Protocol Design Challenges in the Detection of Awareness in Aware Subjects Using EEG Signals

Stability of mental motor-imagery classification in EEG depends on the choice of classifier model and experiment design, but not on signal preprocessing

Introduction

Modern consciousness research has developed diagnostic tests to improve the diagnostic accuracy of different states of consciousness via electroencephalography (EEG)-based mental motor imagery (MI), which is still challenging and lacks a consensus on how to best analyse MI EEG-data. An optimally designed and analyzed paradigm must detect command-following in all healthy individuals, before it can be applied in patients, e.g., for the diagnosis of disorders of consciousness (DOC).

Methods

We investigated the effects of two important steps in the raw signal preprocessing on predicting participant performance (F1) and machine-learning classifier performance (area-under-curve, AUC) in eight healthy individuals, that are based solely on MI using high-density EEG (HD-EEG): artifact correction (manual correction with vs. without Independent Component Analysis [ICA]), region of interest (ROI; motor area vs. whole brain), and machine-learning algorithm (support-vector machine [SVM] vs. k-nearest neighbor [KNN]).

Results

Results revealed no significant effects of artifact correction and ROI on predicting participant performance (F1) and classifier performance (AUC) scores (all ps > 0.05) in the SVM classification model. In the KNN model, ROI had a significant influence on the classifier performance [F(1,8.939) = 7.585, p = 0.023]. There was no evidence for artifact correction and ROI selection changing the prediction of participants performance and classifier performance in EEG-based mental MI if using SVM-based classification (71-100% correct classifications across different signal preprocessing methods). The variance in the prediction of participant performance was significantly higher when the experiment started with a resting-state compared to a mental MI task block [X2(1) = 5.849, p = 0.016].

Discussion

Overall, we could show that classification is stable across different modes of EEG signal preprocessing when using SVM models. Exploratory analysis gave a hint toward potential effects of the sequence of task execution on the prediction of participant performance, which should be taken into account in future studies.

Motor imagery EEG signal classification with a multivariate time series approach

BACKGROUND

Electroencephalogram (EEG) signals record electrical activity on the scalp. Measured signals, especially EEG motor imagery signals, are often inconsistent or distorted, which compromises their classification accuracy. Achieving a reliable classification of motor imagery EEG signals opens the door to possibilities such as the assessment of consciousness, brain computer interfaces or diagnostic tools. We seek a method that works with a reduced number of variables, in order to avoid overfitting and to improve interpretability. This work aims to enhance EEG signal classification accuracy by using methods based on time series analysis. Previous work on this line, usually took a univariate approach, thus losing the possibility to take advantage of the correlation information existing within the time series provided by the different electrodes. To overcome this problem, we propose a multivariate approach that can fully capture the relationships among the different time series included in the EEG data. To perform the multivariate time series analysis, we use a multi-resolution analysis approach based on the discrete wavelet transform, together with a stepwise discriminant that selects the most discriminant variables provided by the discrete wavelet transform analysis RESULTS: Applying this methodology to EEG data to differentiate between the motor imagery tasks of moving either hands or feet has yielded very good classification results, achieving in some cases up to 100% of accuracy for this 2-class pre-processed dataset. Besides, the fact that these results were achieved using a reduced number of variables (55 out of 22,176) can shed light on the relevance and impact of those variables.

CONCLUSIONS

This work has a potentially large impact, as it enables classification of EEG data based on multivariate time series analysis in an interpretable way with high accuracy. The method allows a model with a reduced number of features, facilitating its interpretability and improving overfitting. Future work will extend the application of this classification method to help in diagnosis procedures for detecting brain pathologies and for its use in brain computer interfaces. In addition, the results presented here suggest that this method could be applied to other fields for the successful analysis of multivariate temporal data.

Prognosis for patients with cognitive motor dissociation identified by brain-computer interface

Cognitive motor dissociation describes a subset of patients with disorders of consciousness who show neuroimaging evidence of consciousness but no detectable command-following behaviours. Although essential for family counselling, decision-making, and the design of rehabilitation programmes, the prognosis for patients with cognitive motor dissociation remains under-investigated. The current study included 78 patients with disorders of consciousness who showed no detectable command-following behaviours. These patients included 45 patients with unresponsive wakefulness syndrome and 33 patients in a minimally conscious state, as diagnosed using the Coma Recovery Scale-Revised. Each patient underwent an EEG-based brain-computer interface experiment, in which he or she was instructed to perform an item-selection task (i.e. select a photograph or a number from two candidates). Patients who achieved statistically significant brain-computer interface accuracies were identified as cognitive motor dissociation. Two evaluations using the Coma Recovery Scale-Revised, one before the experiment and the other 3 months later, were carried out to measure the patients' behavioural improvements. Among the 78 patients with disorders of consciousness, our results showed that within the unresponsive wakefulness syndrome patient group, 15 of 18 patients with cognitive motor dissociation (83.33%) regained consciousness, while only five of the other 27 unresponsive wakefulness syndrome patients without significant brain-computer interface accuracies (18.52%) regained consciousness. Furthermore, within the minimally conscious state patient group, 14 of 16 patients with cognitive motor dissociation (87.5%) showed improvements in their Coma Recovery Scale-Revised scores, whereas only four of the other 17 minimally conscious state patients without significant brain-computer interface accuracies (23.53%) had improved Coma Recovery Scale-Revised scores. Our results suggest that patients with cognitive motor dissociation have a better outcome than other patients. Our findings extend current knowledge of the prognosis for patients with cognitive motor dissociation and have important implications for brain-computer interface-based clinical diagnosis and prognosis for patients with disorders of consciousness.