Classification of Alzheimer's disease from quadratic sample entropy of electroencephalogram

Pressure stimulus study on acupuncture points with multi-channel multimode-fiber diffuse speckle contrast analysis (MMF-DSCA)

A multi-channel multimode-fiber deep tissue flowmetry system has been constructed based on diffuse speckle contrast analysis (DSCA) for simultaneous blood flow measurements at different locations on the human body. This system has been utilized in an acupuncture study within the field of traditional Chinese medicine (TCM), primarily focusing on acupuncture points along the large intestine meridian. Deep tissue blood flow was monitored at four different acupuncture points (LI1, LI5, LI10, and ST25) with a sampling rate of 60 Hz while applying pressure stimulus on LI4 (hegu or hapgok). Although the blood flow index (BFI) and blood volume (BV) did not exhibit significant changes after the pressure stimulus, an increase in the amplitude and complexity of low-frequency oscillations (LFOs) in microcirculation was observed.

EEG-based clinical decision support system for Alzheimer's disorders diagnosis using EMD and deep learning techniques

Introduction

Despite the existence of numerous clinical techniques for identifying neurological brain disorders in their early stages, Electroencephalogram (EEG) data shows great promise as a means of detecting Alzheimer's disease (AD) at an early stage. The main goal of this research is to create a reliable and accurate clinical decision support system leveraging EEG signal processing to detect AD in its initial phases.

Methods

The research utilized a dataset consisting of 35 neurotypical individuals, 31 patients with mild AD, and 22 patients with moderate AD. Data were collected while participants were at rest. To extract features from the EEG signals, a band-pass filter was applied to the dataset and the Empirical Mode Decomposition (EMD) technique was employed to decompose the filtered signals. The EMD technique was then leveraged to generate feature vectors by combining multiple signal features, thereby enhancing diagnostic performance. Various artificial intelligence approaches were also explored and compared to identify features of the extracted EEG signals distinguishing mild AD, moderate AD, and neurotypical cases. The performance of the classifiers was evaluated using k-fold cross-validation and leave-one-subject-out (LOSO) cross-validation methods.

Results

The results of this study provided valuable insights into potential avenues for the early diagnosis of AD. The performance of the various offered methodologies has been compared and evaluated by computing the overall diagnosis precision, recall, and accuracy. The proposed methodologies achieved a maximum classification accuracy of 99.9 and 94.8% for k-fold and LOSO cross-validation techniques, respectively.

Conclusion

The study aims to assess and compare different proposed methodologies and determine the most effective combination approach for the early detection of AD. Our research findings strongly suggest that the proposed diagnostic support technique is a highly promising supplementary tool for discovering prospective diagnostic biomarkers that can greatly aid in the early clinical diagnosis of AD.

Ensemble Improved Permutation Entropy: A New Approach for Time Series Analysis

Entropy quantification approaches have gained considerable attention in engineering applications. However, certain limitations persist, including the strong dependence on parameter selection, limited discriminating power, and low robustness to noise. To alleviate these issues, this paper introduces two novel algorithms for time series analysis: the ensemble improved permutation entropy (EIPE) and multiscale EIPE (MEIPE). Our approaches employ a new symbolization process that considers both permutation relations and amplitude information. Additionally, the ensemble technique is utilized to reduce the dependence on parameter selection. We performed a comprehensive evaluation of the proposed methods using various synthetic and experimental signals. The results illustrate that EIPE is capable of distinguishing white, pink, and brown noise with a smaller number of samples compared to traditional entropy algorithms. Furthermore, EIPE displays the potential to discriminate between regular and non-regular dynamics. Notably, when compared to permutation entropy, weighted permutation entropy, and dispersion entropy, EIPE exhibits superior robustness against noise. In practical applications, such as RR interval data classification, bearing fault diagnosis, marine vessel identification, and electroencephalographic (EEG) signal classification, the proposed methods demonstrate better discriminating power compared to conventional entropy measures. These promising findings validate the effectiveness and potential of the algorithms proposed in this paper.

Computational methods of EEG signals analysis for Alzheimer's disease classification

Computational analysis of electroencephalographic (EEG) signals have shown promising results in detecting brain disorders, such as Alzheimer's disease (AD). AD is a progressive neurological illness that causes neuron cells degeneration, resulting in cognitive impairment. While there is no cure for AD, early diagnosis is critical to improving the quality of life of affected individuals. Here, we apply six computational time-series analysis methods (wavelet coherence, fractal dimension, quadratic entropy, wavelet energy, quantile graphs and visibility graphs) to EEG records from 160 AD patients and 24 healthy controls. Results from raw and wavelet-filtered (alpha, beta, theta and delta bands) EEG signals show that some of the time-series analysis methods tested here, such as wavelet coherence and quantile graphs, can robustly discriminate between AD patients from elderly healthy subjects. They represent a promising non-invasive and low-cost approach to the AD detection in elderly patients.

Effects of Pharmacological Treatments in Alzheimer's Disease: Permutation Entropy-Based EEG Complexity Study

Alzheimer's disease (AD) is a neurodegenerative brain disease affecting cognitive and physical functioning. The currently available pharmacological treatments for AD mainly contain cholinesterase inhibitors (AChE-I) and N-methyl-D-aspartic acid (NMDA) receptor antagonists (i.e., memantine). Because brain signals have complex nonlinear dynamics, there has been an increase in interest in researching complexity changes in the time series of brain signals in individuals with AD. In this study, we explore the electroencephalographic (EEG) complexity for making better observation of pharmacological therapy-based treatment effects on AD patients using the permutation entropy (PE) method. We examined EEG sub-band (delta, theta, alpha, beta, and gamma) complexity in de-novo, monotherapy (AChE-I), dual therapy (AChE-I and memantine) receiving AD participants compared with healthy elderly controls. We showed that each frequency band depicts its own complexity profile, which is regionally altered between groups. These alterations were also found to be associated with global cognitive scores. Overall, our findings indicate that entropy measures could be useful to show medication effects in AD.

An Automated Approach for the Detection of Alzheimer's Disease From Resting State Electroencephalography

Early detection is crucial to control the progression of Alzheimer's disease and to postpone intellectual decline. Most current detection techniques are costly, inaccessible, or invasive. Furthermore, they require laborious analysis, what delays the start of medical treatment. To overcome this, researchers have recently investigated AD detection based on electroencephalography, a non-invasive neurophysiology technique, and machine learning algorithms. However, these approaches typically rely on manual procedures such as visual inspection, that requires additional personnel for the analysis, or on cumbersome EEG acquisition systems. In this paper, we performed a preliminary evaluation of a fully-automated approach for AD detection based on a commercial EEG acquisition system and an automated classification pipeline. For this purpose, we recorded the resting state brain activity of 26 participants from three groups: mild AD, mild cognitive impairment (MCI-non-AD), and healthy controls. First, we applied automated data-driven algorithms to reject EEG artifacts. Then, we obtained spectral, complexity, and entropy features from the preprocessed EEG segments. Finally, we assessed two binary classification problems: mild AD vs. controls, and MCI-non-AD vs. controls, through leave-one-subject-out cross-validation. The preliminary results that we obtained are comparable to the best reported in literature, what suggests that AD detection could be automatically detected through automated processing and commercial EEG systems. This is promising, since it may potentially contribute to reducing costs related to AD screening, and to shortening detection times, what may help to advance medical treatment.

COVID-19 mortality risk assessments for individuals with and without diabetes mellitus: Machine learning models integrated with interpretation framework

This research develops machine learning models equipped with interpretation modules for mortality risk prediction and stratification in cohorts of hospitalised coronavirus disease-2019 (COVID-19) patients with and without diabetes mellitus (DM). To this end, routinely collected clinical data from 156 COVID-19 patients with DM and 349 COVID-19 patients without DM were scrutinised. First, a random forest classifier forecasted in-hospital COVID-19 fatality utilising admission data for each cohort. For the DM cohort, the model predicted mortality risk with the accuracy of 82%, area under the receiver operating characteristic curve (AUC) of 80%, sensitivity of 80%, and specificity of 56%. For the non-DM cohort, the achieved accuracy, AUC, sensitivity, and specificity were 80%, 84%, 91%, and 56%, respectively. The models were then interpreted using SHapley Additive exPlanations (SHAP), which explained predictors’ global and local influences on model outputs. Finally, the k-means algorithm was applied to cluster patients on their SHAP values. The algorithm demarcated patients into three clusters. Average mortality rates within the generated clusters were 8%, 20%, and 76% for the DM cohort, 2.7%, 28%, and 41.9% for the non-DM cohort, providing a functional method of risk stratification.

Complexity-Based Analysis of the Variations of Brain and Muscle Reactions in Walking and Standing Balance While Receiving Different Perturbations

In this article, we evaluated the variations of the brain and muscle activations while subjects are exposed to different perturbations to walking and standing balance. Since EEG and EMG signals have complex structures, we utilized the complexity-based analysis. Specifically, we analyzed the fractal dimension and sample entropy of Electroencephalogram (EEG) and Electromyogram (EMG) signals while subjects walked and stood, and received different perturbations in the form of pulling and rotation (via virtual reality). The results showed that the complexity of EEG signals was higher in walking than standing as the result of different perturbations. However, the complexity of EMG signals was higher in standing than walking as the result of different perturbations. Therefore, the alterations in the complexity of EEG and EMG signals are inversely correlated. This analysis could be extended to investigate simultaneous variations of rhythmic patterns of other physiological signals while subjects perform different activities.

EEG Fractal Analysis Reflects Brain Impairment after Stroke

Stroke is the commonest cause of disability. Novel treatments require an improved understanding of the underlying mechanisms of recovery. Fractal approaches have demonstrated that a single metric can describe the complexity of seemingly random fluctuations of physiological signals. We hypothesize that fractal algorithms applied to electroencephalographic (EEG) signals may track brain impairment after stroke. Sixteen stroke survivors were studied in the hyperacute (<48 h) and in the acute phase (∼1 week after stroke), and 35 stroke survivors during the early subacute phase (from 8 days to 32 days and after ∼2 months after stroke): We compared resting-state EEG fractal changes using fractal measures (i.e., Higuchi Index, Tortuosity) with 11 healthy controls. Both Higuchi index and Tortuosity values were significantly lower after a stroke throughout the acute and early subacute stage compared to healthy subjects, reflecting a brain activity which is significantly less complex. These indices may be promising metrics to track behavioral changes in the very early stage after stroke. Our findings might contribute to the neurorehabilitation quest in identifying reliable biomarkers for a better tailoring of rehabilitation pathways.

Slope Entropy: A New Time Series Complexity Estimator Based on Both Symbolic Patterns and Amplitude Information

The development of new measures and algorithms to quantify the entropy or related concepts of a data series is a continuous effort that has brought many innovations in this regard in recent years. The ultimate goal is usually to find new methods with a higher discriminating power, more efficient, more robust to noise and artifacts, less dependent on parameters or configurations, or any other possibly desirable feature. Among all these methods, Permutation Entropy (PE) is a complexity estimator for a time series that stands out due to its many strengths, with very few weaknesses. One of these weaknesses is the PE’s disregarding of time series amplitude information. Some PE algorithm modifications have been proposed in order to introduce such information into the calculations. We propose in this paper a new method, Slope Entropy (SlopEn), that also addresses this flaw but in a different way, keeping the symbolic representation of subsequences using a novel encoding method based on the slope generated by two consecutive data samples. By means of a thorough and extensive set of comparative experiments with PE and Sample Entropy (SampEn), we demonstrate that SlopEn is a very promising method with clearly a better time series classification performance than those previous methods.

Interpretation of Entropy Algorithms in the Context of Biomedical Signal Analysis and Their Application to EEG Analysis in Epilepsy

Biomedical signals are measurable time series that describe a physiological state of a biological system. Entropy algorithms have been previously used to quantify the complexity of biomedical signals, but there is a need to understand the relationship of entropy to signal processing concepts. In this study, ten synthetic signals that represent widely encountered signal structures in the field of signal processing were created to interpret permutation, modified permutation, sample, quadratic sample and fuzzy entropies. Subsequently, the entropy algorithms were applied to two different databases containing electroencephalogram (EEG) signals from epilepsy studies. Transitions from randomness to periodicity were successfully detected in the synthetic signals, while significant differences in EEG signals were observed based on different regions and states of the brain. In addition, using results from one entropy algorithm as features and the k-nearest neighbours algorithm, maximum classification accuracies in the first EEG database ranged from 63% to 73.5%, while these values increased by approximately 20% when using two different entropies as features. For the second database, maximum classification accuracy reached 62.5% using one entropy algorithm, while using two algorithms as features further increased that by 10%. Embedding entropies (sample, quadratic sample and fuzzy entropies) are found to outperform the rest of the algorithms in terms of sensitivity and show greater potential by considering the fine-tuning possibilities they offer. On the other hand, permutation and modified permutation entropies are more consistent across different input parameter values and considerably faster to calculate.

EEG Characterization of the Alzheimer's Disease Continuum by Means of Multiscale Entropies

Alzheimer's disease (AD) is a neurodegenerative disorder with high prevalence, known for its highly disabling symptoms. The aim of this study was to characterize the alterations in the irregularity and the complexity of the brain activity along the AD continuum. Both irregularity and complexity can be studied applying entropy-based measures throughout multiple temporal scales. In this regard, multiscale sample entropy (MSE) and refined multiscale spectral entropy (rMSSE) were calculated from electroencephalographic (EEG) data. Five minutes of resting-state EEG activity were recorded from 51 healthy controls, 51 mild cognitive impaired (MCI) subjects, 51 mild AD patients (AD_MIL), 50 moderate AD patients (AD_MOD), and 50 severe AD patients (AD_SEV). Our results show statistically significant differences (p-values < 0.05, FDR-corrected Kruskal-Wallis test) between the five groups at each temporal scale. Additionally, average slope values and areas under MSE and rMSSE curves revealed significant changes in complexity mainly for controls vs. MCI, MCI vs. AD_MIL and AD_MOD vs. AD_SEV comparisons (p-values < 0.05, FDR-corrected Mann-Whitney U-test). These findings indicate that MSE and rMSSE reflect the neuronal disturbances associated with the development of dementia, and may contribute to the development of new tools to track the AD progression.

Systematic Review on Resting-State EEG for Alzheimer's Disease Diagnosis and Progression Assessment

Alzheimer's disease (AD) is a neurodegenerative disorder that accounts for nearly 70% of the more than 46 million dementia cases estimated worldwide. Although there is no cure for AD, early diagnosis and an accurate characterization of the disease progression can improve the quality of life of AD patients and their caregivers. Currently, AD diagnosis is carried out using standardized mental status examinations, which are commonly assisted by expensive neuroimaging scans and invasive laboratory tests, thus rendering the diagnosis time consuming and costly. Notwithstanding, over the last decade, electroencephalography (EEG) has emerged as a noninvasive alternative technique for the study of AD, competing with more expensive neuroimaging tools, such as MRI and PET. This paper reports on the results of a systematic review on the utilization of resting-state EEG signals for AD diagnosis and progression assessment. Recent journal articles obtained from four major bibliographic databases were analyzed. A total of 112 journal articles published from January 2010 to February 2018 were meticulously reviewed, and relevant aspects of these papers were compared across articles to provide a general overview of the research on this noninvasive AD diagnosis technique. Finally, recommendations for future studies with resting-state EEG were presented to improve and facilitate the knowledge transfer among research groups.

Understanding perception of active noise control system through multichannel EEG analysis

In this Letter, a method is proposed to investigate the effect of noise with and without active noise control (ANC) on multichannel electroencephalogram (EEG) signal. The multichannel EEG signal is recorded during different listening conditions such as silent, music, noise, ANC with background noise and ANC with both background noise and music. The multiscale analysis of EEG signal of each channel is performed using the discrete wavelet transform. The multivariate multiscale matrices are formulated based on the sub-band signals of each EEG channel. The singular value decomposition is applied to the multivariate matrices of multichannel EEG at significant scales. The singular value features at significant scales and the extreme learning machine classifier with three different activation functions are used for classification of multichannel EEG signal. The experimental results demonstrate that, for ANC with noise and ANC with noise and music classes, the proposed method has sensitivity values of 75.831% (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}$p \lt 0.001$\end{document}p<0.001) and 99.31% (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}$p \lt 0.001$\end{document}p<0.001), respectively. The method has an accuracy value of 83.22% for the classification of EEG signal with music and ANC with music as stimuli. The important finding of this study is that by the introduction of ANC, music can be better perceived by the human brain.

Fuzzy Entropy Analysis of the Electroencephalogram in Patients with Alzheimer's Disease: Is the Method Superior to Sample Entropy?

Alzheimer’s disease (AD) is the most prevalent form of dementia in the world, which is characterised by the loss of neurones and the build-up of plaques in the brain, causing progressive symptoms of memory loss and confusion. Although definite diagnosis is only possible by necropsy, differential diagnosis with other types of dementia is still needed. An electroencephalogram (EEG) is a cheap, portable, non-invasive method to record brain signals. Previous studies with non-linear signal processing methods have shown changes in the EEG due to AD, which is characterised reduced complexity and increased regularity. EEGs from 11 AD patients and 11 age-matched control subjects were analysed with Fuzzy Entropy (FuzzyEn), a non-linear method that was introduced as an improvement over the frequently used Approximate Entropy (ApEn) and Sample Entropy (SampEn) algorithms. AD patients had significantly lower FuzzyEn values than control subjects (p < 0.01) at electrodes T6, P3, P4, O1, and O2. Furthermore, when diagnostic accuracy was calculated using Receiver Operating Characteristic (ROC) curves, FuzzyEn outperformed both ApEn and SampEn, reaching a maximum accuracy of 86.36%. These results suggest that FuzzyEn could increase the insight into brain dysfunction in AD, providing potentially useful diagnostic information. However, results depend heavily on the input parameters that are used to compute FuzzyEn.

Fuzzy-entropy threshold based on a complex wavelet denoising technique to diagnose Alzheimer disease

The presence of irregularities in electroencephalographic (EEG) signals entails complexities during the Alzheimer's disease (AD) diagnosis. In addition, the uncertainty presented on EEG raises major issues in the improvement of the classification rate. The multi-resolution analysis through an optimum threshold will likely achieve better results in distinguishing AD and normal EEG signals. Hence, a fuzzy-entropy concept defined in a complex multi-resolution wavelet has been proposed to obtain the most appropriate threshold. First, the complex coefficients are fuzzified using a Gaussian membership function. Afterwards, the ability of the proposed fuzzy-entropy threshold has been compared with traditional thresholds in complex wavelet domain. Experimental results show that the authors' methodology produces a higher signal-to-noise ratio and a lower root-mean-square error than traditional approaches. Moreover, a neural network scheme is performed along several features to classify AD from normal EEG signals obtaining a specificity of 87.5%.