On the proper selection of preictal period for seizure prediction

Calibrating Deep Learning Classifiers for Patient-Independent Electroencephalogram Seizure Forecasting

The recent scientific literature abounds in proposals of seizure forecasting methods that exploit machine learning to automatically analyze electroencephalogram (EEG) signals. Deep learning algorithms seem to achieve a particularly remarkable performance, suggesting that the implementation of clinical devices for seizure prediction might be within reach. However, most of the research evaluated the robustness of automatic forecasting methods through randomized cross-validation techniques, while clinical applications require much more stringent validation based on patient-independent testing. In this study, we show that automatic seizure forecasting can be performed, to some extent, even on independent patients who have never been seen during the training phase, thanks to the implementation of a simple calibration pipeline that can fine-tune deep learning models, even on a single epileptic event recorded from a new patient. We evaluate our calibration procedure using two datasets containing EEG signals recorded from a large cohort of epileptic subjects, demonstrating that the forecast accuracy of deep learning methods can increase on average by more than 20%, and that performance improves systematically in all independent patients. We further show that our calibration procedure works best for deep learning models, but can also be successfully applied to machine learning algorithms based on engineered signal features. Although our method still requires at least one epileptic event per patient to calibrate the forecasting model, we conclude that focusing on realistic validation methods allows to more reliably compare different machine learning approaches for seizure prediction, enabling the implementation of robust and effective forecasting systems that can be used in daily healthcare practice.

An overview of machine learning and deep learning techniques for predicting epileptic seizures

Epilepsy is a neurological disorder (the third most common, following stroke and migraines). A key aspect of its diagnosis is the presence of seizures that occur without a known cause and the potential for new seizures to occur. Machine learning has shown potential as a cost-effective alternative for rapid diagnosis. In this study, we review the current state of machine learning in the detection and prediction of epileptic seizures. The objective of this study is to portray the existing machine learning methods for seizure prediction. Internet bibliographical searches were conducted to identify relevant literature on the topic. Through cross-referencing from key articles, additional references were obtained to provide a comprehensive overview of the techniques. As the aim of this paper aims is not a pure bibliographical review of the subject, the publications here cited have been selected among many others based on their number of citations. To implement accurate diagnostic and treatment tools, it is necessary to achieve a balance between prediction time, sensitivity, and specificity. This balance can be achieved using deep learning algorithms. The best performance and results are often achieved by combining multiple techniques and features, but this approach can also increase computational requirements.

Removing artefacts and periodically retraining improve performance of neural network-based seizure prediction models

The development of seizure prediction models is often based on long-term scalp electroencephalograms (EEGs) since they capture brain electrical activity, are non-invasive, and come at a relatively low-cost. However, they suffer from major shortcomings. First, long-term EEG is usually highly contaminated with artefacts. Second, changes in the EEG signal over long intervals, known as concept drift, are often neglected. We evaluate the influence of these problems on deep neural networks using EEG time series and on shallow neural networks using widely-used EEG features. Our patient-specific prediction models were tested in 1577 hours of continuous EEG, containing 91 seizures from 41 patients with temporal lobe epilepsy who were undergoing pre-surgical monitoring. Our results showed that cleaning EEG data, using a previously developed artefact removal method based on deep convolutional neural networks, improved prediction performance. We also found that retraining the models over time reduced false predictions. Furthermore, the results show that although deep neural networks processing EEG time series are less susceptible to false alarms, they may need more data to surpass feature-based methods. These findings highlight the importance of robust data denoising and periodic adaptation of seizure prediction models.

Unsupervised EEG preictal interval identification in patients with drug-resistant epilepsy

Typical seizure prediction models aim at discriminating interictal brain activity from pre-seizure electrographic patterns. Given the lack of a preictal clinical definition, a fixed interval is widely used to develop these models. Recent studies reporting preictal interval selection among a range of fixed intervals show inter- and intra-patient preictal interval variability, possibly reflecting the heterogeneity of the seizure generation process. Obtaining accurate labels of the preictal interval can be used to train supervised prediction models and, hence, avoid setting a fixed preictal interval for all seizures within the same patient. Unsupervised learning methods hold great promise for exploring preictal alterations on a seizure-specific scale. Multivariate and univariate linear and nonlinear features were extracted from scalp electroencephalography (EEG) signals collected from 41 patients with drug-resistant epilepsy undergoing presurgical monitoring. Nonlinear dimensionality reduction was performed for each group of features and each of the 226 seizures. We applied different clustering methods in searching for preictal clusters located until 2 h before the seizure onset. We identified preictal patterns in 90% of patients and 51% of the visually inspected seizures. The preictal clusters manifested a seizure-specific profile with varying duration (22.9 ± 21.0 min) and starting time before seizure onset (47.6 ± 27.3 min). Searching for preictal patterns on the EEG trace using unsupervised methods showed that it is possible to identify seizure-specific preictal signatures for some patients and some seizures within the same patient.

Weak self-supervised learning for seizure forecasting: a feasibility study

This paper proposes an artificial intelligence system that continuously improves over time at event prediction using initially unlabelled data by using self-supervised learning. Time-series data are inherently autocorrelated. By using a detection model to generate weak labels on the fly, which are concurrently used as targets to train a prediction model on a time-shifted input data stream, this autocorrelation can effectively be harnessed to reduce the burden of manual labelling. This is critical in medical patient monitoring, as it enables the development of personalized forecasting models without demanding the annotation of long sequences of physiological signal recordings. We perform a feasibility study on seizure prediction, which is identified as an ideal test case, as pre-ictal brainwaves are patient-specific, and tailoring models to individual patients is known to improve forecasting performance significantly. Our self-supervised approach is used to train individualized forecasting models for 10 patients, showing an average relative improvement in sensitivity by 14.30% and a reduction in false alarms by 19.61% in early seizure forecasting. This proof-of-concept on the feasibility of using a continuous stream of time-series neurophysiological data paves the way towards a low-power neuromorphic neuromodulation system.

Classification of EEG Signals for Prediction of Epileptic Seizures

Epilepsy is a common brain disorder that causes patients to face multiple seizures in a single day. Around 65 million people are affected by epilepsy worldwide. Patients with focal epilepsy can be treated with surgery, whereas generalized epileptic seizures can be managed with medications. It has been noted that in more than 30% of cases, these medications fail to control epileptic seizures, resulting in accidents and limiting the patient’s life. Predicting epileptic seizures in such patients prior to the commencement of an oncoming seizure is critical so that the seizure can be treated with preventive medicines before it occurs. Electroencephalogram (EEG) signals of patients recorded to observe brain electrical activity during a seizure can be quite helpful in predicting seizures. Researchers have proposed methods that use machine and/or deep learning techniques to predict epileptic seizures using scalp EEG signals; however, prediction of seizures with increased accuracy is still a challenge. Therefore, we propose a three-step approach. It includes preprocessing of scalp EEG signals with PREP pipeline, which is a more sophisticated alternative to basic notch filtering. This method uses a regression-based technique to further enhance the SNR, with a combination of handcrafted, i.e., statistical features such as temporal mean, variance, and skewness, and automated features using CNN, followed by classification of interictal state and preictal state segments using LSTM to predict seizures. We train and validate our proposed technique on the CHB-MIT scalp EEG dataset and achieve accuracy of 94%, sensitivity of 93.8%, and 91.2% specificity. The proposed technique achieves better sensitivity and specificity than existing methods.

Big data analysis and artificial intelligence in epilepsy - common data model analysis and machine learning-based seizure detection and forecasting

There has been significant interest in big data analysis and artificial intelligence (AI) in medicine. Ever-increasing medical data and advanced computing power have enabled the number of big data analyses and AI studies to increase rapidly. Here we briefly introduce epilepsy, big data, and AI and review big data analysis using a common data model. Studies in which AI has been actively applied, such as those of electroencephalography epileptiform discharge detection, seizure detection, and forecasting, will be reviewed. We will also provide practical suggestions for pediatricians to understand and interpret big data analysis and AI research and work together with technical expertise.

Seizure Prediction Based on Transformer Using Scalp Electroencephalogram

Epilepsy is a chronic and recurrent brain dysfunction disease. An acute epileptic attack will interfere with a patient’s normal behavior and consciousness, having a great impact on their life. The purpose of this study was to design a seizure prediction model to improve the quality of patients’ lives and assist doctors in making diagnostic decisions. This paper presents a transformer-based seizure prediction model. Firstly, the time-frequency characteristics of electroencephalogram (EEG) signals were extracted by short-time Fourier transform (STFT). Secondly, a three transformer tower model was used to fuse and classify the features of the EEG signals. Finally, when combined with the attention mechanism of transformer networks, the EEG signal was processed as a whole, which solves the problem of length limitations in deep learning models. Experiments were conducted with a Children’s Hospital Boston and the Massachusetts Institute of Technology database to evaluate the performance of the model. The experimental results show that, compared with previous EEG classification models, our model can enhance the ability to use time, frequency, and channel information from EEG signals to improve the accuracy of seizure prediction.

Interpretable EEG seizure prediction using a multiobjective evolutionary algorithm

Seizure prediction might be the solution to tackle the apparent unpredictability of seizures in patients with drug-resistant epilepsy, which comprise about a third of all patients with epilepsy. Designing seizure prediction models involves defining the pre-ictal period, a transition stage between inter-ictal brain activity and the seizure discharge. This period is typically a fixed interval, with some recent studies reporting the evaluation of different patient-specific pre-ictal intervals. Recently, researchers have aimed to determine the pre-ictal period, a transition stage between regular brain activity and a seizure. Authors have been using deep learning models given the ability of such models to automatically perform pre-processing, feature extraction, classification, and handling temporal and spatial dependencies. As these approaches create black-box models, clinicians may not have sufficient trust to use them in high-stake decisions. By considering these problems, we developed an evolutionary seizure prediction model that identifies the best set of features while automatically searching for the pre-ictal period and accounting for patient comfort. This methodology provides patient-specific interpretable insights, which might contribute to a better understanding of seizure generation processes and explain the algorithm’s decisions. We tested our methodology on 238 seizures and 3687 h of continuous data, recorded on scalp recordings from 93 patients with several types of focal and generalised epilepsies. We compared the results with a seizure surrogate predictor and obtained a performance above chance for 32% patients. We also compared our results with a control method based on the standard machine learning pipeline (pre-processing, feature extraction, classifier training, and post-processing), where the control marginally outperformed our approach by validating 35% of the patients. In total, 54 patients performed above chance for at least one method: our methodology or the control one. Of these 54 patients, 21 (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\approx$$\end{document}≈38%) were solely validated by our methodology, while 24 (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\approx$$\end{document}≈44%) were only validated by the control method. These findings may evidence the need for different methodologies concerning different patients.

Deep Learning of Simultaneous Intracranial and Scalp EEG for Prediction, Detection, and Lateralization of Mesial Temporal Lobe Seizures

In people with drug resistant epilepsy (DRE), seizures are unpredictable, often occurring with little or no warning. The unpredictability causes anxiety and much of the morbidity and mortality of seizures. In this work, 102 seizures of mesial temporal lobe onset were analyzed from 19 patients with DRE who had simultaneous intracranial EEG (iEEG) and scalp EEG as part of their surgical evaluation. The first aim of this paper was to develop machine learning models for seizure prediction and detection (i) using iEEG only, (ii) scalp EEG only and (iii) jointly analyzing both iEEG and scalp EEG. The second goal was to test if machine learning could detect a seizure on scalp EEG when that seizure was not detectable by the human eye (surface negative) but was seen in iEEG. The final question was to determine if the deep learning algorithm could correctly lateralize the seizure onset. The seizure detection and prediction problems were addressed jointly by training Deep Neural Networks (DNN) on 4 classes: non-seizure, pre-seizure, left mesial temporal onset seizure and right mesial temporal onset seizure. To address these aims, the classification accuracy was tested using two deep neural networks (DNN) against 3 different types of similarity graphs which used different time series of EEG data. The convolutional neural network (CNN) with the Waxman similarity graph yielded the highest accuracy across all EEG data (iEEG, scalp EEG and combined). Specifically, 1 second epochs of EEG were correctly assigned to their seizure, pre-seizure, or non-seizure category over 98% of the time. Importantly, the pre-seizure state was classified correctly in the vast majority of epochs (>97%). Detection from scalp EEG data alone of surface negative seizures and the seizures with the delayed scalp onset (the surface negative portion) was over 97%. In addition, the model accurately lateralized all of the seizures from scalp data, including the surface negative seizures. This work suggests that highly accurate seizure prediction and detection is feasible using either intracranial or scalp EEG data. Furthermore, surface negative seizures can be accurately predicted, detected and lateralized with machine learning even when they are not visible to the human eye.

Detection of preictal state in epileptic seizures using ensemble classifier

OBJECTIVE

Epilepsy affected patient experiences more than one frequency seizures which can not be treated with medication or surgical procedures in 30% of the cases. Therefore, an early prediction of these seizures is inevitable for these cases to control them with therapeutic interventions.

METHODS

In recent years, researchers have proposed multiple deep learning based methods for detection of preictal state in electroencephalogram (EEG) signals, however, accurate detection of start of preictal state remains a challenge. We propose a novel ensemble classifier based method that gets the comprehensive feature set as input and combines three different classifiers to detect the preictal state.

RESULTS

We have applied the proposed method on the publicly available scalp EEG dataset CHBMIT of 22 subjects. An average accuracy of 94.31% with sensitivity and specificity of 94.73% and 93.72% respectively has been achieved with the method proposed in this study.

CONCLUSIONS

Proposed study utilizes the preprocessing techniques for noise removal, combines deep learning based and handcrafted features and an ensemble classifier for detection of start of preictal state. Proposed method gives better results in terms of accuracy, sensitivity, and specificity.

Prediction of Epilepsy Based on Tensor Decomposition and Functional Brain Network

Epilepsy is a chronic neurological disorder which can affect 65 million patients worldwide. Recently, network based analyses have been of great help in the investigation of seizures. Now graph theory is commonly applied to analyze functional brain networks, but functional brain networks are dynamic. Methods based on graph theory find it difficult to reflect the dynamic changes of functional brain network. In this paper, an approach to extracting features from brain functional networks is presented. Dynamic functional brain networks can be obtained by stacking multiple functional brain networks on the time axis. Then, a tensor decomposition method is used to extract features, and an ELM classifier is introduced to complete epilepsy prediction. In the prediction of epilepsy, the accuracy and F1 score of the feature extracted by tensor decomposition are higher than the degree and clustering coefficient. The features extracted from the dynamic functional brain network by tensor decomposition show better and more comprehensive performance than degree and clustering coefficient in epilepsy prediction.

Heart rate variability analysis for the identification of the preictal interval in patients with drug-resistant epilepsy

Electrocardiogram (ECG) recordings, lasting hours before epileptic seizures, have been studied in the search for evidence of the existence of a preictal interval that follows a normal ECG trace and precedes the seizure's clinical manifestation. The preictal interval has not yet been clinically parametrized. Furthermore, the duration of this interval varies for seizures both among patients and from the same patient. In this study, we performed a heart rate variability (HRV) analysis to investigate the discriminative power of the features of HRV in the identification of the preictal interval. HRV information extracted from the linear time and frequency domains as well as from nonlinear dynamics were analysed. We inspected data from 238 temporal lobe seizures recorded from 41 patients with drug-resistant epilepsy from the EPILEPSIAE database. Unsupervised methods were applied to the HRV feature dataset, thus leading to a new perspective in preictal interval characterization. Distinguishable preictal behaviour was exhibited by 41% of the seizures and 90% of the patients. Half of the preictal intervals were identified in the 40 min before seizure onset. The results demonstrate the potential of applying clustering methods to HRV features to deepen the current understanding of the preictal state.

A personalized and evolutionary algorithm for interpretable EEG epilepsy seizure prediction

Seizure prediction may improve the quality of life of patients suffering from drug-resistant epilepsy, which accounts for about 30% of the total epileptic patients. The pre-ictal period determination, characterized by a transitional stage between normal brain activity and seizure, is a critical step. Past approaches failed to attain real-world applicability due to lack of generalization capacity. More recently, deep learning techniques may outperform traditional classifiers and handle time dependencies. However, despite the existing efforts for providing interpretable insights, clinicians may not be willing to make high-stake decisions based on them. Furthermore, a disadvantageous aspect of the more usual seizure prediction pipeline is its modularity and significant independence between stages. An alternative could be the construction of a search algorithm that, while considering pipeline stages' synergy, fine-tunes the selection of a reduced set of features that are widely used in the literature and computationally efficient. With extracranial recordings from 19 patients suffering from temporal-lobe seizures, we developed a patient-specific evolutionary optimization strategy, aiming to generate the optimal set of features for seizure prediction with a logistic regression classifier, which was tested prospectively in a total of 49 seizures and 710 h of continuous recording and performed above chance for 32% of patients, using a surrogate predictor. These results demonstrate the hypothesis of pre-ictal period identification without the loss of interpretability, which may help understanding brain dynamics leading to seizures and improve prediction algorithms.

A Study of EEG Feature Complexity in Epileptic Seizure Prediction

The purpose of this study is (1) to provide EEG feature complexity analysis in seizure prediction by inter-ictal and pre-ital data classification and, (2) to assess the between-subject variability of the considered features. In the past several decades, there has been a sustained interest in predicting epilepsy seizure using EEG data. Most methods classify features extracted from EEG, which they assume are characteristic of the presence of an epilepsy episode, for instance, by distinguishing a pre-ictal interval of data (which is in a given window just before the onset of a seizure) from inter-ictal (which is in preceding windows following the seizure). To evaluate the difficulty of this classification problem independently of the classification model, we investigate the complexity of an exhaustive list of 88 features using various complexity metrics, i.e., the Fisher discriminant ratio, the volume of overlap, and the individual feature efficiency. Complexity measurements on real and synthetic data testbeds reveal that that seizure prediction by pre-ictal/inter-ictal feature distinction is a problem of significant complexity. It shows that several features are clearly useful, without decidedly identifying an optimal set.

Deep Convolutional Neural Network Based Interictal-Preictal Electroencephalography Prediction: Application to Focal Cortical Dysplasia Type-II

We aimed to differentiate between the interictal and preictal states in epilepsy patients with focal cortical dysplasia (FCD) type-II using deep learning-based classifiers based on intracranial electroencephalography (EEG). We also investigated the practical conditions for high interictal-preictal discriminability in terms of spatiotemporal EEG characteristics and data size efficiency. Intracranial EEG recordings of nine epilepsy patients with FCD type-II (four female, five male; mean age: 10.7 years) were analyzed. Seizure onset and channel ranking were annotated by two epileptologists. We performed three consecutive interictal-preictal classification steps by varying the preictal length, number of electrodes, and sampling frequency with convolutional neural networks (CNN) using 30 s time-frequency data matrices. Classification performances were evaluated based on accuracy, F1 score, precision, and recall with respect to the above-mentioned three parameters. We found that (1) a 5 min preictal length provided the best classification performance, showing a remarkable enhancement of >13% on average compared to that with the 120 min preictal length; (2) four electrodes provided considerably high classification performance with a decrease of only approximately 1% on average compared to that with all channels; and (3) there was minimal performance change when quadrupling the sampling frequency from 128 Hz. Patient-specific performance variations were noticeable with respect to the preictal length, and three patients showed above-average performance enhancements of >28%. However, performance enhancements were low with respect to both the number of electrodes and sampling frequencies, and some patients showed at most 1–2% performance change. CNN-based classifiers from intracranial EEG recordings using a small number of electrodes and efficient sampling frequency are feasible for predicting the interictal-preictal state transition preceding seizures in epilepsy patients with FCD type-II. Preictal lengths affect the predictability in a patient-specific manner; therefore, pre-examinations for optimal preictal length will be helpful in seizure prediction.

EEG Synchronization Analysis for Seizure Prediction: A Study on Data of Noninvasive Recordings

Objective: Epilepsy is a neurological disorder arising from anomalies of the electrical activity in the brain, affecting ~65 million individuals worldwide. Prediction methods, typically based on machine learning methods, require a large amount of data for training, in order to correctly classify seizures with small false alarm rates. Methods: In this work, we present a new database containing EEG scalp signals of 14 epileptic patients acquired at the Unit of Neurology and Neurophysiology of the University of Siena, Italy. Furthermore, a patient-specific seizure prediction method, based on the detection of synchronization patterns in the EEG, is proposed and tested on the data of the database. The use of noninvasive EEG data aims to explore the possibility of developing a noninvasive monitoring/control device for the prediction of seizures. The prediction method employs synchronization measures computed over all channel pairs and a computationally inexpensive threshold-based classification approach. Results and conclusions: The experimental analysis, performed by inspection and by the proposed threshold-based classifier on all the patients of the database, shows that the features extracted by the synchronization measures are able to detect preictal and ictal states and allow the prediction of the seizures few minutes before the seizure onsets.

Weak supervision as an efficient approach for automated seizure detection in electroencephalography

Automated seizure detection from electroencephalography (EEG) would improve the quality of patient care while reducing medical costs, but achieving reliably high performance across patients has proven difficult. Convolutional Neural Networks (CNNs) show promise in addressing this problem, but they are limited by a lack of large labeled training datasets. We propose using imperfect but plentiful archived annotations to train CNNs for automated, real-time EEG seizure detection across patients. While these weak annotations indicate possible seizures with precision scores as low as 0.37, they are commonly produced in large volumes within existing clinical workflows by a mixed group of technicians, fellows, students, and board-certified epileptologists. We find that CNNs trained using such weak annotations achieve Area Under the Receiver Operating Characteristic curve (AUROC) values of 0.93 and 0.94 for pediatric and adult seizure onset detection, respectively. Compared to currently deployed clinical software, our model provides a 31% increase (18 points) in F1-score for pediatric patients and a 17% increase (11 points) for adult patients. These results demonstrate that weak annotations, which are sustainably collected via existing clinical workflows, can be leveraged to produce clinically useful seizure detection models.

Preictal Time Assessment using Heart Rate Variability Features in Drug-resistant Epilepsy Patients

Epileptic seizures are by default associated with the occurrence of EEG changes as a consequence of alterations in brain activity seconds to hours before the seizure onset. Additionally, the influence of the autonomic nervous system may also be reflected in the electrocardiogram (ECG) trace. In both biosignals (EEG and ECG), differences have been reported between normal epochs, known as interictal periods and the interval preceding seizures, preictal period. However, the existence of a preictal state indicating the transition between epileptic brain states has not yet been clinically defined. In fact, some studies report differences in preictal location and duration among patients and among seizures occurring in the same patient as well. Based on the above, a study was designed in order to investigate the existence of a preictal interval specific for each seizure, using heart rate variability (HRV) features. Time and frequency domain features (linear and non-linear) were extracted from ECG data acquired in 37 drug-resistant epilepsy patients, comprised in EPILEPSIAE database. A total of 209 seizures occurring in the temporal lobe were analysed. The existence of a transition period before the seizure onset was inspected using a linear discriminant analysis classifier. The overall best performance (88.04%±12.30% of accuracy) was obtained by combining RRMean, NN50 and SD₂ features when discriminating the 50 min of interictal located farthest from seizure onset from the nearest preictal 50 min.

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.

Semi-supervised Training Data Selection Improves Seizure Forecasting in Canines with Epilepsy

Objective

Conventional selection of pre-ictal EEG epochs for seizure prediction algorithm training data typically assumes a continuous pre-ictal brain state preceding a seizure. This is carried out by defining a fixed duration, pre-ictal time period before seizures from which pre-ictal training data epochs are uniformly sampled. However, stochastic physiological and pathological fluctuations in EEG data characteristics and underlying brain states suggest that pre-ictal state dynamics may be more complex, and selection of pre-ictal training data segments to reflect this could improve algorithm performance.

Methods

We propose a semi-supervised technique to select pre-ictal training data most distinguishable from interictal EEG according to pre-specified data characteristics. The proposed method uses hierarchical clustering to identify optimal pre-ictal data epochs.

Results

In this paper we compare the performance of a seizure forecasting algorithm with and without hierarchical clustering of pre-ictal periods in chronic iEEG recordings from six canines with naturally occurring epilepsy. Hierarchical clustering of training data improved results for Time In Warning (TIW) (0.18 vs. 0.23) and False Positive Rate (FPR) (0.5 vs. 0.59) when evaluated across all subjects (p<0.001, n=6). Results were mixed when evaluating TIW, FPR, and Sensitivity for individual dogs.

Conclusion

Hierarchical clustering is a helpful method for training data selection overall, but should be evaluated on a subject-wise basis.

Significance

The clustering method can be used to optimize results of forecasting towards sensitivity or TIW or FPR, and therefore can be useful for epilepsy management.

Automatic seizure detection using three-dimensional CNN based on multi-channel EEG

BACKGROUND

Automated seizure detection from clinical EEG data can reduce the diagnosis time and facilitate targeting treatment for epileptic patients. However, current detection approaches mainly rely on limited features manually designed by domain experts, which are inflexible for the detection of a variety of patterns in a large amount of patients' EEG data. Moreover, conventional machine learning algorithms for seizure detection cannot accommodate multi-channel Electroencephalogram (EEG) data effectively, which contains both temporal and spatial information. Recently, deep learning technology has been widely applied to perform image processing tasks, which could learns useful features from data and process multi-channel data automatically. To provide an effective system for automatic seizure detection, we proposed a new three-dimensional (3D) convolutional neural network (CNN) structure, whose inputs are multi-channel EEG signals.

METHODS

EEG data of 13 patients were collected from one center hospital, which has already been inspected by experts. To represent EEG data in CNN, firstly time series of each channel of EEG data was converted into the two-dimensional image. Then all channel images were combined into 3D images according to the mutual correlation intensity between different electrodes. Finally, a CNN was constructed using 3D kernels to predict different stages of EEG data, including inter-ictal, pre-ictal, and ictal stages. The system performance was evaluated and compared with the traditional feature-based classifier and the two-dimensional (2D) deep learning method.

RESULTS

It demonstrated that multi-channel EEG data could provide more information for increasing the specificity and sensitivity in cpmparison result between the single and multi-channel. And the 3D CNN based on multi-channel outperformed the 2D CNN and traditional signal processing methods with an accuracy of more than 90%, an sensitivity of 88.90% and an specificity of 93.78%.

CONCLUSIONS

This is the first effort to apply 3D CNN in detecting seizures from EEG. It provides a new way of learning patterns simultaneously from multi-channel EEG signals, and demonstrates that deep neural networks in combination with 3D kernels can establish an effective system for seizure detection.

Automated seizure prediction

In the past two decades, significant advances have been made on automated electroencephalogram (EEG)-based diagnosis of epilepsy and seizure detection. A number of innovative algorithms have been introduced that can aid in epilepsy diagnosis with a high degree of accuracy. In recent years, the frontiers of computational epilepsy research have moved to seizure prediction, a more challenging problem. While antiepileptic medication can result in complete seizure freedom in many patients with epilepsy, up to one-third of patients living with epilepsy will have medically intractable epilepsy, where medications reduce seizure frequency but do not completely control seizures. If a seizure can be predicted prior to its clinical manifestation, then there is potential for abortive treatment to be given, either self-administered or via an implanted device administering medication or electrical stimulation. This will have a far-reaching impact on the treatment of epilepsy and patient's quality of life. This paper presents a state-of-the-art review of recent efforts and journal articles on seizure prediction. The technologies developed for epilepsy diagnosis and seizure detection are being adapted and extended for seizure prediction. The paper ends with some novel ideas for seizure prediction using the increasingly ubiquitous machine learning technology, particularly deep neural network machine learning.

Towards an Online Seizure Advisory System-An Adaptive Seizure Prediction Framework Using Active Learning Heuristics

In the last decade, seizure prediction systems have gained a lot of attention because of their enormous potential to largely improve the quality-of-life of the epileptic patients. The accuracy of the prediction algorithms to detect seizure in real-world applications is largely limited because the brain signals are inherently uncertain and affected by various factors, such as environment, age, drug intake, etc., in addition to the internal artefacts that occur during the process of recording the brain signals. To deal with such ambiguity, researchers transitionally use active learning, which selects the ambiguous data to be annotated by an expert and updates the classification model dynamically. However, selecting the particular data from a pool of large ambiguous datasets to be labelled by an expert is still a challenging problem. In this paper, we propose an active learning-based prediction framework that aims to improve the accuracy of the prediction with a minimum number of labelled data. The core technique of our framework is employing the Bernoulli-Gaussian Mixture model (BGMM) to determine the feature samples that have the most ambiguity to be annotated by an expert. By doing so, our approach facilitates expert intervention as well as increasing medical reliability. We evaluate seven different classifiers in terms of the classification time and memory required. An active learning framework built on top of the best performing classifier is evaluated in terms of required annotation effort to achieve a high level of prediction accuracy. The results show that our approach can achieve the same accuracy as a Support Vector Machine (SVM) classifier using only 20 % of the labelled data and also improve the prediction accuracy even under the noisy condition.

Visibility Graph from Adaptive Optimal Kernel Time-Frequency Representation for Classification of Epileptiform EEG

Detecting epileptic seizure from EEG signals constitutes a challenging problem of significant importance. Combining adaptive optimal kernel time-frequency representation and visibility graph, we develop a novel method for detecting epileptic seizure from EEG signals. We construct complex networks from EEG signals recorded from healthy subjects and epilepsy patients. Then we employ clustering coefficient, clustering coefficient entropy and average degree to characterize the topological structure of the networks generated from different brain states. In addition, we combine energy deviation and network measures to recognize healthy subjects and epilepsy patients, and further distinguish brain states during seizure free interval and epileptic seizures. Three different experiments are designed to evaluate the performance of our method. The results suggest that our method allows a high-accurate classification of epileptiform EEG signals.

SVM-Based System for Prediction of Epileptic Seizures From iEEG Signal

OBJECTIVE

This paper describes a data-analytic modeling approach for the prediction of epileptic seizures from intracranial electroencephalogram (iEEG) recording of brain activity. Even though it is widely accepted that statistical characteristics of iEEG signal change prior to seizures, robust seizure prediction remains a challenging problem due to subject-specific nature of data-analytic modeling.

METHODS

Our work emphasizes the understanding of clinical considerations important for iEEG-based seizure prediction, and proper translation of these clinical considerations into data-analytic modeling assumptions. Several design choices during preprocessing and postprocessing are considered and investigated for their effect on seizure prediction accuracy.

RESULTS

Our empirical results show that the proposed support vector machine-based seizure prediction system can achieve robust prediction of preictal and interictal iEEG segments from dogs with epilepsy. The sensitivity is about 90-100%, and the false-positive rate is about 0-0.3 times per day. The results also suggest that good prediction is subject specific (dog or human), in agreement with earlier studies.

CONCLUSION

Good prediction performance is possible only if the training data contain sufficiently many seizure episodes, i.e., at least 5-7 seizures.

SIGNIFICANCE

The proposed system uses subject-specific modeling and unbalanced training data. This system also utilizes three different time scales during training and testing stages.