processing in order to tackle the aforementioned informational challenges. An electroencephalogram's (EEG) raw data were first normalized after undergoing pre-processing. A RNN model was fed the normalized EEG sequence data and trained to accurately extract features from the data. Afterwards, the features were passed to the BiLSTM layers for processing so that further temporal information could be retrieved. In addition, the proposed RNN-BiLSTM model was tested in an experimental setting using the freely accessible UCI epileptic seizure dataset. Experimental findings of the suggested model have achieved avg values of 98.90%, 98.50%, 98. 20%, and 98.60%, respectively, for accuracy, sensitivity, precision, and specificity. To further verify the new model's efficacy, it is compared to other models, such as the RNN-LSTM and the RNN-GRU learning models, and is shown to have improved the same metrics by 1.8%, 1.69%, 1.95%, and 2.2% on using 5-fold. Additionally, the proposed method was compared to state-of-the-art approaches and proved to be a more accurate categorization of such techniques.
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20
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Escobar-Ipuz F, Torres A, García-Jiménez M, Basar C, Cascón J, Mateo J. Prediction of patients with idiopathic generalized epilepsy from healthy controls using machine learning from scalp EEG recordings. Brain Res 2022; 1798:148131. [DOI: 10.1016/j.brainres.2022.148131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/14/2022] [Accepted: 10/23/2022] [Indexed: 11/05/2022]
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21
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Ray J, Wijesekera L, Cirstea S. Machine learning and clinical neurophysiology. J Neurol 2022; 269:6678-6684. [PMID: 35907045 DOI: 10.1007/s00415-022-11283-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/05/2022] [Accepted: 07/09/2022] [Indexed: 11/29/2022]
Abstract
Clinical neurophysiology constructs a wealth of dynamic information pertaining to the integrity and function of both central and peripheral nervous systems. As with many technological fields, there has been an explosion of data in neurophysiology over recent years, and this requires considerable analysis by experts. Computational algorithms and especially advances in machine learning (ML) have the ability to assist with this task and potentially reveal hidden insights. In this update article, we will provide a brief overview where such technology is being applied in clinical neurophysiology and possible future directions.
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Affiliation(s)
- Julian Ray
- Department of Clinical Neurophysiology, Addenbrooke's Hospital, Cambridge University Hospitals Neurosciences, Cambridge, UK.
| | - Lokesh Wijesekera
- Department of Clinical Neurophysiology, Addenbrooke's Hospital, Cambridge University Hospitals Neurosciences, Cambridge, UK
| | - Silvia Cirstea
- Department of Clinical Neurophysiology, Addenbrooke's Hospital, Cambridge University Hospitals Neurosciences, Cambridge, UK
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22
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Cheng C, Liu Y, You B, Zhou Y, Gao F, Yang L, Dai Y. Multilevel Feature Learning Method for Accurate Interictal Epileptiform Spike Detection. IEEE Trans Neural Syst Rehabil Eng 2022; 30:2506-2516. [PMID: 35877795 DOI: 10.1109/tnsre.2022.3193666] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Interictal epileptiform spike (referred to as spike) detected from electroencephalograms lasting only 20- to 200-ms can provide a reliable evidence-based indicator for clinical seizure type diagnosis. Recent feature representation approaches focus either on the concrete-level or on abstract-level information mining of the spike, thus demonstrating suboptimal detection performance. Additionally, existing abstract-level information mining methods of the spike based deep learning networks have not realized the effective feature representation of long-term dependent distinguished information within similar waveform cycles caused by morphological heterogeneity, which affects detection performance. Thus, a multilevel feature learning method for accurate spike detection was proposed in this study. Specifically, the spatio-temporal-frequency multidomain information in concrete-level first are inferred the common mimetic properties of the spike using the multidomain feature extractors. Then, the effective feature representation of long-term dependent distinguished information within similar waveform cycles caused by morphological heterogeneity is suitably captured using the temporal convolutional network. Finally, the spatio-temporal-frequency multidomain long-term dependent feature representation of spike is calculated using the element-wise manner to fuse the feature representation in concrete- and abstract-levels. The experimental results indicate that the proposed method can achieve an accuracy of 90.62±1.38%, sensitivity of 90.38±1.52%, specificity of 91.00±1.60%, precision of 90.33±4.71%, and the false detection rate per minute is 0.148±0.020m-1, which are higher than when using the feature representation in the concrete- or abstract-level alone. Additionally, the detection results indicate that the proposed method avoids the subjectivity and inefficiency of visual inspection, and it enables a highly accurate detection of the spike.
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23
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Cheng C, Zhou Y, You B, Liu Y, Fei G, Yang L, Dai Y. Multiview Feature Fusion Representation for Interictal Epileptiform Spikes Detection. Int J Neural Syst 2022; 32:2250014. [PMID: 35272587 DOI: 10.1142/s0129065722500149] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Interictal epileptiform spikes (IES) of scalp electroencephalogram (EEG) signals have a strong relation with the epileptogenic region. Since IES are highly unlikely to be detected in scalp EEG signals, the primary diagnosis depends heavily on the visual evaluation of IES. However, visual inspection of EEG signals, the standard IES detection procedure is time-consuming, highly subjective, and error-prone. Furthermore, the highly complex, nonlinear, and nonstationary characteristics of EEG signals lead to the incomplete representation of EEG signals in existing computer-aided methods and consequently unsatisfactory detection performance. Therefore, a novel multiview feature fusion representation (MVFFR) method was developed and combined with a robustness classifier to detect EEG signals with/without IES. MVFFR comprises two steps: First, temporal, frequency, temporal-frequency, spatial, and nonlinear domain features are transformed by the IES to express the latent information effectively. Second, the unsupervised infinite feature-selection method determines the most distinct feature fusion representations. Experimental results using a balanced dataset of six patients showed that MVFFR achieved the optimal detection performance (accuracy: 89.27%, sensitivity: 89.01%, specificity: 89.54%, and precision: 89.82%) compared with other feature ranking methods, and the MVFFR-related method were complementary and indispensable. Additionally, in an independent test, MVFFR maintained excellent generalization capacity with a false detection rate per minute of 0.15 on the unbalanced dataset of one patient.
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Affiliation(s)
- Chenchen Cheng
- School of Mechanical and Power Engineering, Harbin University of Science and Technology, Harbin 150080, P. R. China.,Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, P. R. China.,Heilongjiang Provincial Key Laboratory, of Complex Intelligent System and Integration, Harbin University of Science and Technology, Harbin 150080, P. R. China
| | - Yuanfeng Zhou
- Department of Neurology, Children's Hospital of Fudan University, Shanghai 200000, P. R. China
| | - Bo You
- School of Mechanical and Power Engineering, Harbin University of Science and Technology, Harbin 150080, P. R. China.,Heilongjiang Provincial Key Laboratory, of Complex Intelligent System and Integration, Harbin University of Science and Technology, Harbin 150080, P. R. China.,School of Automation, Harbin University of Science and Technology, Harbin 150080, P. R. China
| | - Yan Liu
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, P. R. China.,Jinan Guoke Medical Engineering Technology Development Co., Ltd, Jinan 250000, P. R. China
| | - Gao Fei
- Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University Jinan, P. R. China
| | - Liling Yang
- Department of Neurology, Shandong Provincial Hospital, Affiliated to Shandong First Medical University, Jinan 250021, P. R. China
| | - Yakang Dai
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, P. R. China.,Jinan Guoke Medical Engineering Technology Development Co., Ltd, Jinan 250000, P. R. China
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Kural MA, Jing J, Fürbass F, Perko H, Qerama E, Johnsen B, Fuchs S, Westover MB, Beniczky S. Accurate identification of EEG recordings with interictal epileptiform discharges using a hybrid approach: Artificial intelligence supervised by human experts. Epilepsia 2022; 63:1064-1073. [PMID: 35184276 PMCID: PMC9148170 DOI: 10.1111/epi.17206] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/17/2022] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Mustafa Aykut Kural
- Department of Clinical Neurophysiology Danish Epilepsy Centre Filadelfia Dianalund Denmark
- Department of Clinical Neurophysiology Aarhus University Hospital Aarhus Denmark
- Department of Clinical Medicine Aarhus University Aarhus Denmark
| | - Jin Jing
- Department of Neurology Harvard Medical School Massachusetts General Hospital Boston Massachusetts USA
| | - Franz Fürbass
- Center for Health & Bioresources AIT Austrian Institute of Technology GmbH Vienna Austria
| | - Hannes Perko
- Center for Health & Bioresources AIT Austrian Institute of Technology GmbH Vienna Austria
| | - Erisela Qerama
- Department of Clinical Neurophysiology Aarhus University Hospital Aarhus Denmark
- Department of Clinical Medicine Aarhus University Aarhus Denmark
| | - Birger Johnsen
- Department of Clinical Neurophysiology Aarhus University Hospital Aarhus Denmark
- Department of Clinical Medicine Aarhus University Aarhus Denmark
| | - Steffen Fuchs
- Department of Clinical Neurophysiology Aarhus University Hospital Aarhus Denmark
| | - M. Brandon Westover
- Department of Neurology Harvard Medical School Massachusetts General Hospital Boston Massachusetts USA
| | - Sándor Beniczky
- Department of Clinical Neurophysiology Danish Epilepsy Centre Filadelfia Dianalund Denmark
- Department of Clinical Neurophysiology Aarhus University Hospital Aarhus Denmark
- Department of Clinical Medicine Aarhus University Aarhus Denmark
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25
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A Survey on EEG Signal Processing Techniques and Machine Learning: Applications to the Neurofeedback of Autobiographical Memory Deficits in Schizophrenia. ELECTRONICS 2021. [DOI: 10.3390/electronics10233037] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In this paper, a general overview regarding neural recording, classical signal processing techniques and machine learning classification algorithms applied to monitor brain activity is presented. Currently, several approaches classified as electrical, magnetic, neuroimaging recordings and brain stimulations are available to obtain neural activity of the human brain. Among them, non-invasive methods like electroencephalography (EEG) are commonly employed, as they can provide a high degree of temporal resolution (on the order of milliseconds) and acceptable space resolution. In addition, it is simple, quick, and does not create any physical harm or stress to patients. Concerning signal processing, once the neural signals are acquired, different procedures can be applied for feature extraction. In particular, brain signals are normally processed in time, frequency, and/or space domains. The features extracted are then used for signal classification depending on its characteristics such us the mean, variance or band power. The role of machine learning in this regard has become of key importance during the last years due to its high capacity to analyze complex amounts of data. The algorithms employed are generally classified in supervised, unsupervised and reinforcement techniques. A deep review of the most used machine learning algorithms and the advantages/drawbacks of most used methods is presented. Finally, a study of these procedures utilized in a very specific and novel research field of electroencephalography, i.e., autobiographical memory deficits in schizophrenia, is outlined.
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Quon RJ, Meisenhelter S, Camp EJ, Testorf ME, Song Y, Song Q, Culler GW, Moein P, Jobst BC. AiED: Artificial intelligence for the detection of intracranial interictal epileptiform discharges. Clin Neurophysiol 2021; 133:1-8. [PMID: 34773796 DOI: 10.1016/j.clinph.2021.09.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/02/2021] [Accepted: 09/21/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Deep learning provides an appealing solution for the ongoing challenge of automatically classifying intracranial interictal epileptiform discharges (IEDs). We report results from an automated method consisting of a template-matching algorithm and convolutional neural network (CNN) for the detection of intracranial IEDs ("AiED"). METHODS 1000 intracranial electroencephalogram (EEG) epochs extracted randomly from 307 subjects with refractory epilepsy were annotated independently by two expert neurophysiologists. These annotated epochs were divided into 1062 two-second epochs with IEDs and 1428 two-second epochs without IEDs, which were transformed into spectrograms prior to training the neural network. The highest performing network was validated on an annotated external test set. RESULTS The final network had an F1-score of 0.95 (95% CI: 0.91-0.98) and an average Area Under the Receiver Operating Characteristic of 0.98 (95% CI: 0.96-1.00). For the external test set, it showed an overall F1-score of 0.71, correctly identifying 100% of all high-amplitude IED complexes, 96.23% of all high-amplitude isolated IEDs, and 66.15% of all IEDs of atypical morphology. CONCLUSIONS Template-matching combined with a CNN offers a fast, robust method for detecting intracranial IEDs. SIGNIFICANCE "AiED" is generalizable and achieves comparable performance to human reviewers; it may support clinical and research EEG analyses.
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Affiliation(s)
- Robert J Quon
- Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA; Department of Quantitative Biomedical Sciences, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
| | | | - Edward J Camp
- Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
| | - Markus E Testorf
- Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; Thayer School of Engineering at Dartmouth College, Hanover, NH, USA.
| | - Yinchen Song
- Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA; Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
| | - Qingyuan Song
- Department of Quantitative Biomedical Sciences, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
| | - George W Culler
- Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
| | - Payam Moein
- Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
| | - Barbara C Jobst
- Department of Neurology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA; Department of Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
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27
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Patient-specific method of sleep electroencephalography using wavelet packet transform and Bi-LSTM for epileptic seizure prediction. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102963] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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