Computerized seizure detection of complex partial seizures

Closed-Loop Implantable Neurostimulators for Individualized Treatment of Intractable Epilepsy: A Review of Recent Developments, Ongoing Challenges, and Future Opportunities

Driven by its proven therapeutic efficacy in treating movement disorders and psychiatric conditions, neurostimulation has emerged as a promising intervention for intractable epilepsy. Researchers envision an advanced implantable device capable of long-term neuronal monitoring, high spatio-temporal resolution data processing, and timely responsive neurostimulation upon seizure detection. However, the stringent energy constraints of implantable devices and significant inter-patient variability in neural activity pose substantial challenges and opportunities for biomedical circuits and systems researchers. For seizure detection, various ASIC solutions employing both deterministic and data-driven algorithms have been developed. These solutions leverage a subset of numerous signal features (spanning time and frequency domains) and classifiers (such as SVMs, DNNs, SNNs) to achieve notable success in terms of detection accuracy, latency, and energy efficiency. Implementations vary widely in computational approaches (digital, mixed-signal, analog, spike-based), training strategies (online versus offline), and application targets (patient-specific versus cross-patient). In terms of treatment, recent efforts have focused on the personalization of stimulation waveforms to enhance therapeutic efficacy. This personalization faces complex challenges, including a limited understanding of how stimulation parameters influence neuronal activity, the lack of a comprehensive brain model to capture its intricate electrochemical dynamics, and recording neural signals in the presence of stimulation artifacts. This review provides a comprehensive overview of the field, detailing the foundational principles, recent advancements, and ongoing challenges in enhancing the diagnostic accuracy, treatment efficacy, and energy efficiency of implantable patient-optimized neurostimulators. We also discuss potential future directions, emphasizing the need for standardized performance metrics, advanced computational models, and adaptive stimulation protocols to realize the full potential of this transformative technology.

Zero-crossing patterns reveal subtle epileptiform discharges in the scalp EEG

Clinical diagnosis of epilepsy depends heavily on the detection of interictal epileptiform discharges (IEDs) from scalp electroencephalographic (EEG) signals, which by purely visual means is far from straightforward. Here, we introduce a simple signal analysis procedure based on scalp EEG zero-crossing patterns which can extract the spatiotemporal structure of scalp voltage fluctuations. We analyzed simultaneous scalp and intracranial EEG recordings from patients with pharmacoresistant temporal lobe epilepsy. Our data show that a large proportion of intracranial IEDs manifest only as subtle, low-amplitude waveforms below scalp EEG background and could, therefore, not be detected visually. We found that scalp zero-crossing patterns allow detection of these intracranial IEDs on a single-trial level with millisecond temporal precision and including some mesial temporal discharges that do not propagate to the neocortex. Applied to an independent dataset, our method discriminated accurately between patients with epilepsy and normal subjects, confirming its practical applicability.

Detecting Epileptic Seizures in EEG Signals with Complementary Ensemble Empirical Mode Decomposition and Extreme Gradient Boosting

Epilepsy is a common nervous system disease that is characterized by recurrent seizures. An electroencephalogram (EEG) records neural activity, and it is commonly used for the diagnosis of epilepsy. To achieve accurate detection of epileptic seizures, an automatic detection approach of epileptic seizures, integrating complementary ensemble empirical mode decomposition (CEEMD) and extreme gradient boosting (XGBoost), named CEEMD-XGBoost, is proposed. Firstly, the decomposition method, CEEMD, which is capable of effectively reducing the influence of mode mixing and end effects, was utilized to divide raw EEG signals into a set of intrinsic mode functions (IMFs) and residues. Secondly, the multi-domain features were extracted from raw signals and the decomposed components, and they were further selected according to the importance scores of the extracted features. Finally, XGBoost was applied to develop the epileptic seizure detection model. Experiments were conducted on two benchmark epilepsy EEG datasets, named the Bonn dataset and the CHB-MIT (Children's Hospital Boston and Massachusetts Institute of Technology) dataset, to evaluate the performance of our proposed CEEMD-XGBoost. The extensive experimental results indicated that, compared with some previous EEG classification models, CEEMD-XGBoost can significantly enhance the detection performance of epileptic seizures in terms of sensitivity, specificity, and accuracy.

Epileptic Seizure Detection with EEG Textural Features and Imbalanced Classification Based on EasyEnsemble Learning

Imbalance data classification is a challenging task in automatic seizure detection from electroencephalogram (EEG) recordings when the durations of non-seizure periods are much longer than those of seizure activities. An imbalanced learning model is proposed in this paper to improve the identification of seizure events in long-term EEG signals. To better represent the underlying microstructure distributions of EEG signals while preserving the non-stationary nature, discrete wavelet transform (DWT) and uniform 1D-LBP feature extraction procedure are introduced. A learning framework is then designed by the ensemble of weakly trained support vector machines (SVMs). Under-sampling is employed to split the imbalanced seizure and non-seizure samples into multiple balanced subsets where each of them is utilized to train an individual SVM classifier. The weak SVMs are incorporated to build a strong classifier which emphasizes seizure samples and in the meantime analyzing the imbalanced class distribution of EEG data. Final seizure detection results are obtained in a multi-level decision fusion process by considering temporal and frequency factors. The model was validated over two long-term and one short-term public EEG databases. The model achieved a [Formula: see text]-mean of 97.14% with respect to epoch-level assessment, an event-level sensitivity of 96.67%, and a false detection rate of 0.86/h on the long-term intracranial database. An epoch-level [Formula: see text]-mean of 95.28% and event-level false detection rate of 0.81/h were yielded over the long-term scalp database. The comparisons with 14 published methods demonstrated the improved detection performance for imbalanced EEG signals and the generalizability of the proposed model.

Evaluation of time domain features using best feature subsets based on mutual information for detecting epilepsy

In this pattern recognition study of detecting epilepsy, the first time the authors have attempted to use time domain (TD) features such as waveform length (WL), number of zero-crossings (ZC) and number of slope sign changes (SSC) which are extracted from the discrete wavelet transform (DWT) for the detecting the epilepsy for University of Bonn datasets and real-time clinical data. The performance of these TD features is studied along with mean absolute value (MAV) which has been attempted by other researchers. The performance of the TD features derived from DWT is studied using naive Bayes (NB) and support vector machines (SVM) for five different datasets from University of Bonn with 14 different combinations datasets and 24 patients datasets from Christian Medical College and Hospital (CMCH), India database. Using feature selection and feature ranking based on the estimation of mutual information (MI), the significant features required for the classifier to get higher accuracy is obtained. Further, NB achieves 100% classification accuracy (CA) in distinguishing normal eyes open and epileptic dataset with top 4 ranked features and it gives 100% accuracy with top-ranked two features in using CMCH data.

An effective approach to classify epileptic EEG signal using local neighbor gradient pattern transformation methods

Electroencephalographic (EEG) signal records the neuronal activity in the brain and it is used in the diagnosis of epileptic seizure activities. Human inspection of non-stationary EEG signal for diagnosing epilepsy is cumbersome, time-consuming and inaccurate. In this paper an effective automatic approach to detect epilepsy using two feature extraction techniques namely local neighbor gradient pattern (LNGP) and symmetrically weighted local neighbor gradient pattern (SWLNGP) are proposed. Extracted features are fed into machine learning algorithms like k-nearest neighbor (k-NN), quadratic linear discriminant analysis, support vector machine, ensemble classifier and artificial neural network (ANN) to classify the EEG signals. In this study, the classification performance for 17 different cases using 10-fold cross validation with the following classification problems are executed (i) healthy-ictal, (ii) interictal-ictal, (iii) healthy-interictal, (iv) seizure free-ictal and (v) healthy-interictal-ictal. The experimental result shows that in all the cases LNGP and SWLNGP attained higher classification accuracy using ANN. Further, the computational performance and the classification accuracy of the proposed methods are compared with the recently proposed techniques for epileptic detection. It shows that the performance of LNGP and SWLNGP method with ANN classifier are superior over other recently proposed techniques for the aforesaid problems. Hence, the proposed methods are simple, fast, reliable and easily implementable for real-time epileptic detection.

A Hybrid Approach Based on Higher Order Spectra for Clinical Recognition of Seizure and Epilepsy Using Brain Activity

Introduction

This paper proposes a reliable and efficient technique to recognize different epilepsy states, including healthy, interictal, and ictal states, using Electroencephalogram (EEG) signals.

Methods

The proposed approach consists of pre-processing, feature extraction by higher order spectra, feature normalization, feature selection by genetic algorithm and ranking method, and classification by support vector machine with Gaussian and polynomial radial basis function kernels. The proposed approach is validated on a public benchmark dataset to compare it with previous studies.

Results

The results indicate that the combined use of above elements can effectively decipher the cognitive process of epilepsy and seizure recognition. There are several bispectrum and bicoherence peaks at every bi-frequency plane, which reveal the location of the quadratic phase coupling. The proposed approach can reach, in almost all of the experiments, up to 100% performance in terms of sensitivity, specificity, and accuracy.

Conclusion

Comparing between the obtained results and previous approaches approves the effectiveness of the proposed approach for seizure and epilepsy recognition.

Seizure detection: do current devices work? And when can they be useful?

PURPOSE OF REVIEW

The unpredictability and apparent randomness of epileptic seizures is one of the most vexing aspects of epilepsy. Methods or devices capable of detecting seizures may help prevent injury or even death and significantly improve quality of life. Here, we summarize and evaluate currently available, unimodal, or polymodal detection systems for epileptic seizures, mainly in the ambulatory setting.

RECENT FINDINGS

There are two broad categories of detection devices: EEG-based and non-EEG-based systems. Wireless wearable EEG devices are now available both in research and commercial arenas. Neuro-stimulation devices are currently evolving and initial experiences of these show potential promise. As for non-EEG devices, different detecting systems show different sensitivity according to the different patient and seizure types. Regardless, when used in combination, these modalities may complement each other to increase positive predictive value. Although some devices with high sensitivity are promising, practical widespread use of such detection systems is still some way away. More research and experience are needed to evaluate the most efficient and integrated systems, to allow for better approaches to detection and prediction of seizures. The concept of closed-loop systems and prompt intervention may substantially improve quality of life for patients and carers.

Epileptic Seizure Detection with Log-Euclidean Gaussian Kernel-Based Sparse Representation

Epileptic seizure detection plays an important role in the diagnosis of epilepsy and reducing the massive workload of reviewing electroencephalography (EEG) recordings. In this work, a novel algorithm is developed to detect seizures employing log-Euclidean Gaussian kernel-based sparse representation (SR) in long-term EEG recordings. Unlike the traditional SR for vector data in Euclidean space, the log-Euclidean Gaussian kernel-based SR framework is proposed for seizure detection in the space of the symmetric positive definite (SPD) matrices, which form a Riemannian manifold. Since the Riemannian manifold is nonlinear, the log-Euclidean Gaussian kernel function is applied to embed it into a reproducing kernel Hilbert space (RKHS) for performing SR. The EEG signals of all channels are divided into epochs and the SPD matrices representing EEG epochs are generated by covariance descriptors. Then, the testing samples are sparsely coded over the dictionary composed by training samples utilizing log-Euclidean Gaussian kernel-based SR. The classification of testing samples is achieved by computing the minimal reconstructed residuals. The proposed method is evaluated on the Freiburg EEG dataset of 21 patients and shows its notable performance on both epoch-based and event-based assessments. Moreover, this method handles multiple channels of EEG recordings synchronously which is more speedy and efficient than traditional seizure detection methods.

Multifractal Analysis and Relevance Vector Machine-Based Automatic Seizure Detection in Intracranial EEG

Automatic seizure detection technology is of great significance for long-term electroencephalogram (EEG) monitoring of epilepsy patients. The aim of this work is to develop a seizure detection system with high accuracy. The proposed system was mainly based on multifractal analysis, which describes the local singular behavior of fractal objects and characterizes the multifractal structure using a continuous spectrum. Compared with computing the single fractal dimension, multifractal analysis can provide a better description on the transient behavior of EEG fractal time series during the evolvement from interictal stage to seizures. Thus both interictal EEG and ictal EEG were analyzed by multifractal formalism and their differences in the multifractal features were used to distinguish the two class of EEG and detect seizures. In the proposed detection system, eight features (α0, αmin, αmax, Δα, f(α min ), f(α max ), Δf and R) were extracted from the multifractal spectrums of the preprocessed EEG to construct feature vectors. Subsequently, relevance vector machine (RVM) was applied for EEG patterns classification, and a series of post-processing operations were used to increase the accuracy and reduce false detections. Both epoch-based and event-based evaluation methods were performed to appraise the system's performance on the EEG recordings of 21 patients in the Freiburg database. The epoch-based sensitivity of 92.94% and specificity of 97.47% were achieved, and the proposed system obtained a sensitivity of 92.06% with a false detection rate of 0.34/h in event-based performance assessment.

Epileptic Seizure Detection Based on Partial Directed Coherence Analysis

Long-term video EEG epilepsy monitoring can help doctors diagnose and cure epilepsy. The workload of doctors to read the EEG signals of epilepsy patients can be effectively reduced by automatic seizure detection. The application of partial directed coherence (PDC) analysis as mechanism for feature extraction in the scalp EEG recordings for seizure detection could reflect the physiological changes of brain activity before and after seizure onsets. In this study, a new approach on the basis of PDC was proposed to detect the seizure intervals of epilepsy patients. First of all, the multivariate autoregressive model was established for a moving window and the direction and intensity of information flow based on PDC analysis was calculated. Then, the outflow information related to certain EEG channel could be obtained by summing up the intensity of information flow propagated to other EEG channels in order to reduce the feature dimensionality. At last, according to the pathological features of epileptic seizures, the outflow information was regarded as the input vectors to a support vector machine classifier for discriminating interictal periods and ictal periods of EEG signals. The proposed method had achieved a good performance with the correct rate of 98.3%, the selectivity rate of 67.88%, the sensitivity rate of 91.44%, the specificity rate of 99.34%, and the average detection rate of 95.39%, which demonstrated that this method was suitable for detecting the seizure intervals of epilepsy patients. By comparing with other existing techniques, the proposed method based on PDC analysis achieved significant improvement in terms of seizure detection.

Automatic seizure detection using Stockwell transform and boosting algorithm for long-term EEG

Automatic detection of seizures has vital significance for epileptic diagnosis and can efficiently reduce the workload of the medical staff. In this study, a novel seizure detection method based on Stockwell transform is proposed for intracranial long-term EEG data. The Stockwell transform is employed to obtain the time-frequency representation of the EEG signals, and then the power spectral density is calculated in the time-frequency plane to characterize the behavior of EEG recordings. After that, a classifier based on gradient boosting algorithm is used to make the classification. Finally, the postprocessing is utilized on the outputs of the classifier to obtain more stable and accurate detection results, which includes Kalman filter, threshold judgment, and collar technique. The performance of this method is assessed on the publicly available EEG database which contains approximately 533h of intracranial EEG recordings. The experimental results indicate that the proposed method can achieve a satisfactory sensitivity of 94.26%, a specificity of 96.34%, as well as a very short delay time of 0.56s.

Kernel Collaborative Representation-Based Automatic Seizure Detection in Intracranial EEG

Automatic seizure detection is of great significance in the monitoring and diagnosis of epilepsy. In this study, a novel method is proposed for automatic seizure detection in intracranial electroencephalogram (iEEG) recordings based on kernel collaborative representation (KCR). Firstly, the EEG recordings are divided into 4s epochs, and then wavelet decomposition with five scales is performed. After that, detail signals at scales 3, 4 and 5 are selected to be sparsely coded over the training sets using KCR. In KCR, l2-minimization replaces l1-minimization and the sparse coefficients are computed with regularized least square (RLS), and a kernel function is utilized to improve the separability between seizure and nonseizure signals. The reconstructed residuals of each EEG epoch associated with seizure and nonseizure training samples are compared and EEG epochs are categorized as the class that minimizes the reconstructed residual. At last, a multi-decision rule is applied to obtain the final detection decision. In total, 595 h of iEEG recordings from 21 patients with 87 seizures are employed to evaluate the system. The average sensitivity of 94.41%, specificity of 96.97%, and false detection rate of 0.26/h are achieved. The seizure detection system based on KCR yields both a high sensitivity and a low false detection rate for long-term EEG.

Automatic seizure detection using diffusion distance and BLDA in intracranial EEG

Approximately 1% of the world's population suffers from epilepsy. An automatic seizure detection system is of great significance in the monitoring and diagnosis of epilepsy. In this paper, a novel method is proposed for automatic seizure detection in intracranial EEG recordings. The EEG recordings are divided into 4-s epochs, and then wavelet decomposition with five scales is performed to the EEG epochs. Detail signals at scales 3, 4, and 5 are selected to form a signal distribution. The diffusion distances are extracted as features, and Bayesian linear discriminant analysis (BLDA) is used as the classifier. A total of 193.75h of intracranial EEG recordings from 21 patients having 87 seizures are employed to evaluate the system, and the average sensitivity of 94.99%, specificity of 98.74%, and false-detection rate of 0.24/h are achieved. The seizure detection system based on diffusion distance yields a high sensitivity as well as a low false-detection rate for long-term EEG recordings.

Early detection of epileptic seizures based on parameter identification of neural mass model

Physiologically based models are attractive for seizure detection, as their parameters can be explicitly related to neurological mechanisms. We propose an early seizure detection algorithm based on parameter identification of a neural mass model. The occurrence of a seizure is detected by analysing the time shift of key model parameters. The algorithm was evaluated against the manual scoring of a human expert on intracranial EEG samples from 16 patients suffering from different types of epilepsy. Results suggest that the algorithm is best suited for patients suffering from temporal lobe epilepsy (sensitivity was 95.0% ± 10.0% and false positive rate was 0.20 ± 0.22 per hour).

A New Approach to Detect Epileptic Seizures in Electroencephalograms Using Teager Energy

A Teager energy (TE) based approach to discriminate electroencephalogram signals corresponding to nonseizure (eyes open, eyes closed, or interictal) and seizure (ictal) intervals is proposed. Though a good number of contributions have been made for seizure detection, the challenges of unbalanced data (nonseizure and seizure events) and system computational efficiency still remain a challenge. It is reported in the literature that the seizures are characterized by abnormal sudden discharges in the brain which get manifested in the EEG recordings by frequency changes and increased amplitudes. Teager energy (TE) is capable of tracking such rapid changes in frequency as well as amplitude in the time domain. An important finding of this study is that the mean TE quantifier is largely independent of the window length and exhibits relative consistency when used as a relative measure for comparison. We compared the diagnostic capability of TE quantifier with those of Higuchi’s fractal dimension and sample entropy in discriminating nonseizure and seizure states in the EEGs and found that TE outperforms the other two nonlinear quantifiers. The result shows that the application of this method compares favorably with conventional classification methods in terms of performance and is well suited for real-time automatic epileptic seizure detection.

A fuzzy logic system for seizure onset detection in intracranial EEG

We present a multistage fuzzy rule-based algorithm for epileptic seizure onset detection. Amplitude, frequency, and entropy-based features were extracted from intracranial electroencephalogram (iEEG) recordings and considered as the inputs for a fuzzy system. These features extracted from multichannel iEEG signals were combined using fuzzy algorithms both in feature domain and in spatial domain. Fuzzy rules were derived based on experts' knowledge and reasoning. An adaptive fuzzy subsystem was used for combining characteristics features extracted from iEEG. For the spatial combination, three channels from epileptogenic zone and one from remote zone were considered into another fuzzy subsystem. Finally, a threshold procedure was applied to the fuzzy output derived from the final fuzzy subsystem. The method was evaluated on iEEG datasets selected from Freiburg Seizure Prediction EEG (FSPEEG) database. A total of 112.45 hours of intracranial EEG recordings was selected from 20 patients having 56 seizures was used for the system performance evaluation. The overall sensitivity of 95.8% with false detection rate of 0.26 per hour and average detection latency of 15.8 seconds was achieved.

Features and futures: seizure detection in partial epilepsies

Many factors underlying basic epileptic conditions determine the characteristics of epileptic seizures and the therapeutic outcome. Diagnosis and treatment rely on the clinical manifestations as well as electroencephalographic (EEG) epileptic activities. This article briefly reviews the fundamentals of the EEG, interictal, and ictal electrical activities of both extracranial and intracranial EEG of partial epilepsies, based on the information obtained from epilepsy patients who have undergone epilepsy surgery. The authors also present the status of their current research, focusing on decomposed seizure sources and the rendered spatial-temporal transitions in focal seizure.

Comparison of fractal dimension estimation algorithms for epileptic seizure onset detection

Fractal dimension (FD) is a natural measure of the irregularity of a curve. In this study the performances of three waveform FD estimation algorithms (i.e. Katz's, Higuchi's and the k-nearest neighbour (k-NN) algorithm) were compared in terms of their ability to detect the onset of epileptic seizures in scalp electroencephalogram (EEG). The selection of parameters involved in FD estimation, evaluation of the accuracy of the different algorithms and assessment of their robustness in the presence of noise were performed based on synthetic signals of known FD. When applied to scalp EEG data, Katz's and Higuchi's algorithms were found to be incapable of producing consistent changes of a single type (either a drop or an increase) during seizures. On the other hand, the k-NN algorithm produced a drop, starting close to the seizure onset, in most seizures of all patients. The k-NN algorithm outperformed both Katz's and Higuchi's algorithms in terms of robustness in the presence of noise and seizure onset detection ability. The seizure detection methodology, based on the k-NN algorithm, yielded in the training data set a sensitivity of 100% with 10.10 s mean detection delay and a false positive rate of 0.27 h(-1), while the corresponding values in the testing data set were 100%, 8.82 s and 0.42 h(-1), respectively. The above detection results compare favourably to those of other seizure onset detection methodologies applied to scalp EEG in the literature. The methodology described, based on the k-NN algorithm, appears to be promising for the detection of the onset of epileptic seizures based on scalp EEG.

Automatic epileptic seizure detection in EEGs based on line length feature and artificial neural networks

About 1% of the people in the world suffer from epilepsy. The main characteristic of epilepsy is the recurrent seizures. Careful analysis of the electroencephalogram (EEG) recordings can provide valuable information for understanding the mechanisms behind epileptic disorders. Since epileptic seizures occur irregularly and unpredictably, automatic seizure detection in EEG recordings is highly required. Wavelet transform (WT) is an effective analysis tool for non-stationary signals, such as EEGs. The line length feature reflects the waveform dimensionality changes and is a measure sensitive to variation of the signal amplitude and frequency. This paper presents a novel method for automatic epileptic seizure detection, which uses line length features based on wavelet transform multiresolution decomposition and combines with an artificial neural network (ANN) to classify the EEG signals regarding the existence of seizure or not. To the knowledge of the authors, there exists no similar work in the literature. A famous public dataset was used to evaluate the proposed method. The high accuracy obtained for three different classification problems testified the great success of the method.

Seizure detection in intracranial EEG using a fuzzy inference system

In this paper, we present a fuzzy rule-based system for the automatic detection of seizures in the intracranial EEG (IEEG) recordings. A total of 302.7 hours of the IEEG with 78 seizures, recorded from 21 patients aged between 10 and 47 years were used for the evaluation of the system. After preprocessing, temporal, spectral, and complexity features were extracted from the segmented IEEGs. The results were thresholded using the statistics of a reference window and integrated spatio-temporally using a fuzzy rule-based decision making system. The system yielded a sensitivity of 98.7%, a false detection rate of 0.27/h, and an average detection latency of 11 s. The results from the automatic system correlate well with the visual analysis of the seizures by the expert. This system may serve as a good seizure detection tool for monitoring long-term IEEG with relatively high sensitivity and low false detection rate.

A fuzzy rule-based system for epileptic seizure detection in intracranial EEG

OBJECTIVE

We present a method for automatic detection of seizures in intracranial EEG recordings from patients suffering from medically intractable focal epilepsy.

METHODS

We designed a fuzzy rule-based seizure detection system based on knowledge obtained from experts' reasoning. Temporal, spectral, and complexity features were extracted from IEEG segments, and spatio-temporally integrated using the fuzzy rule-based system for seizure detection. A total of 302.7h of intracranial EEG recordings from 21 patients having 78 seizures was used for evaluation of the system.

RESULTS

The system yielded a sensitivity of 98.7%, a false detection rate of 0.27/h, and an average detection latency of 11s. There was only one missed seizure. Most of false detections were caused by high-amplitude rhythmic activities. The results from the system correlate well with those from expert visual analysis.

CONCLUSION

The fuzzy rule-based seizure detection system enabled us to deal with imprecise boundaries between interictal and ictal IEEG patterns.

SIGNIFICANCE

This system may serve as a good seizure detection tool with high sensitivity and low false detection rate for monitoring long-term IEEG.

Automated seizure onset detection for accurate onset time determination in intracranial EEG

OBJECTIVE

A novel algorithm for automated seizure onset detection is presented. The method allows for precise identification of electrographic seizure onset times within large databases of electrographic data.

METHODS

The patient-specific algorithm extracts salient spectral and temporal features in five frequency bands within a sliding window of an electrographic recording. Feature windows are classified as containing or not containing a seizure onset via support vector machines. A clustering and regression analysis is utilized to accurately localize seizure onsets in time. User-adjustable parameters allow for tuning of detection sensitivity, false positive rate, and latency. The method was tested on intracranial electrographic data recorded from six patients with a total of 1792 recorded seizure onsets from 8246 total electrographic recordings.

RESULTS

Testing of algorithm performance via cross-validation resulted in sensitivities between 80% and 98%, false positive rates from 0.002 to 0.046 per minute (0.12-2.8 per hour), and median detection time within 100ms of the electrographic onset for all patients. In five of the six patients, more than 90% of all detected onsets were less than 3s from the electrographic onset.

CONCLUSIONS

The detection system was able to detect seizure onset times in a temporally unbiased fashion with low latency while maintaining reasonable sensitivities and false positive rates. The regression algorithm for temporal localization of onsets confers a considerable benefit in terms of detection latency.

SIGNIFICANCE

With the use of our algorithm, large databases of electrographic data can be rapidly processed and seizure onset times accurately marked, facilitating research and analyses of peri-onset events that require precise seizure onset alignment.

Detecting epileptic seizures in long-term human EEG: a new approach to automatic online and real-time detection and classification of polymorphic seizure patterns

Epileptic seizures can cause a variety of temporary changes in perception and behavior. In the human EEG they are reflected by multiple ictal patterns, where epileptic seizures typically become apparent as characteristic, usually rhythmic signals, often coinciding with or even preceding the earliest observable changes in behavior. Their detection at the earliest observable onset of ictal patterns in the EEG can, thus, be used to start more-detailed diagnostic procedures during seizures and to differentiate epileptic seizures from other conditions with seizure-like symptoms. Recently, warning and intervention systems triggered by the detection of ictal EEG patterns have attracted increasing interest. Since the workload involved in the detection of seizures by human experts is quite formidable, several attempts have been made to develop automatic seizure detection systems. So far, however, none of these found widespread application. Here, we present a novel procedure for generic, online, and real-time automatic detection of multimorphologic ictal-patterns in the human long-term EEG and its validation in continuous, routine clinical EEG recordings from 57 patients with a duration of approximately 43 hours and additional 1,360 hours of seizure-free EEG data for the estimation of the false alarm rates. We analyzed 91 seizures (37 focal, 54 secondarily generalized) representing the six most common ictal morphologies (alpha, beta, theta, and delta- rhythmic activity, amplitude depression, and polyspikes). We found that taking the seizure morphology into account plays a crucial role in increasing the detection performance of the system. Moreover, besides enabling a reliable (mean false alarm rate<0.5/h, for specific ictal morphologies<0.25/h), early and accurate detection (average correct detection rate>96%) within the first few seconds of ictal patterns in the EEG, this procedure facilitates the automatic categorization of the prevalent seizure morphologies without the necessity to adapt the proposed system to specific patients.

Seizure detection in EEG signals: a comparison of different approaches

In this paper, the performance of traditional variance-based method for detection of epileptic seizures in EEG signals are compared with various methods based on nonlinear time series analysis, entropies, logistic regression,discrete wavelet transform and time frequency distributions.We noted that variance-based method in compare to the mentioned methods had the best result (100%) applied on the same database.

An efficient, robust and fast method for the offline detection of epileptic seizures in long-term scalp EEG recordings

OBJECTIVE

A robust and fast algorithm for the offline detection of epileptic seizures in scalp EEG is described. It is aimed for seizure detection with high sensitivity and low number of false detections in long-term EEG data without a priori information.

METHODS

To capture the characteristic electrographic changes of seizures, we developed an efficient method based on power spectral analysis techniques. The integrated power is calculated in two frequency bands for three multi-channel seizure detection montages (referenced against the average of Fz-Cz-Pz, common average, bipolar) using the same parameters for all montages and all patients taking into account an appropriate artifact rejection.

RESULTS

A total of 3248 h of scalp recordings containing 148 seizures from 19 patients were examined. The averaged sensitivity was 90.9% and selectivity (false-positive errors/h, FPH) was 0.29/h of the Fz-Cz-Pz montage; the other montages yielded lower sensitivities but even better selectivity values.

CONCLUSIONS

Taking into account that the method has been performed in a standardized way with fixed parameters for all patients and montages the obtained values for sensitivity are quite high while the selectivity is acceptably low. The parameters can additionally be tuned to patient specific seizures. It is assumed that this may further improve the seizure detection performance.

SIGNIFICANCE

The proposed method may enhance the clinical use for the detection of seizures in scalp EEG long-term monitoring during presurgical evaluation.

Approximate Entropy-Based Epileptic EEG Detection Using Artificial Neural Networks

The electroencephalogram (EEG) signal plays an important role in the diagnosis of epilepsy. The EEG recordings of the ambulatory recording systems generate very lengthy data and the detection of the epileptic activity requires a time-consuming analysis of the entire length of the EEG data by an expert. The traditional methods of analysis being tedious, many automated diagnostic systems for epilepsy have emerged in recent years. This paper proposes a neural-network-based automated epileptic EEG detection system that uses approximate entropy (ApEn) as the input feature. ApEn is a statistical parameter that measures the predictability of the current amplitude values of a physiological signal based on its previous amplitude values. It is known that the value of the ApEn drops sharply during an epileptic seizure and this fact is used in the proposed system. Two different types of neural networks, namely, Elman and probabilistic neural networks, are considered in this paper. ApEn is used for the first time in the proposed system for the detection of epilepsy using neural networks. It is shown that the overall accuracy values as high as 100% can be achieved by using the proposed system.

Automatic seizure detection based on time-frequency analysis and artificial neural networks

The recording of seizures is of primary interest in the evaluation of epileptic patients. Seizure is the phenomenon of rhythmicity discharge from either a local area or the whole brain and the individual behavior usually lasts from seconds to minutes. Since seizures, in general, occur infrequently and unpredictably, automatic detection of seizures during long-term electroencephalograph (EEG) recordings is highly recommended. As EEG signals are nonstationary, the conventional methods of frequency analysis are not successful for diagnostic purposes. This paper presents a method of analysis of EEG signals, which is based on time-frequency analysis. Initially, selected segments of the EEG signals are analyzed using time-frequency methods and several features are extracted for each segment, representing the energy distribution in the time-frequency plane. Then, those features are used as an input in an artificial neural network (ANN), which provides the final classification of the EEG segments concerning the existence of seizures or not. We used a publicly available dataset in order to evaluate our method and the evaluation results are very promising indicating overall accuracy from 97.72% to 100%.

Artificial Neural Network Based Epileptic Detection Using Time-Domain and Frequency-Domain Features

Electroencephalogram (EEG) signal plays an important role in the diagnosis of epilepsy. The long-term EEG recordings of an epileptic patient obtained from the ambulatory recording systems contain a large volume of EEG data. Detection of the epileptic activity requires a time consuming analysis of the entire length of the EEG data by an expert. The traditional methods of analysis being tedious, many automated diagnostic systems for epilepsy have emerged in recent years. This paper discusses an automated diagnostic method for epileptic detection using a special type of recurrent neural network known as Elman network. The experiments are carried out by using time-domain as well as frequency-domain features of the EEG signal. Experimental results show that Elman network yields epileptic detection accuracy rates as high as 99.6% with a single input feature which is better than the results obtained by using other types of neural networks with two and more input features.

Comparison of predictability of epileptic seizures by a linear and a nonlinear method

The performance of traditional linear (variance based) methods for the identification and prediction of epileptic seizures are contrasted with "modern" methods from nonlinear time series analysis. We note several flaws of design in demonstrations claiming to establish the efficacy of nonlinear techniques; in particular, we examine published evidence for precursor identification. We perform null hypothesis tests using relevant surrogate data to demonstrate that decreases in the correlation density prior to and during seizure may simply reflect increases in the variance.

Linear and non-linear methods for automatic seizure detection in scalp electro-encephalogram recordings

The electro-encephalogram is a time-varying signal that measures electrical activity in the brain. A conceptually intuitive non-linear technique, multi-dimensional probability evolution (MDPE), is introduced. It is based on the time evolution of the probability density function within a multi-dimensional state space. A synthetic recording is employed to illustrate why MDPE is capable of detecting changes in the underlying dynamics that are invisible to linear statistics. If a non-linear statistic cannot outperform a simple linear statistic such as variance, then there is no reason to advocate its use. Both variance and MDPE were able to detect the seizure in each of the ten scalp EEG recordings investigated. Although MDPE produced fewer false positives, there is no firm evidence to suggest that MDPE, or any other non-linear statistic considered, outperforms variance-based methods at identifying seizures.

Using simulated neuronal cell models for detection of epileptic seizures in foramen ovale and scalp EEG

OBJECTIVE

To demonstrate a novel approach for real-time and automatic detection of epileptic seizures in EEG recorded with foramen ovale (Fov) or scalp electrodes.

METHODS

Our seizure detection method is based on simulated leaky integrate and fire units (LIFU), which are classical simple neuronal cell models. The LIFUs are connected to a signal preprocessing stage and increase their spiking rates in response to rhythmic and synchronous EEG signals as typically occur at the onset and during seizures.

RESULTS

We analyzed 22 short-term (10+/-3 min) and 4 long-term (18+/-7 h) Fov or scalp EEGs of 10 patients with drug resistant partial epilepsy. Seizures (n=36) were marked by increases of the LIFUs spiking rates above a preset threshold. The durations of increased spiking rates due to seizures were always longer than 10 s (36+/-21 s) and allowed separation from artifacts, which caused only short durations (1.2+/-0.6 s) of high spiking rates. The LIFUs correctly detected all the seizures and produced no false alarms. In the long term Fov EEGs seizure detection occurred before the onset of clinical signs (41+/-22 s).

CONCLUSIONS

By using simulated neuronal cell models it is possible to automatically detect epileptic seizures in scalp and Fov EEG with high sensitivity and specificity.

Automatic detection of seizures and spikes

The recording of seizures and spikes is of primary importance in the evaluation of epileptic patients. This is not always an easy process because these events can be rare and are usually unpredictable. Since the earliest days of computer analysis of the EEG, researchers have developed methods for the automatic detection of spikes and, more recently, of seizures. The problems are complex because spikes and seizures are not clearly defined and have extremely varied morphologies. Nevertheless, it has been possible to develop automatic detection methods that can be of great assistance during long-term monitoring of epileptic patients. No method is absolutely fail-safe and all require human validation, but they save a considerable amount of time in the interpretation of long recordings. Recent developments include detection of the patterns specific to newborns, and the possibility of warning a patient or observer that a seizure is starting.

Real-time automated detection and quantitative analysis of seizures and short-term prediction of clinical onset

PURPOSE

We describe an algorithm for rapid real-time detection, quantitation, localization of seizures, and prediction of their clinical onset.

METHODS

Advanced digital signal processing techniques used in time-frequency localization, image processing, and identification of time-varying stochastic systems were used to develop the algorithm, which operates in generic or adaptable "modes." The "generic mode" was tested on (a) 125 partial seizures (each contained in a 10-min segment) involving the mesial temporal regions and recorded using depth electrodes from 16 subjects, and (b) 205 ten-minute segments of randomly selected interictal (nonseizure) data. The performance of the algorithm was compared with expert visual analysis, the current "gold standard."

RESULTS

The generic algorithm achieved perfect sensitivity and specificity (no false-positive and no false-negative detections) over the entire data set. Seizure intensity, a novel measure that seems clinically relevant, ranged between 35.7 and 6129. Detection was sufficiently rapid to allow prediction of clinical onset in 92% of seizures by a mean of 15.5 s.

CONCLUSIONS

This algorithm, which was implemented with a personal computer, represents a definitive step toward rapid and accurate detection and prediction of seizures. It may also enable development of intelligent devices for automated seizure warning and treatment and stimulate new study of the dynamics of seizures and of the epileptic brain.

Computer-based electroencephalography: technical basics, basis for new applications, and potential pitfalls

EEG has been recorded on paper-based analog systems for over 50 years. In the past 5 years, computer-based digital systems have become more widely used. Digital systems eliminate some artifacts that plagued analog recordings but introduce subtle new problems including aliasing and dynamic range. Digital systems allow reformatting of the same EEG segment using different gain, filter and montage settings. The digital signal allows for measurement and computations on the EEG, leading to applications such as power spectrum, topographic mapping, and spike or seizure detection.

Enhancing the detection of seizures with a clustering algorithm

Automated detection algorithms of EEG seizures or similar clinical events typically analyze a finite epoch a given channel at a time, producing a probability or a weight estimating how likely it is for the event to resemble a clinical pattern. Epochs are normally shorter than the duration of a seizure, which may spread to more than one electrode. This may result in a weak correspondence between the seizure pattern in the record and its calculated detector event counterpart. As a result, such algorithms suffer from a high rate of false detections. We show that the weights/probabilities of a generic detector can be described as a weight function embedded in a directed graph (digraph). Extended objects such as seizures therefore correspond to the connected components of the digraph. We introduce a clustering algorithm that accounts for the shortcomings of a generic detector of the type described above. By correlating detector results with respect to both time and channel, we effectively extend the detection to an unlimited number of electrodes over an indefinite time. The algorithm is fast (linear - O(m)) and may be implemented in real time. We argue that the algorithm enhances the detection of seizure onset and lowers the rate of false detections. Preliminary results demonstrate a strong correlation between the seizure and the cluster's boundaries and over 50% reduction of false detection rate.

A practical analysis of computer based seizure detection during continuous video-EEG monitoring

Computer based seizure detection (CSD) systems improve the efficiency of CCTV-EEG monitoring by capturing epileptic seizures which would have otherwise been missed. We prospectively evaluated the yield of a commercial CSD system in 83 consecutive CCTV-EEG admissions. All seizures were coded as to the method of detection. The percentage of seizures detected only by CSD was calculated for each patient and the impact on length of hospital stay was estimated. Overall, 33% of epileptic seizures were signaled by the patient, 45% were directly observed by family or medical personnel, and 22% were captured only by CSD. Forty admissions (48%) had at least one seizure captured only by CSD. The majority of these events were clinical and electrographic seizures (73%) and the remainder were purely electrographic. Five admissions concluded with all seizures captured only by CSD. We estimated an average saving of 1.3 hospital days per admission, based on the percentage of seizures captured only by CSD.

A patient-specific algorithm for the detection of seizure onset in long-term EEG monitoring: possible use as a warning device

During long-term electroencephalogram (EEG) monitoring of epileptic patients, a seizure warning system would allow patients and observers to take appropriate precautions. It would also allow observers to interact with patients early during the seizure, thus revealing clinically useful information. We designed patient-specific classifiers to detect seizure onsets. After a seizure and some nonseizure data are recorded in a patient, they are used to train a classifier. In subsequent monitoring sessions, EEG patterns have to pass this classifier to determine if a seizure onset occurs. If it does, an alarm is triggered. Extreme care has been taken to ensure a low false-alarm rate, since a high false-alarm rate would render the system ineffective. Features were extracted from the time and frequency domains and a modified nearest-neighbor (NN) classifier was used. The system reached an onset detection rate of 100% with an average delay of 9.35 a after onset. The average false-alarm rate was only 0.02/h. The method was evaluated in 12 patients with a total of 47 seizures. Results indicate that the system is effective and reasonably reliable. Computation load has been kept to a minimum so that real-time processing is possible.

An Adaptive Structure Neural Networks with Application to EEG Automatic Seizure Detection

This paper introduces a new algorithm for adaptively adjusting the structure of a multi-layer back-propagation network. The proposed algorithm belongs to the class of neuron generating strategies as opposed to the class of neuron pruning strategies. Initially a "small" multi-layer perceptron network is selected. The stabilized error is used as an index to determine whether the network needs to generate a new neuron or not. If after a period of learning the error is stabilized, but the error is larger than a desired value, then new neuron(s) is (are) generated. The new neurons are placed at locations that contribute most to the network error behavior through the fluctuation in their input weight vectors. Among the features of the new architecture are its improved performance and generalization capabilities compared to a standard fixed-structure back-propagation network. Application to an electroencephalogram (EEG) automatic epileptic seizure detection is presented to illustrate advantages and capabilities of the proposed algorithm. Using an actual data from five patients it is shown that the proposed approach correctly identifies all true seizures that are also identified by an expert physician. The new algorithm provides a reduction of 60-70% in the training epochs as compared to a back-propagation algorithm. Furthermore, it is shown that by utilizing a new training algorithm it is possible to reduce the false seizure detections to zero while resulting in a 5.1% error in identifying the true seizures. Copyright 1996 Elsevier Science Ltd

Detection of seizures from small samples using nonlinear dynamic system theory

The electroencephalogram (EEG), like many other biological phenomena, is quite likely governed by nonlinear dynamics. Certain characteristics of the underlying dynamics have recently been quantified by computing the correlation dimensions (D2) of EEG time series data. In this paper, D2 of the unbiased autocovariance function of the scalp EEG data was used to detect electrographic seizure activity. Digital EEG data were acquired at a sampling rate of 200 Hz per channel and organized in continuous frames (duration 2.56 s, 512 data points). To increase the reliability of D2 computations with short duration data, raw EEG data were initially simplified using unbiased autocovariance analysis to highlight the periodic activity that is present during seizures. The D2 computation was then performed from the unbiased autocovariance function of each channel using the Grassberger-Procaccia method with Theiler's box-assisted correlation algorithm. Even with short duration data, this preprocessing proved to be computationally robust and displayed no significant sensitivity to implementation details such as the choices of embedding dimension and box size. The system successfully identified various types of seizures in clinical studies.