A multi-level wavelet approach for automatic detection of epileptic spikes in the electroencephalogram

A Review of EEG-based Localization of Epileptic Seizure Foci: Common Points with Multimodal Fusion of Brain Data

Unexpected seizures significantly decrease the quality of life in epileptic patients. Seizure attacks are caused by hyperexcitability and anatomical lesions of special regions of the brain, and cognitive impairments and memory deficits are their most common concomitant effects. In addition to seizure reduction treatments, medical rehabilitation involving brain-computer interfaces and neurofeedback can improve cognition and quality of life in patients with focal epilepsy in most cases, in particular when resective epilepsy surgery has been considered treatment in drug-resistant epilepsy. Source estimation and precise localization of epileptic foci can improve such rehabilitation and treatment. Electroencephalography (EEG) monitoring and multimodal noninvasive neuroimaging techniques such as ictal/interictal single-photon emission computerized tomography (SPECT) imaging and structural magnetic resonance imaging are common practices for the localization of epileptic foci and have been studied in several kinds of researches. In this article, we review the most recent research on EEG-based localization of seizure foci and discuss various methods, their advantages, limitations, and challenges with a focus on model-based data processing and machine learning algorithms. In addition, we survey whether combined analysis of EEG monitoring and neuroimaging techniques, which is known as multimodal brain data fusion, can potentially increase the precision of the seizure foci localization. To this end, we further review and summarize the key parameters and challenges of processing, fusion, and analysis of multiple source data, in the framework of model-based signal processing, for the development of a multimodal brain data analyzing system. This article has the potential to be used as a valuable resource for neuroscience researchers for the development of EEG-based rehabilitation systems based on multimodal data analysis related to focal epilepsy.

Interictal Epileptiform Discharge Detection Using Time-Frequency Analysis and Transfer Learning

Interictal epileptiform discharges (IEDs) are electrophysiological events that intermittently occur in between seizures in Epilepsy patients. Automated detection of IEDs is crucial for assisting clinicians in epilepsy diagnosis as they can help identify the extent of cortical irritations and may indicate an upcoming seizure, thus helping in preventing seizure. It also minimizes visual inspection of very long EEG signals by physicians. This paper presents a transfer-learning-based approach for analyzing time-frequency representations of different types of IEDs from scalp EEG data using a fine-tuned deep residual network. The proposed method was evaluated using the publicly available Temple University Events EEG dataset. Experimental results show that our method demonstrates promising performance, by achieving an F1-score of 88.52% on this dataset for binary classification of IEDs.

Mobile neuroimaging: What we have learned about the neural control of human walking, with an emphasis on EEG-based research

Our understanding of the neural control of human walking has changed significantly over the last twenty years and mobile brain imaging methods have contributed substantially to current knowledge. High-density electroencephalography (EEG) has the advantages of being lightweight and mobile while providing temporal resolution of brain changes within a gait cycle. Advances in EEG hardware and processing methods have led to a proliferation of research on the neural control of locomotion in neurologically intact adults. We provide a narrative review of the advantages and disadvantages of different mobile brain imaging methods, then summarize findings from mobile EEG studies quantifying electrocortical activity during human walking. Contrary to historical views on the neural control of locomotion, recent studies highlight the widespread involvement of many areas, such as the anterior cingulate, posterior parietal, prefrontal, premotor, sensorimotor, supplementary motor, and occipital cortices, that show active fluctuations in electrical power during walking. The electrocortical activity changes with speed, stability, perturbations, and gait adaptation. We end with a discussion on the next steps in mobile EEG research.

Deep-Learning-Based Automated Anomaly Detection of EEGs in Intensive Care Units

An intensive care unit (ICU) is a special ward in the hospital for patients who require intensive care. It is equipped with many instruments monitoring patients' vital signs and supported by the medical staff. However, continuous monitoring demands a massive workload of medical care. To ease the burden, we aim to develop an automatic detection model to monitor when brain anomalies occur. In this study, we focus on electroencephalography (EEG), which monitors the brain electroactivity of patients continuously. It is mainly for the diagnosis of brain malfunction. We propose the gated-recurrent-unit-based (GRU-based) model for detecting brain anomalies; it predicts whether the spike or sharp wave happens within a short time window. Based on the banana montage setting, the proposed model exploits characteristics of multiple channels simultaneously to detect anomalies. It is trained, validated, and tested on separated EEG data and achieves more than 90% testing performance on sensitivity, specificity, and balanced accuracy. The proposed anomaly detection model detects the existence of a spike or sharp wave precisely; it will notify the ICU medical staff, who can provide immediate follow-up treatment. Consequently, it can reduce the medical workload in the ICU significantly.

V2IED: Dual-view learning framework for detecting events of interictal epileptiform discharges

Interictal epileptiform discharges (IED) as large intermittent electrophysiological events are associated with various severe brain disorders. Automated IED detection has long been a challenging task, and mainstream methods largely focus on singling out IEDs from backgrounds from the perspective of waveform, leaving normal sharp transients/artifacts with similar waveforms almost unattended. An open issue still remains to accurately detect IED events that directly reflect the abnormalities in brain electrophysiological activities, minimizing the interference from irrelevant sharp transients with similar waveforms only. This study then proposes a dual-view learning framework (namely V2IED) to detect IED events from multi-channel EEG via aggregating features from the two phases: (1) Morphological Feature Learning: directly treating the EEG as a sequence with multiple channels, a 1D-CNN (Convolutional Neural Network) is applied to explicitly learning the deep morphological features; and (2) Spatial Feature Learning: viewing the EEG as a 3D tensor embedding channel topology, a CNN captures the spatial features at each sampling point followed by an LSTM (Long Short-Term Memories) to learn the evolution of these features. Experimental results from a public EEG dataset against the state-of-the-art counterparts indicate that: (1) compared with the existing optimal models, V2IED achieves a larger area under the receiver operating characteristic (ROC) curve in detecting IEDs from normal sharp transients with a 5.25% improvement in accuracy; (2) the introduction of spatial features improves performance by 2.4% in accuracy; and (3) V2IED also performs excellently in distinguishing IEDs from background signals especially benign variants.

A Novel Framework for Epileptic Seizure Detection Using Electroencephalogram Signals Based on the Bat Feature Selection Algorithm

The precise electroencephalogram (EEG) signal classification with the highest possible accuracy is a key goal in the brain-computer interface (BCI). Considering the complexity and nonstationary nature of the EEG signals, there is an urgent need for effective feature extraction and data mining techniques. Here, we introduce a novel pipeline based on Bat and genetic algorithms for feature construction and dimension reduction of EEG signals. After wavelet extraction and segmentation, the Bat algorithm identifies the most relevant features. We use these features and a genetic algorithm combined with a neural network method to automatically classify the segments of the epilepsy EEG signals. We also use available classification methods based on k-Nearest Neighbors or naïve Bayes for comparison purposes. The code distinguishes individual signals within various combinations of data obtained from healthy volunteers with open or closed eyes and patients suffering from epilepsy disorders during seizure-free periods or seizure activities. Compared to the previously introduced methods, our proposed framework demonstrates a superior balance of high accuracy and short runtime. The minimum achieved accuracies for balanced and unbalanced classes are 100% and 75.9%, respectively. This approach has the potential for direct applications in clinics, enabling accurate and rapid analysis of the epilepsy EEG signals obtained from patients.

A review of signal processing and machine learning techniques for interictal epileptiform discharge detection

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.

Pitfalls in scalp EEG: Current obstacles and future directions

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.

CLEP: Contrastive Learning for Epileptic Seizure Prediction Using a Spatio-Temporal-Spectral Network

Seizure prediction of epileptic preictal period through electroencephalogram (EEG) signals is important for clinical epilepsy diagnosis. However, recent deep learning-based methods commonly employ intra-subject training strategy and need sufficient data, which are laborious and time-consuming for a practical system and pose a great challenge for seizure predicting. Besides, multi-domain characterizations, including spatio-temporal-spectral dependencies in an epileptic brain are generally neglected or not considered simultaneously in current approaches, and this insufficiency commonly leads to suboptimal seizure prediction performance. To tackle the above issues, in this paper, we propose Contrastive Learning for Epileptic seizure Prediction (CLEP) using a Spatio-Temporal-Spectral Network (STS-Net). Specifically, the CLEP learns intrinsic epileptic EEG patterns across subjects by contrastive learning. The STS-Net extracts multi-scale temporal and spectral representations under different rhythms from raw EEG signals. Then, a novel triple attention layer (TAL) is employed to construct inter-dimensional interaction among multi-domain features. Moreover, a spatio dynamic graph convolution network (sdGCN) is proposed to dynamically model the spatial relationships between electrodes and aggregate spatial information. The proposed CLEP-STS-Net achieves a sensitivity of 96.7% and a false prediction rate of 0.072/h on the CHB-MIT scalp EEG database. We also validate the proposed method on clinical intracranial EEG (iEEG) database from our Xuanwu Hospital of Capital Medical University, and the predicting system yielded a sensitivity of 95%, a false prediction rate of 0.087/h. The experimental results outperform the state-of-the-art studies which validate the efficacy of our method. Our code is available at https://github.com/LianghuiGuo/CLEP-STS-Net.

Feature separation and adversarial training for the patient-independent detection of epileptic seizures

An epileptic seizure is the external manifestation of abnormal neuronal discharges, which seriously affecting physical health. The pathogenesis of epilepsy is complex, and the types of epileptic seizures are diverse, resulting in significant variation in epileptic seizure data between subjects. If we feed epilepsy data from multiple patients directly into the model for training, it will lead to underfitting of the model. To overcome this problem, we propose a robust epileptic seizure detection model that effectively learns from multiple patients while eliminating the negative impact of the data distribution shift between patients. The model adopts a multi-level temporal-spectral feature extraction network to achieve feature extraction, a feature separation network to separate features into category-related and patient-related components, and an invariant feature extraction network to extract essential feature information related to categories. The proposed model is evaluated on the TUH dataset using leave-one-out cross-validation and achieves an average accuracy of 85.7%. The experimental results show that the proposed model is superior to the related literature and provides a valuable reference for the clinical application of epilepsy detection.

Interictal Epileptiform Discharge Detection Using Multi-Head Deep Convolutional Neural Network

Interictal epileptiform discharges (IEDs) are intermittent electrophysiological events that occur in patients with epilepsy between seizures. Automated detection of IEDs helps clinician to identify cortical irritations and relations to seizure recurrence. It also reduces the necessity of visual inspection by physicians interpreting the EEG. This paper presents a novel deep learning-based approach that combines one-dimensional local binary pattern symbolization method with a regularized multi-head one-dimensional convolutional neural network to learn unique morphological patterns from different EEG sub-bands for IED detection. Experimentation using the Temple University Events corpus scalp EEG data shows promising performance, e.g. F1-score of 87.18%.

Improving automated diagnosis of epilepsy from EEGs beyond IEDs

Objective.Clinical diagnosis of epilepsy relies partially on identifying interictal epileptiform discharges (IEDs) in scalp electroencephalograms (EEGs). This process is expert-biased, tedious, and can delay the diagnosis procedure. Beyond automatically detecting IEDs, there are far fewer studies on automated methods to differentiate epileptic EEGs (potentially without IEDs) from normal EEGs. In addition, the diagnosis of epilepsy based on a single EEG tends to be low. Consequently, there is a strong need for automated systems for EEG interpretation. Traditionally, epilepsy diagnosis relies heavily on IEDs. However, since not all epileptic EEGs exhibit IEDs, it is essential to explore IED-independent EEG measures for epilepsy diagnosis. The main objective is to develop an automated system for detecting epileptic EEGs, both with or without IEDs. In order to detect epileptic EEGs without IEDs, it is crucial to include EEG features in the algorithm that are not directly related to IEDs.Approach.In this study, we explore the background characteristics of interictal EEG for automated and more reliable diagnosis of epilepsy. Specifically, we investigate features based on univariate temporal measures (UTMs), spectral, wavelet, Stockwell, connectivity, and graph metrics of EEGs, besides patient-related information (age and vigilance state). The evaluation is performed on a sizeable cohort of routine scalp EEGs (685 epileptic EEGs and 1229 normal EEGs) from five centers across Singapore, USA, and India.Main results.In comparison with the current literature, we obtained an improved Leave-One-Subject-Out (LOSO) cross-validation (CV) area under the curve (AUC) of 0.871 (Balanced Accuracy (BAC) of 80.9%) with a combination of three features (IED rate, and Daubechies and Morlet wavelets) for the classification of EEGs with IEDs vs. normal EEGs. The IED-independent feature UTM achieved a LOSO CV AUC of 0.809 (BAC of 74.4%). The inclusion of IED-independent features also helps to improve the EEG-level classification of epileptic EEGs with and without IEDs vs. normal EEGs, achieving an AUC of 0.822 (BAC of 77.6%) compared to 0.688 (BAC of 59.6%) for classification only based on the IED rate. Specifically, the addition of IED-independent features improved the BAC by 21% in detecting epileptic EEGs that do not contain IEDs.Significance.These results pave the way towards automated detection of epilepsy. We are one of the first to analyze epileptic EEGs without IEDs, thereby opening up an underexplored option in epilepsy diagnosis.

Spatio-Temporal-Spectral Hierarchical Graph Convolutional Network With Semisupervised Active Learning for Patient-Specific Seizure Prediction

Graph theory analysis using electroencephalogram (EEG) signals is currently an advanced technique for seizure prediction. Recent deep learning approaches, which fail to fully explore both the characterizations in EEGs themselves and correlations among different electrodes simultaneously, generally neglect the spatial or temporal dependencies in an epileptic brain and, thus, produce suboptimal seizure prediction performance consequently. To tackle this issue, in this article, a patient-specific EEG seizure predictor is proposed by using a novel spatio-temporal-spectral hierarchical graph convolutional network with an active preictal interval learning scheme (STS-HGCN-AL). Specifically, since the epileptic activities in different brain regions may be of different frequencies, the proposed STS-HGCN-AL framework first infers a hierarchical graph to concurrently characterize an epileptic cortex under different rhythms, whose temporal dependencies and spatial couplings are extracted by a spectral-temporal convolutional neural network and a variant self-gating mechanism, respectively. Critical intrarhythm spatiotemporal properties are then captured and integrated jointly and further mapped to the final recognition results by using a hierarchical graph convolutional network. Particularly, since the preictal transition may be diverse from seconds to hours prior to a seizure onset among different patients, our STS-HGCN-AL scheme estimates an optimal preictal interval patient dependently via a semisupervised active learning strategy, which further enhances the robustness of the proposed patient-specific EEG seizure predictor. Competitive experimental results validate the efficacy of the proposed method in extracting critical preictal biomarkers, indicating its promising abilities in automatic seizure prediction.

Fast parametric curve matching (FPCM) for automatic spike detection

Epilepsy is a widely spread neurological disease, whose treatment often requires resection of the pathological cortical tissue. Interictal spike analysis observed in the non-invasively collected EEG or MEG data offers a way to localize epileptogenic cortical structures for surgery planning purposes. While a plethora of automatic spike detection techniques have been developed each with its own assumptions and limitations, non of them is ideal and the best results are achieved when the output of several automatic spike detectors are combined. This is especially true in the low signal-to-noise ratio conditions. To this end we propose a novel biomimetic approach for automatic spike detection based on a constrained mixed spline machinery that we dub as fast parametric curve matching (FPCM). Using the peak-wave shape parametrization, the constrained parametric morphological model is constructed and convolved with the observed multichannel data to very efficiently determine mixed spline parameters corresponding to each time-point in the dataset. Then the logical predicates that directly map to the expected interictal event morphology allow us to accomplish the spike detection task. The results of simulations mimicking typical low SNR scenario show the robustness and high ROC AUC values of the FPCM method as compared to the spike detection performed by the means of more conventional approaches such as wavelet decomposition, template matching or simple amplitude thresholding. Applied to the real MEG and EEG data from the human patients and to ECoG data from the rat, the FPCM technique demonstrates reliable detection of the interictal events and localization of epileptogenic zones concordant with independent conclusions made by the epileptologist. Since the FPCM is computationally light, tolerant to high amplitude artifacts and flexible to accommodate verbalized descriptions of the arbitrary target morphology, it may complement the existing arsenal of means for analysis of noisy interictal datasets.

Higher-order tensor decomposition based scalp-to-intracranial EEG projection for detection of interictal epileptiform discharges

Objective.Interictal epileptiform discharges (IEDs) occur between two seizures onsets. IEDs are mainly captured by intracranial recordings and are often invisible over the scalp. This study proposes a model based on tensor factorization to map the time-frequency (TF) features of scalp EEG (sEEG) to the TF features of intracranial EEG (iEEG) in order to detect IEDs from over the scalp with high sensitivity.Approach.Continuous wavelet transform is employed to extract the TF features. Time, frequency, and channel modes of IED segments from iEEG recordings are concatenated into a four-way tensor. Tucker and CANDECOMP/PARAFAC decomposition techniques are employed to decompose the tensor into temporal, spectral, spatial, and segmental factors. Finally, TF features of both IED and non-IED segments from scalp recordings are projected onto the temporal components for classification.Main results.The model performance is obtained in two different approaches: within- and between-subject classification approaches. Our proposed method is compared with four other methods, namely a tensor-based spatial component analysis method, TF-based method, linear regression mapping model, and asymmetric-symmetric autoencoder mapping model followed by convolutional neural networks. Our proposed method outperforms all these methods in both within- and between-subject classification approaches by respectively achieving 84.2% and 72.6% accuracy values.Significance.The findings show that mapping sEEG to iEEG improves the performance of the scalp-based IED detection model. Furthermore, the tensor-based mapping model outperforms the autoencoder- and regression-based mapping models.

Epileptic Spike Detection Using Neural Networks with Linear-Phase Convolutions

To cope with the lack of highly skilled professionals, machine learning with proper signal processing is key for establishing automated diagnostic-aid technologies with which to conduct epileptic electroencephalogram (EEG) testing. In particular, frequency filtering with the appropriate passbands is essential for enhancing the biomarkerssuch as epileptic spike wavesthat are noted in the EEG. This paper introduces a novel class of neural networks (NNs) that have a bank of linear-phase finite impulse response filters at the first layer as a preprocessor that can behave as bandpass filters that extract biomarkers without destroying waveforms because of a linear-phase condition. Besides, the parameters of the filters are also data-driven. The proposed NNs were trained with a large amount of clinical EEG data, including 15,833 epileptic spike waveforms recorded from 50 patients, and their labels were annotated by specialists. In the experiments, we compared three scenarios for the first layer: no preprocessing, discrete wavelet transform, and the proposed data-driven filters. The experimental results show that the trained data-driven filter bank with supervised learning behaves like multiple bandpass filters. In particular, the trained filter passed a frequency band of approximately 1030 Hz. Moreover, the proposed method detected epileptic spikes, with the area under the receiver operating characteristic curve of 0.967 in the mean of 50 intersubject validations.

Time-Frequency Decomposition of Scalp Electroencephalograms Improves Deep Learning-Based Epilepsy Diagnosis

Epilepsy diagnosis based on Interictal Epileptiform Discharges (IEDs) in scalp electroencephalograms (EEGs) is laborious and often subjective. Therefore, it is necessary to build an effective IED detector and an automatic method to classify IED-free versus IED EEGs. In this study, we evaluate features that may provide reliable IED detection and EEG classification. Specifically, we investigate the IED detector based on convolutional neural network (ConvNet) with different input features (temporal, spectral, and wavelet features). We explore different ConvNet architectures and types, including 1D (one-dimensional) ConvNet, 2D (two-dimensional) ConvNet, and noise injection at various layers. We evaluate the EEG classification performance on five independent datasets. The 1D ConvNet with preprocessed full-frequency EEG signal and frequency bands (delta, theta, alpha, beta) with Gaussian additive noise at the output layer achieved the best IED detection results with a false detection rate of 0.23/min at 90% sensitivity. The EEG classification system obtained a mean EEG classification Leave-One-Institution-Out (LOIO) cross-validation (CV) balanced accuracy (BAC) of 78.1% (area under the curve (AUC) of 0.839) and Leave-One-Subject-Out (LOSO) CV BAC of 79.5% (AUC of 0.856). Since the proposed classification system only takes a few seconds to analyze a 30-min routine EEG, it may help in reducing the human effort required for epilepsy diagnosis.

Machine learning for detection of interictal epileptiform discharges

The electroencephalogram (EEG) is a fundamental tool in the diagnosis and classification of epilepsy. In particular, Interictal Epileptiform Discharges (IEDs) reflect an increased likelihood of seizures and are routinely assessed by visual analysis of the EEG. Visual assessment is, however, time consuming and prone to subjectivity, leading to a high misdiagnosis rate and motivating the development of automated approaches. Research towards automating IED detection started 45 years ago. Approaches range from mimetic methods to deep learning techniques. We review different approaches to IED detection, discussing their performance and limitations. Traditional machine learning and deep learning methods have yielded the best results so far and their application in the field is still growing. Standardization of datasets and outcome measures is necessary to compare models more objectively and decide which should be implemented in a clinical setting.

Incorporating Uncertainty in Data Labeling into Automatic Detection of Interictal Epileptiform Discharges from Concurrent Scalp-EEG via Multi-way Analysis

Interictal epileptiform discharges (IEDs) are elicited from an epileptic brain, whereas they can also be due to other neurological abnormalities. The diversity in their morphologies, their strengths, and their sources within the brain cause a great deal of uncertainty in their labeling by clinicians. The aim of this study is therefore to exploit and incorporate this uncertainty (the probability of the waveform being an IED) in the IED detection system which combines spatial component analysis (SCA) with the IED probabilities referred to as SCA-IEDP-based method. For comparison, we also propose and study SCA-based method in which probability of the waveform being an IED is ignored. The proposed models are employed to detect IEDs in two different classification approaches: (1) subject-dependent and (2) subject-independent classification approaches. The proposed methods are compared with two other state-of-the-art methods namely, time-frequency features and tensor factorization methods. The proposed SCA-IEDP model has achieved superior performance in comparison with the traditional SCA and other competing methods. It achieved 79.9% and 63.4% accuracy values in subject-dependent and subject-independent classification approaches, respectively. This shows that considering the IED probabilities in designing an IED detection system can boost its performance.

Suppressing the Spikes in Electroencephalogram via an Iterative Joint Singular Spectrum Analysis and Low-Rank Decomposition Approach

The novelty and the contribution of this paper consists of applying an iterative joint singular spectrum analysis and low-rank decomposition approach for suppressing the spikes in an electroencephalogram. First, an electroencephalogram is filtered by an ideal lowpass filter via removing its discrete Fourier transform coefficients outside the wave band, the wave band, the wave band, the wave band and the wave band. Second, the singular spectrum analysis is performed on the filtered electroencephalogram to obtain the singular spectrum analysis components. The singular spectrum analysis components are sorted according to the magnitudes of their corresponding eigenvalues. The singular spectrum analysis components are sequentially added together starting from the last singular spectrum analysis component. If the variance of the summed singular spectrum analysis component under the unit energy normalization is larger than a threshold value, then the summation is terminated. The summed singular spectrum analysis component forms the first scale of the electroencephalogram. The rest singular spectrum analysis components are also summed up together separately to form the residue of the electroencephalogram. Next, the low-rank decomposition is performed on the residue of the electroencephalogram to obtain both the low-rank component and the sparse component. The low-rank component is added to the previous scale of the electroencephalogram to obtain the next scale of the electroencephalogram. Finally, the above procedures are repeated on the sparse component until the variance of the current scale of the electroencephalogram under the unit energy normalization is larger than another threshold value. The computer numerical simulation results show that the spike suppression performance based on our proposed method outperforms that based on the state-of-the-art methods.

Multi-channel EEG epileptic spike detection by a new method of tensor decomposition

OBJECTIVE

Epilepsy is one of the most common brain disorders. For epilepsy diagnosis or treatment, the neurologist needs to observe epileptic spikes from electroencephalography (EEG) data. Since multi-channel EEG records can be naturally represented by multi-way tensors, it is of interest to see whether tensor decomposition is able to analyze EEG epileptic spikes.

APPROACH

In this paper, we first proposed the problem of simultaneous multilinear low-rank approximation of tensors (SMLRAT) and proved that SMLRAT can obtain local optimum solutions by using two well-known tensor decomposition algorithms (HOSVD and Tucker-ALS). Second, we presented a new system for automatic epileptic spike detection based on SMLRAT.

MAIN RESULTS

We propose to formulate the problem of feature extraction from a set of EEG segments, represented by tensors, as the SMLRAT problem. Efficient EEG features were obtained, based on estimating the 'eigenspikes' derived from nonnegative GSMLRAT. We compared the proposed tensor analysis method with other common tensor methods in analyzing EEG signal and compared the proposed feature extraction method with the state-of-the-art methods. Experimental results indicated that our proposed method is able to detect epileptic spikes with high accuracy.

SIGNIFICANCE

Our method, for the first time, makes a step forward for automatic detection EEG epileptic spikes based on tensor decomposition. The method can provide a practical solution to distinguish epileptic spikes from artifacts in real-life EEG datasets.

Epileptic seizure prediction based on EEG spikes detection of ictal-preictal states

Epileptic seizures are known for their unpredictable nature. However, recent research provides that the transition to seizure event is not random but the result of evidence accumulations. Therefore, a reliable method capable to detect these indications can predict seizures and improve the life quality of epileptic patients. Seizures periods are generally characterized by epileptiform discharges with different changes including spike rate variation according to the shapes, spikes, and the amplitude. In this study, spike rate is used as the indicator to anticipate seizures in electroencephalogram (EEG) signal. Spikes detection step is used in EEG signal during interictal, preictal, and ictal periods followed by a mean filter to smooth the spike number. The maximum spike rate in interictal periods is used as an indicator to predict seizures. When the spike number in the preictal period exceeds the threshold, an alarm is triggered. Using the CHB-MIT database, the proposed approach has ensured 92% accuracy in seizure prediction for all patients.

A fast machine learning approach to facilitate the detection of interictal epileptiform discharges in the scalp electroencephalogram

BACKGROUND

Finding interictal epileptiform discharges (IEDs) in the EEG is a part of diagnosing epilepsy. Automated software for annotating EEGs of patients with suspected epilepsy can therefore help with reaching a diagnosis. A large amount of data is required for training and evaluating an effective IED detection system. IEDs occur infrequently in the most patients' EEG, therefore, interictal EEG recordings contain mostly background waveforms.

NEW METHOD

As the first step to detect IEDs, we propose a machine learning technique eliminating most EEG background data using an ensemble of simple fast classifiers based on several EEG features. This could save computation time for an IED detection method, allowing the remaining waveforms to be classified by more computationally intensive methods. We consider several efficient features and reject background by applying thresholds on them in consecutive steps.

RESULTS

We applied the proposed algorithm on a dataset of 156 EEGs (93 and 63 with and without IEDs, respectively). We were able to eliminate 78% of background waveforms while retaining 97% of IEDs on our cross-validated dataset.

COMPARISON WITH EXISTING METHODS

We applied support vector machine, k-nearest neighbours, and random forest classifiers to detect IEDs with and without initial background rejection. Results show that rejecting background by our proposed method speeds up the overall classification by a factor ranging from 1.8 to 4.7 for the considered classifiers.

CONCLUSIONS

The proposed method successfully reduces computation time of an IED detection system. Therefore, it is beneficial in speeding up IED detection especially when utilizing large EEG datasets.

Improved Patient-Independent System for Detection of Electrical Onset of Seizures

PURPOSE

To design a non-patient-specific system to detect the electrical onset of seizures in patients with temporal lobe epilepsy.

METHODS

We used EEG data from 29 seizures of 18 temporal lobe epilepsy patients who underwent multiday video-scalp EEG monitoring as part of their presurgical evaluations. We segmented each data set into preictal and ictal phases, and identified spectral entropy, spectral energy, and signal energy as useful features for discriminating normal and seizure conditions. The performance of five different classifiers was analyzed using these features to design an automated detection system.

RESULTS

Among the five classifiers, decision tree, k-nearest neighbor, and support vector machine performed with sensitivity (specificity) of 79% (81%), 75% (85%), and 80% (86%), respectively. The other two, linear discriminant algorithm and Naive Bayes classifiers, performed with sensitivity (specificity) of 54% (94%), 47% (96%), respectively.

CONCLUSIONS

The support vector machine-based seizure detection system showed better detection capability in terms of sensitivity and specificity measures as compared to linear discriminant algorithm, Naive Bayes, decision tree, and k-nearest neighbor classifiers.

CONCLUSIONS

Our study shows that a generalized system to detect the electrical onset of seizures in temporal lobe epilepsy using scalp-recorded EEG is possible. If confirmed on a larger data set, our findings may have significant implications for the management of seizures, especially in patients with drug-resistant epilepsy.

CLASSIFIER CASCADE TO AID IN DETECTION OF EPILEPTIFORM TRANSIENTS IN INTERICTAL EEG

The presence of Epileptiform Transients (ET) in the electroencephalogram (EEG) is a key finding in the medical workup of a patient with suspected epilepsy. Automated ET detection can increase the uniformity and speed of ET detection. Current ET detection methods suffer from insufficient precision and high false positive rates. Since ETs occur infrequently in the EEG of most patients, the majority of recordings comprise background EEG waveforms. In this work we establish a method to exclude as much background data as possible from EEG recordings by applying a classifier cascade. The remaining data can then be classified using other ET detection methods. We compare a single Support Vector Machine (SVM) to a cascade of SVMs for detecting ETs. Our results show that the precision and false positive rate improve significantly by incorporating a classifier cascade before ET detection. Our method can help improve the precision and false positive rate of an ET detection system. At a fixed sensitivity, we were able to improve precision by 6.78%; and at a fixed false positive rate, the sensitivity improved by 2.83%.

Comparing Similarity Perception in Time Series Visualizations

A common challenge faced by many domain experts working with time series data is how to identify and compare similar patterns. This operation is fundamental in high-level tasks, such as detecting recurring phenomena or creating clusters of similar temporal sequences. While automatic measures exist to compute time series similarity, human intervention is often required to visually inspect these automatically generated results. The visualization literature has examined similarity perception and its relation to automatic similarity measures for line charts, but has not yet considered if alternative visual representations, such as horizon graphs and colorfields, alter this perception. Motivated by how neuroscientists evaluate epileptiform patterns, we conducted two experiments that study how these three visualization techniques affect similarity perception in EEG signals. We seek to understand if the time series results returned from automatic similarity measures are perceived in a similar manner, irrespective of the visualization technique; and if what people perceive as similar with each visualization aligns with different automatic measures and their similarity constraints. Our findings indicate that horizon graphs align with similarity measures that allow local variations in temporal position or speed (i.e., dynamic time warping) more than the two other techniques. On the other hand, horizon graphs do not align with measures that are insensitive to amplitude and y-offset scaling (i.e., measures based on z-normalization), but the inverse seems to be the case for line charts and colorfields. Overall, our work indicates that the choice of visualization affects what temporal patterns we consider as similar, i.e., the notion of similarity in time series is not visualization independent.

Fast EEG spike detection via eigenvalue analysis and clustering of spatial amplitude distribution

OBJECTIVE

In the current study, we tested a proposed method for fast spike detection in electroencephalography (EEG).

APPROACH

We performed eigenvalue analysis in two-dimensional space spanned by gradients calculated from two neighboring samples to detect high-amplitude negative peaks. We extracted the spike candidates by imposing restrictions on parameters regarding spike shape and eigenvalues reflecting detection characteristics of individual medical doctors. We subsequently performed clustering, classifying detected peaks by considering the amplitude distribution at 19 scalp electrodes. Clusters with a small number of candidates were excluded. We then defined a score for eliminating spike candidates for which the pattern of detected electrodes differed from the overall pattern in a cluster. Spikes were detected by setting the score threshold.

MAIN RESULTS

Based on visual inspection by a psychiatrist experienced in EEG, we evaluated the proposed method using two statistical measures of precision and recall with respect to detection performance. We found that precision and recall exhibited a trade-off relationship. The average recall value was 0.708 in eight subjects with the score threshold that maximized the F-measure, with 58.6  ±  36.2 spikes per subject. Under this condition, the average precision was 0.390, corresponding to a false positive rate 2.09 times higher than the true positive rate. Analysis of the required processing time revealed that, using a general-purpose computer, our method could be used to perform spike detection in 12.1% of the recording time. The process of narrowing down spike candidates based on shape occupied most of the processing time.

SIGNIFICANCE

Although the average recall value was comparable with that of other studies, the proposed method significantly shortened the processing time.

Epileptic MEG Spike Detection Using Statistical Features and Genetic Programming with KNN

Epilepsy is a neurological disorder that affects millions of people worldwide. Monitoring the brain activities and identifying the seizure source which starts with spike detection are important steps for epilepsy treatment. Magnetoencephalography (MEG) is an emerging epileptic diagnostic tool with high-density sensors; this makes manual analysis a challenging task due to the vast amount of MEG data. This paper explores the use of eight statistical features and genetic programing (GP) with the K-nearest neighbor (KNN) for interictal spike detection. The proposed method is comprised of three stages: preprocessing, genetic programming-based feature generation, and classification. The effectiveness of the proposed approach has been evaluated using real MEG data obtained from 28 epileptic patients. It has achieved a 91.75% average sensitivity and 92.99% average specificity.

Interictal epileptiform discharge characteristics underlying expert interrater agreement

OBJECTIVE

The presence of interictal epileptiform discharges (IED) in the electroencephalogram (EEG) is a key finding in the medical workup of a patient with suspected epilepsy. However, inter-rater agreement (IRA) regarding the presence of IED is imperfect, leading to incorrect and delayed diagnoses. An improved understanding of which IED attributes mediate expert IRA might help in developing automatic methods for IED detection able to emulate the abilities of experts. Therefore, using a set of IED scored by a large number of experts, we set out to determine which attributes of IED predict expert agreement regarding the presence of IED.

METHODS

IED were annotated on a 5-point scale by 18 clinical neurophysiologists within 200 30-s EEG segments from recordings of 200 patients. 5538 signal analysis features were extracted from the waveforms, including wavelet coefficients, morphological features, signal energy, nonlinear energy operator response, electrode location, and spectrogram features. Feature selection was performed by applying elastic net regression and support vector regression (SVR) was applied to predict expert opinion, with and without the feature selection procedure and with and without several types of signal normalization.

RESULTS

Multiple types of features were useful for predicting expert annotations, but particular types of wavelet features performed best. Local EEG normalization also enhanced best model performance. As the size of the group of EEGers used to train the models was increased, the performance of the models leveled off at a group size of around 11.

CONCLUSIONS

The features that best predict inter-rater agreement among experts regarding the presence of IED are wavelet features, using locally standardized EEG. Our models for predicting expert opinion based on EEGer's scores perform best with a large group of EEGers (more than 10).

SIGNIFICANCE

By examining a large group of EEG signal analysis features we found that wavelet features with certain wavelet basis functions performed best to identify IEDs. Local normalization also improves predictability, suggesting the importance of IED morphology over amplitude-based features. Although most IED detection studies in the past have used opinion from three or fewer experts, our study suggests a "wisdom of the crowd" effect, such that pooling over a larger number of expert opinions produces a better correlation between expert opinion and objectively quantifiable features of the EEG.

Surface and intracranial EEG spike detection based on discrete wavelet decomposition and random forest classification

Epilepsy is a neurological disorder for which the electroencephalogram (EEG) is the most important diagnostic tool. In particular, this diagnosis heavily depends on the detection of interictal (between seizures) paroxysmal epileptic discharges (IPED) in the EEG. This is a time-consuming task requiring significant training and experience. Automatic detection of these EEG patterns would greatly assist visual inspections of human readers. We present a new method, which allows automatic detection of IPED based on discrete wavelet decomposition and a random forest classifier. The algorithm was trained and cross validated using 17 subjects with scalp EEG and 10 subjects with intracranial EEG. The performance of this method reached 62% recall and 26% precision for surface EEG subjects and 63% recall and 53% precision for intracranial EEG subjects. Thus, the method hereby proposed has great potential for diagnosis support in clinical environments.

Characteristics of EEG Interpreters Associated With Higher Interrater Agreement

PURPOSE

The goal of the project is to determine characteristics of academic neurophysiologist EEG interpreters (EEGers), which predict good interrater agreement (IRA) and to determine the number of EEGers needed to develop an ideal standardized testing and training data set for epileptiform transient (ET) detection algorithms.

METHODS

A three-phase scoring method was used. In phase 1, 19 EEGers marked the location of ETs in two hundred 30-second segments of EEG from 200 different patients. In phase 2, EEG events marked by at least 2 EEGers were annotated by 18 EEGers on a 5-point scale to indicate whether they were ETs. In phase 3, a third opinion was obtained from EEGers on any inconsistencies between phase 1 and phase 2 scoring.

RESULTS

The IRA for the 18 EEGers was only fair. A select group of the EEGers had good IRA and the other EEGers had low IRA. Board certification by the American Board of Clinical Neurophysiology was associated with better IRA performance but other board certifications, years of fellowship training, and years of practice were not. As the number of EEGers used for scoring is increased, the amount of change in the consensus opinion decreases steadily and is quite low as the group size approaches 10.

CONCLUSIONS

The IRA among EEGers varies considerably. The EEGers must be tested before use as scorers for ET annotation research projects. The American Board of Clinical Neurophysiology certification is associated with improved performance. The optimal size for a group of experts scoring ETs in EEG is probably in the 6 to 10 range.

Applying dynamic data collection to improve dry electrode system performance for a P300-based brain-computer interface

OBJECTIVE

Dry electrodes have an advantage over gel-based 'wet' electrodes by providing quicker set-up time for electroencephalography recording; however, the potentially poorer contact can result in noisier recordings. We examine the impact that this may have on brain-computer interface communication and potential approaches for mitigation.

APPROACH

We present a performance comparison of wet and dry electrodes for use with the P300 speller system in both healthy participants and participants with communication disabilities (ALS and PLS), and investigate the potential for a data-driven dynamic data collection algorithm to compensate for the lower signal-to-noise ratio (SNR) in dry systems.

MAIN RESULTS

Performance results from sixteen healthy participants obtained in the standard static data collection environment demonstrate a substantial loss in accuracy with the dry system. Using a dynamic stopping algorithm, performance may have been improved by collecting more data in the dry system for ten healthy participants and eight participants with communication disabilities; however, the algorithm did not fully compensate for the lower SNR of the dry system. An analysis of the wet and dry system recordings revealed that delta and theta frequency band power (0.1-4 Hz and 4-8 Hz, respectively) are consistently higher in dry system recordings across participants, indicating that transient and drift artifacts may be an issue for dry systems.

SIGNIFICANCE

Using dry electrodes is desirable for reduced set-up time; however, this study demonstrates that online performance is significantly poorer than for wet electrodes for users with and without disabilities. We test a new application of dynamic stopping algorithms to compensate for poorer SNR. Dynamic stopping improved dry system performance; however, further signal processing efforts are likely necessary for full mitigation.

Spike pattern recognition by supervised classification in low dimensional embedding space

Epileptiform discharges in interictal electroencephalography (EEG) form the mainstay of epilepsy diagnosis and localization of seizure onset. Visual analysis is rater-dependent and time consuming, especially for long-term recordings, while computerized methods can provide efficiency in reviewing long EEG recordings. This paper presents a machine learning approach for automated detection of epileptiform discharges (spikes). The proposed method first detects spike patterns by calculating similarity to a coarse shape model of a spike waveform and then refines the results by identifying subtle differences between actual spikes and false detections. Pattern classification is performed using support vector machines in a low dimensional space on which the original waveforms are embedded by locality preserving projections. The automatic detection results are compared to experts' manual annotations (101 spikes) on a whole-night sleep EEG recording. The high sensitivity (97 %) and the low false positive rate (0.1 min-1), calculated by intra-patient cross-validation, highlight the potential of the method for automated interictal EEG assessment.

Detection of Intracranial Signatures of Interictal Epileptiform Discharges from Concurrent Scalp EEG

Interictal epileptiform discharges (IEDs) are transient neural electrical activities that occur in the brain of patients with epilepsy. A problem with the inspection of IEDs from the scalp electroencephalogram (sEEG) is that for a subset of epileptic patients, there are no visually discernible IEDs on the scalp, rendering the above procedures ineffective, both for detection purposes and algorithm evaluation. On the other hand, intracranially placed electrodes yield a much higher incidence of visible IEDs as compared to concurrent scalp electrodes. In this work, we utilize concurrent scalp and intracranial EEG (iEEG) from a group of temporal lobe epilepsy (TLE) patients with low number of scalp-visible IEDs. The aim is to determine whether by considering the timing information of the IEDs from iEEG, the resulting concurrent sEEG contains enough information for the IEDs to be reliably distinguished from non-IED segments. We develop an automatic detection algorithm which is tested in a leave-subject-out fashion, where each test subject’s detection algorithm is based on the other patients’ data. The algorithm obtained a [Formula: see text] accuracy in recognizing scalp IED from non-IED segments with [Formula: see text] accuracy when trained and tested on the same subject. Also, it was able to identify nonscalp-visible IED events for most patients with a low number of false positive detections. Our results represent a proof of concept that IED information for TLE patients is contained in scalp EEG even if they are not visually identifiable and also that between subject differences in the IED topology and shape are small enough such that a generic algorithm can be used.

Mouse EEG spike detection based on the adapted continuous wavelet transform

OBJECTIVE

Electroencephalography (EEG) is an important tool in the diagnosis of epilepsy. Interictal spikes on EEG are used to monitor the development of epilepsy and the effects of drug therapy. EEG recordings are generally long and the data voluminous. Thus developing a sensitive and reliable automated algorithm for analyzing EEG data is necessary.

APPROACH

A new algorithm for detecting and classifying interictal spikes in mouse EEG recordings is proposed, based on the adapted continuous wavelet transform (CWT). The construction of the adapted mother wavelet is founded on a template obtained from a sample comprising the first few minutes of an EEG data set.

MAIN RESULT

The algorithm was tested with EEG data from a mouse model of epilepsy and experimental results showed that the algorithm could distinguish EEG spikes from other transient waveforms with a high degree of sensitivity and specificity.

SIGNIFICANCE

Differing from existing approaches, the proposed approach combines wavelet denoising, to isolate transient signals, with adapted CWT-based template matching, to detect true interictal spikes. Using the adapted wavelet constructed from a predefined template, the adapted CWT is calculated on small EEG segments to fit dynamical changes in the EEG recording.

Epileptic EEG visualization and sonification based on linear discriminate analysis

In this paper, we first presents a high accuracy epileptic electroencephalogram (EEG) classification algorithm. EEG data of epilepsy patients are preprocessed, segmented, and decomposed to intrinsic mode functions, from which features are extracted. Two classifiers are trained based on linear discriminant analysis (LDA) to classify EEG data into three types, i.e., normal, spike, and seizure. We further in-depth investigate the changes of the decision values in LDA on continuous EEG data. An epileptic EEG visualization and sonification algorithm is proposed to provide both temporal and spatial information of spike and seizure of epilepsy patients. In the experiment, EEG data of six subjects (two normal and four seizure patients) are included. The experiment result shows the proposed epileptic EEG classification algorithm achieves high accuracy. As well, the visualization and sonification algorithm exhibits a great help in nursing seizure patients and localizing the area of seizures.

Selection of Mother Wavelet Functions for Multi-Channel EEG Signal Analysis during a Working Memory Task

We performed a comparative study to select the efficient mother wavelet (MWT) basis functions that optimally represent the signal characteristics of the electrical activity of the human brain during a working memory (WM) task recorded through electro-encephalography (EEG). Nineteen EEG electrodes were placed on the scalp following the 10–20 system. These electrodes were then grouped into five recording regions corresponding to the scalp area of the cerebral cortex. Sixty-second WM task data were recorded from ten control subjects. Forty-five MWT basis functions from orthogonal families were investigated. These functions included Daubechies (db1–db20), Symlets (sym1–sym20), and Coiflets (coif1–coif5). Using ANOVA, we determined the MWT basis functions with the most significant differences in the ability of the five scalp regions to maximize their cross-correlation with the EEG signals. The best results were obtained using “sym9” across the five scalp regions. Therefore, the most compatible MWT with the EEG signals should be selected to achieve wavelet denoising, decomposition, reconstruction, and sub-band feature extraction. This study provides a reference of the selection of efficient MWT basis functions.

A study of morphology-based wavelet features and multiple-wavelet strategy for EEG signal classification: results and selected statistical analysis

Automatic detection and classification of Epileptiform transients is an open and important clinical issue. In this paper, we test 5 feature sets derived from a group of morphology-based wavelet features and compare the results with that of a Guler-suggested feature set. We also implement a multiple-mother-wavelet strategy and compare performance with the usual single-mother-wavelet strategy. The results indicate that both the derived features and the multiple-mother-wavelet strategy improved classifier performance, using a variety of performance measures. We assess the statistical significance of the performance improvement of the new feature sets/strategy. In most cases, the performance improvement is either significant or highly significant.

A Robustness Comparison of Two Algorithms Used for EEG Spike Detection

Spikes and sharp waves recorded on scalp EEG may play an important role in identifying the epileptogenic network as well as in understanding the central nervous system. Therefore, several automatic and semi-automatic methods have been implemented to detect these two neural transients. A consistent gold standard associated with a high degree of agreement among neuroscientists is required to measure relevant performance of different methods. In fact, scalp EEG data can often be corrupted by a set of artifacts and are not always served as data of gold standard. For this reason, the use of intracerebral EEG data mixed with gaussian noise seems to best resemble the output of scalp EEG brain and serves as a consistent gold standard. In the present framework, we test the robustness of two important methods that have been previously used for the automatic detection of epileptiform transients (spikes and sharp waves). These methods are based respectively on Discrete Wavelet Transform (DWT) and Continuous Wavelet Transform (CWT). Our purpose is to elaborate a comparative study in terms of sensitivity and selectivity changes via the decrease of Signal to Noise Ratio (SNR), which is ranged from 10 dB up to -10 dB. The results demonstrate that, DWT approach turns to be more stable in terms of sensitivity, and it successfully follows the detection of relevant spikes with the decrease of SNR. However, CWT-based approach remains more stable in terms of selectivity, so that, it performs well in terms of rejecting false spikes compared to DWT approach.

Feature selection and classifier parameters estimation for EEG signals peak detection using particle swarm optimization

Electroencephalogram (EEG) signal peak detection is widely used in clinical applications. The peak point can be detected using several approaches, including time, frequency, time-frequency, and nonlinear domains depending on various peak features from several models. However, there is no study that provides the importance of every peak feature in contributing to a good and generalized model. In this study, feature selection and classifier parameters estimation based on particle swarm optimization (PSO) are proposed as a framework for peak detection on EEG signals in time domain analysis. Two versions of PSO are used in the study: (1) standard PSO and (2) random asynchronous particle swarm optimization (RA-PSO). The proposed framework tries to find the best combination of all the available features that offers good peak detection and a high classification rate from the results in the conducted experiments. The evaluation results indicate that the accuracy of the peak detection can be improved up to 99.90% and 98.59% for training and testing, respectively, as compared to the framework without feature selection adaptation. Additionally, the proposed framework based on RA-PSO offers a better and reliable classification rate as compared to standard PSO as it produces low variance model.

A reliable approach to distinguish between transient with and without HFOs using TQWT and MCA

Recent studies have reported that discrete high frequency oscillations (HFOs) in the range of 80-500Hz may serve as promising biomarkers of the seizure focus in humans. Visual scoring of HFOs is tiring, time consuming, highly subjective and requires a great deal of mental concentration. Due to the recent explosion of HFOs research, development of a robust automated detector is expected to play a vital role in studying HFOs and their relationship to epileptogenesis. Therefore, a handful of automated detectors have been introduced in the literature over the past few years. In fact, all the proposed methods have been associated with high false-positive rates, which essentially arising from filtered sharp transients like spikes, sharp waves and artifacts. In order to specifically minimize false positive rates and improve the specificity of HFOs detection, we proposed a new approach, which is a combination of tunable Q-factor wavelet transform (TQWT), morphological component analysis (MCA) and complex Morlet wavelet (CMW). The main findings of this study can be summarized as follows: The proposed method results in a sensitivity of 96.77%, a specificity of 85.00% and a false discovery rate (FDR) of 07.41%. Compared to this, the classical CMW method applied directly on the signals without pre-processing by TQWT-MCA achieves a sensitivity of 98.71%, a specificity of 18.75%, and an FDR of 29.95%. The proposed method may be considered highly accurate to distinguish between transients with and without HFOs. Consequently, it is remarkably reliable and robust for the detection of HFOs.

Electroencephalography in the pediatric emergency department: when is it most useful?

This study aimed to identify the indications in which electroencephalography in the pediatric emergency department is most useful. We retrospectively reviewed the influence that the results of the emergent electroencephalogram had on the eventual disposition of patients at our pediatric emergency department. Sixty-eight children (mean age, 7.3 years; 32 males) underwent 70 emergent electroencephalograms. Fifty-seven emergent electroencephalograms were performed for the suspicion of ongoing seizures or status epilepticus. Thirteen of the 22 children (59.1%) discharged from the emergency department were sent home mainly based on the results of the emergent electroencephalogram, which prevented an admission. In particular, 11 of 38 children with frequent and recurrent paroxysmal events concerning for seizures and 2 of 19 children with suspected ongoing status epilepticus were discharged after excluding an epileptic disturbance. The emergent electroencephalogram provided meaningful clinical information that influenced disposition, especially in patients with ongoing events in which the clinical picture was clarified by a rapidly acquired electroencephalogram.