A hybrid decision support system for automatic detection of Schizophrenia using EEG signals

A systematic review of EEG based automated schizophrenia classification through machine learning and deep learning

The electroencephalogram (EEG) serves as an essential tool in exploring brain activity and holds particular importance in the field of mental health research. This review paper examines the application of artificial intelligence (AI), encompassing machine learning (ML) and deep learning (DL), for classifying schizophrenia (SCZ) through EEG. It includes a thorough literature review that addresses the difficulties, methodologies, and discoveries in this field. ML approaches utilize conventional models like Support Vector Machines and Decision Trees, which are interpretable and effective with smaller data sets. In contrast, DL techniques, which use neural networks such as convolutional neural networks (CNNs) and long short-term memory networks (LSTMs), are more adaptable to intricate EEG patterns but require significant data and computational power. Both ML and DL face challenges concerning data quality and ethical issues. This paper underscores the importance of integrating various techniques to enhance schizophrenia diagnosis and highlights AI's potential role in this process. It also acknowledges the necessity for collaborative and ethically informed approaches in the automated classification of SCZ using AI.

Development of EEG connectivity from preschool to school-age children

Introduction

Many studies have collected normative developmental EEG data to better understand brain function in early life and associated changes during both aging and pathology. Higher cognitive functions of the brain do not normally stem from the workings of a single brain region that works but, rather, on the interaction between different brain regions. In this regard studying the connectivity between brain regions is of great importance towards understanding higher cognitive functions and its underlying mechanisms.

Methods

In this study, EEG data of children (N = 253; 3-10 years old; 113 females, 140 males) from pre-school to schoolage was collected, and the weighted phase delay index and directed transfer function method was used to find the electrophysiological indicators of both functional connectivity and effective connectivity. A general linear model was built between the indicators and age, and the change trend of electrophysiological indicators analyzed for age.

Results

The results showed an age trend for the functional and effective connectivity of the brain of children.

Discussion

The results are of importance in understanding normative brain development and in defining those conditions that deviate from typical growth trajectories.

Classification of First-Episode Psychosis with EEG Signals: ciSSA and Machine Learning Approach

First-episode psychosis (FEP) typically marks the onset of severe psychiatric disorders and represents a critical period in the field of mental health. The early diagnosis of this condition is essential for timely intervention and improved clinical outcomes. In this study, the classification of FEP was investigated using the analysis of electroencephalography (EEG) signals and circulant spectrum analysis (ciSSA) sub-band signals. FEP poses a significant diagnostic challenge in the realm of mental health, and it is aimed at introducing a novel and effective approach for early diagnosis. To achieve this, the LASSO method was utilized to select the most significant features derived from entropy, frequency, and statistical-based characteristics obtained from ciSSA sub-band signals, as well as their hybrid combinations. Subsequently, a high-performance classification model has been developed using machine learning techniques, including ensemble, support vector machine (SVM), and artificial neural network (ANN) methods. The results of this study demonstrated that the hybrid features extracted from EEG signals' ciSSA sub-bands, in combination with the SVM method, achieved a high level of performance, with an area under curve (AUC) of 0.9893, an accuracy of 96.23%, a sensitivity of 0.966, a specificity of 0.956, a precision of 0.9667, and an F1 score of 0.9666. This has revealed the effectiveness of the ciSSA-based method for classifying FEP from EEG signals.

Exploring deep residual network based features for automatic schizophrenia detection from EEG

Schizophrenia is a severe mental illness which can cause lifelong disability. Most recent studies on the Electroencephalogram (EEG)-based diagnosis of schizophrenia rely on bespoke/hand-crafted feature extraction techniques. Traditional manual feature extraction methods are time-consuming, imprecise, and have a limited ability to balance accuracy and efficiency. Addressing this issue, this study introduces a deep residual network (deep ResNet) based feature extraction design that can automatically extract representative features from EEG signal data for identifying schizophrenia. This proposed method consists of three stages: signal pre-processing by average filtering method, extraction of hidden patterns of EEG signals by deep ResNet, and classification of schizophrenia by softmax layer. To assess the performance of the obtained deep features, ResNet softmax classifier and also several machine learning (ML) techniques are applied on the same feature set. The experimental results for a Kaggle schizophrenia EEG dataset show that the deep features with support vector machine classifier could achieve the highest performances (99.23% accuracy) compared to the ResNet classifier. Furthermore, the proposed model performs better than the existing approaches. The findings suggest that our proposed strategy has capability to discover important biomarkers for automatic diagnosis of schizophrenia from EEG, which will aid in the development of a computer assisted diagnostic system by specialists.

An explainable and interpretable model for attention deficit hyperactivity disorder in children using EEG signals

BACKGROUND

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects a person's sleep, mood, anxiety, and learning. Early diagnosis and timely medication can help individuals with ADHD perform daily tasks without difficulty. Electroencephalogram (EEG) signals can help neurologists to detect ADHD by examining the changes occurring in it. The EEG signals are complex, non-linear, and non-stationary. It is difficult to find the subtle differences between ADHD and healthy control EEG signals visually. Also, making decisions from existing machine learning (ML) models do not guarantee similar performance (unreliable).

METHOD

The paper explores a combination of variational mode decomposition (VMD), and Hilbert transform (HT) called VMD-HT to extract hidden information from EEG signals. Forty-one statistical parameters extracted from the absolute value of analytical mode functions (AMF) have been classified using the explainable boosted machine (EBM) model. The interpretability of the model is tested using statistical analysis and performance measurement. The importance of the features, channels and brain regions has been identified using the glass-box and black-box approach. The model's local and global explainability has been visualized using Local Interpretable Model-agnostic Explanations (LIME), SHapley Additive exPlanations (SHAP), Partial Dependence Plot (PDP), and Morris sensitivity. To the best of our knowledge, this is the first work that explores the explainability of the model prediction in ADHD detection, particularly for children.

RESULTS

Our results show that the explainable model has provided an accuracy of 99.81%, a sensitivity of 99.78%, 99.84% specificity, an F-1 measure of 99.83%, the precision of 99.87%, a false detection rate of 0.13%, and Mathew's correlation coefficient, negative predicted value, and critical success index of 99.61%, 99.73%, and 99.66%, respectively in detecting the ADHD automatically with ten-fold cross-validation. The model has provided an area under the curve of 100% while the detection rate of 99.87% and 99.73% has been obtained for ADHD and HC, respectively.

CONCLUSIONS

The model show that the interpretability and explainability of frontal region is highest compared to pre-frontal, central, parietal, occipital, and temporal regions. Our findings has provided important insight into the developed model which is highly reliable, robust, interpretable, and explainable for the clinicians to detect ADHD in children. Early and rapid ADHD diagnosis using robust explainable technologies may reduce the cost of treatment and lessen the number of patients undergoing lengthy diagnosis procedures.

Evaluation of Risk of Bias in Neuroimaging-Based Artificial Intelligence Models for Psychiatric Diagnosis: A Systematic Review

IMPORTANCE

Neuroimaging-based artificial intelligence (AI) diagnostic models have proliferated in psychiatry. However, their clinical applicability and reporting quality (ie, feasibility) for clinical practice have not been systematically evaluated.

OBJECTIVE

To systematically assess the risk of bias (ROB) and reporting quality of neuroimaging-based AI models for psychiatric diagnosis.

EVIDENCE REVIEW

PubMed was searched for peer-reviewed, full-length articles published between January 1, 1990, and March 16, 2022. Studies aimed at developing or validating neuroimaging-based AI models for clinical diagnosis of psychiatric disorders were included. Reference lists were further searched for suitable original studies. Data extraction followed the CHARMS (Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. A closed-loop cross-sequential design was used for quality control. The PROBAST (Prediction Model Risk of Bias Assessment Tool) and modified CLEAR (Checklist for Evaluation of Image-Based Artificial Intelligence Reports) benchmarks were used to systematically evaluate ROB and reporting quality.

FINDINGS

A total of 517 studies presenting 555 AI models were included and evaluated. Of these models, 461 (83.1%; 95% CI, 80.0%-86.2%) were rated as having a high overall ROB based on the PROBAST. The ROB was particular high in the analysis domain, including inadequate sample size (398 of 555 models [71.7%; 95% CI, 68.0%-75.6%]), poor model performance examination (with 100% of models lacking calibration examination), and lack of handling data complexity (550 of 555 models [99.1%; 95% CI, 98.3%-99.9%]). None of the AI models was perceived to be applicable to clinical practices. Overall reporting completeness (ie, number of reported items/number of total items) for the AI models was 61.2% (95% CI, 60.6%-61.8%), and the completeness was poorest for the technical assessment domain with 39.9% (95% CI, 38.8%-41.1%).

CONCLUSIONS AND RELEVANCE

This systematic review found that the clinical applicability and feasibility of neuroimaging-based AI models for psychiatric diagnosis were challenged by a high ROB and poor reporting quality. Particularly in the analysis domain, ROB in AI diagnostic models should be addressed before clinical application.

Fusion of pattern-based and statistical features for Schizophrenia detection from EEG signals

Schizophrenia (SZ) is a chronic disorder affecting the functioning of the brain. It can lead to irrational behaviour amongst the patients suffering from this disease. A low-cost diagnostic needs to be developed for SZ so that timely treatment can be provided to the patients. In this work, we propose an accurate and easy-to-implement system to detect SZ using electroencephalogram (EEG) signals. The signal is divided into sub-band components by a Fourier-based technique that can be implemented in real-time using fast Fourier transform. Thereafter, statistical features are computed from these components. Further, look ahead pattern (LAP) is developed as a feature to capture local variations in the EEG signal. The fusion of these two distinct schemes enables a thorough examination of EEG signals. Kruskal-Wallis test is utilized for the selection of significant features. Various machine learning classifiers are employed and the proposed framework achieves 98.62% and 99.24% accuracy in identifying SZ cases, considering two distinct datasets, using boosted trees classifier. This method provides a promising candidate for widespread deployment in efficient real-time systems for SZ detection.

SchizoGoogLeNet: The GoogLeNet-Based Deep Feature Extraction Design for Automatic Detection of Schizophrenia

Schizophrenia (SZ) is a severe and prolonged disorder of the human brain where people interpret reality in an abnormal way. Traditional methods of SZ detection are based on handcrafted feature extraction methods (manual process), which are tedious and unsophisticated, and also limited in their ability to balance efficiency and accuracy. To solve this issue, this study designed a deep learning-based feature extraction scheme involving the GoogLeNet model called "SchizoGoogLeNet" that can efficiently and automatically distinguish schizophrenic patients from healthy control (HC) subjects using electroencephalogram (EEG) signals with improved performance. The proposed framework involves multiple stages of EEG data processing. First, this study employs the average filtering method to remove noise and artifacts from the raw EEG signals to improve the signal-to-noise ratio. After that, a GoogLeNet model is designed to discover significant hidden features from denoised signals to identify schizophrenic patients from HC subjects. Finally, the obtained deep feature set is evaluated by the GoogleNet classifier and also some renowned machine learning classifiers to find a sustainable classification method for the obtained deep feature set. Experimental results show that the proposed deep feature extraction model with a support vector machine performs the best, producing a 99.02% correct classification rate for SZ, with an overall accuracy of 98.84%. Furthermore, our proposed model outperforms other existing methods. The proposed design is able to accurately discriminate SZ from HC, and it will be useful for developing a diagnostic tool for SZ detection.