Automatic epileptic seizure detection using scalp EEG and advanced artificial intelligence techniques

Automatic detection of epilepsy from EEGs using a temporal convolutional network with a self-attention layer

BACKGROUND

Over 60% of epilepsy patients globally are children, whose early diagnosis and treatment are critical for their development and can substantially reduce the disease's burden on both families and society. Numerous algorithms for automated epilepsy detection from EEGs have been proposed. Yet, the occurrence of epileptic seizures during an EEG exam cannot always be guaranteed in clinical practice. Models that exclusively use seizure EEGs for detection risk artificially enhanced performance metrics. Therefore, there is a pressing need for a universally applicable model that can perform automatic epilepsy detection in a variety of complex real-world scenarios.

METHOD

To address this problem, we have devised a novel technique employing a temporal convolutional neural network with self-attention (TCN-SA). Our model comprises two primary components: a TCN for extracting time-variant features from EEG signals, followed by a self-attention (SA) layer that assigns importance to these features. By focusing on key features, our model achieves heightened classification accuracy for epilepsy detection.

RESULTS

The efficacy of our model was validated on a pediatric epilepsy dataset we collected and on the Bonn dataset, attaining accuracies of 95.50% on our dataset, and 97.37% (A v. E), and 93.50% (B vs E), respectively. When compared with other deep learning architectures (temporal convolutional neural network, self-attention network, and standardized convolutional neural network) using the same datasets, our TCN-SA model demonstrated superior performance in the automated detection of epilepsy.

CONCLUSION

The proven effectiveness of the TCN-SA approach substantiates its potential as a valuable tool for the automated detection of epilepsy, offering significant benefits in diverse and complex real-world clinical settings.

An epilepsy detection method based on multi-dimensional feature extraction and dual-branch hypergraph convolutional network

Epilepsy is a disease caused by abnormal neural discharge, which severely harms the health of patients. Its pathogenesis is complex and variable with various forms of seizures, leading to significant differences in epilepsy manifestations among different patients. The changes of brain network are strongly correlated with related pathologies. Therefore, it is crucial to effectively and deeply explore the intrinsic features of epilepsy signals to reveal the rules of epilepsy occurrence and achieve accurate detection. Existing methods have faced the following issues: 1) single approach for feature extraction, resulting in insufficient classification information due to the lack of rich dimensions in captured features; 2) inability to deeply analyze the essential commonality of epilepsy signal after feature extraction, making the model susceptible to data distribution and noise interference. Thus, we proposed a high-precision and robust model for epileptic seizure detection, which, for the first time, applies hypergraph convolution to the field of epilepsy detection. Through a hypergraph network structure constructed based on relationships between channels in electroencephalogram (EEG) signals, the model explores higher-order characteristics of epilepsy EEG data. Specifically, we use the Conv-LSTM module and Power spectral density (PSD), a two-branch parallel method, to extract channel features from space-time and frequency domains to solve the problem of insufficient feature extraction, and can adequately describe the data structure and distribution from multiple perspectives through double-branch parallel feature extraction. In addition, we construct a hypergraph on the captured features to explore the intrinsic features in the high-dimensional space in an attempt to reveal the essential commonality of epileptic signal feature extraction. Finally, using the ensemble learning concept, we accomplished epilepsy detection on the dual-branch hypergraph convolution. The model underwent leave-one-out cross-validation on the TUH dataset, achieving an average accuracy of 96.9%, F1 score of 97.3%, Pre of 98.2% and Re of 96.7%. In addition, the model was generalized performance tested on CHB-MIT scalp EEG dataset with leave-one-out cross-validation, and the average ACC, F1 score, Pre and Re were 94.4%, 95.1%, 95.8%, and 93.9% respectively. Experimental results indicate that the model outperforms related literature, providing valuable reference for the clinical application of epilepsy detection.

Automatic epileptic seizure detection based on persistent homology

Epilepsy is a prevalent brain disease, which is quite difficult-to-treat or cure. This study developed a novel automatic seizure detection method based on the persistent homology method. In this study, a Vietoris-Rips (VR) complex filtration model was constructed based on the EEG data. And the persistent homology method was applied to calculate the VR complex filtration barcodes to describe the topological changes of EEG recordings. Afterward, the barcodes as the topological characteristics of EEG signals were fed into the GoogLeNet for classification. The persistent homology is applicable for multi-channel EEG data analysis, where the global topological information is calculated and the features are extracted by considering the multi-channel EEG data as a whole, without the multiple calculations or the post-stitching. Three databases were used to evaluate the proposed approach and the results showed that the approach had high performances in the epilepsy detection. The results obtained from the CHB-MIT Database recordings revealed that the proposed approach can achieve a segment-based averaged accuracy, sensitivity and specificity values of 97.05%, 96.71% and 97.38%, and achieve an event-based averaged sensitivity value of 100% with 1.22 s average detection latency. In addition, on the Siena Scalp Database, the proposed method yields averaged accuracy, sensitivity and specificity values of 96.42%, 95.23% and 97.6%. Multiple tasks of the Bonn Database also showed achieved accuracy of 99.55%, 98.63%, 98.28% and 97.68%, respectively. The experimental results on these three EEG databases illustrate the efficiency and robustness of our approach for automatic detection of epileptic seizure.

Estimating Patient-Level Uncertainty in Seizure Detection Using Group-Specific Out-of-Distribution Detection Technique

Epilepsy is a chronic neurological disorder affecting around 1% of the global population, characterized by recurrent epileptic seizures. Accurate diagnosis and treatment are crucial for reducing mortality rates. Recent advancements in machine learning (ML) algorithms have shown potential in aiding clinicians with seizure detection in electroencephalography (EEG) data. However, these algorithms face significant challenges due to the patient-specific variability in seizure patterns and the limited availability of high-quality EEG data for training, causing erratic predictions. These erratic predictions are harmful, especially for high-stake domains in healthcare, negatively affecting patients. Therefore, ensuring safety in AI is of the utmost importance. In this study, we propose a novel ensemble method for uncertainty quantification to identify patients with low-confidence predictions in ML-based seizure detection algorithms. Our approach aims to mitigate high-risk predictions in previously unseen seizure patients, thereby enhancing the robustness of existing seizure detection algorithms. Additionally, our method can be implemented with most of the deep learning (DL) models. We evaluated the proposed method against established uncertainty detection techniques, demonstrating its effectiveness in identifying patients for whom the model's predictions are less certain. Our proposed method managed to achieve 87%, 89% and 75% in accuracy, specificity and sensitivity, respectively. This study represents a novel attempt to improve the reliability and robustness of DL algorithms in the domain of seizure detection. This study underscores the value of integrating uncertainty quantification into ML algorithms for seizure detection, offering clinicians a practical tool to gauge the applicability of ML models for individual patients.

Implementing Artificial Intelligence: Assessing the Cost and Benefits of Algorithmic Decision-Making in Critical Care

This article provides an overview of the most useful artificial intelligence algorithms developed in critical care, followed by a comprehensive outline of the benefits and limitations. We begin by describing how nurses and physicians might be aided by these new technologies. We then move to the possible changes in clinical guidelines with personalized medicine that will allow tailored therapies and probably will increase the quality of the care provided to patients. Finally, we describe how artificial intelligence models can unleash researchers' minds by proposing new strategies, by increasing the quality of clinical practice, and by questioning current knowledge and understanding.

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.

Study on characteristic of epileptic multi-electroencephalograph base on Hilbert-Huang transform and brain network dynamics

Lots of studies have been carried out on characteristic of epileptic Electroencephalograph (EEG). However, traditional EEG characteristic research methods lack exploration of spatial information. To study the characteristics of epileptic EEG signals from the perspective of the whole brain，this paper proposed combination methods of multi-channel characteristics from time-frequency and spatial domains. This paper was from two aspects: Firstly, signals were converted into 2D Hilbert Spectrum (HS) images which reflected the time-frequency characteristics by Hilbert-Huang Transform (HHT). These images were identified by Convolutional Neural Network (CNN) model whose sensitivity was 99.8%, accuracy was 98.7%, specificity was 97.4%, F1-score was 98.7%, and AUC-ROC was 99.9%. Secondly, the multi-channel signals were converted into brain networks which reflected the spatial characteristics by Symbolic Transfer Entropy (STE) among different channels EEG. And the results show that there are different network properties between ictal and interictal phase and the signals during the ictal enter the synchronization state more quickly, which was verified by Kuramoto model. To summarize, our results show that there was different characteristics among channels for the ictal and interictal phase, which can provide effective physical non-invasive indicators for the identification and prediction of epileptic seizures.

Deep-EEG: An Optimized and Robust Framework and Method for EEG-Based Diagnosis of Epileptic Seizure

Detecting brain disorders using deep learning methods has received much hype during the last few years. Increased depth leads to more computational efficiency, accuracy, and optimization and less loss. Epilepsy is one of the most common chronic neurological disorders characterized by repeated seizures. We have developed a deep learning model using Deep convolutional Autoencoder-Bidirectional Long Short Memory for Epileptic Seizure Detection (DCAE-ESD-Bi-LSTM) for automatic detection of seizures using EEG data. The significant feature of our model is that it has contributed to the accurate and optimized diagnosis of epilepsy in ideal and real-life situations. The results on the benchmark (CHB-MIT) dataset and the dataset collected by the authors show the relevance of the proposed approach over the baseline deep learning techniques by achieving an accuracy of 99.8%, classification accuracy of 99.7%, sensitivity of 99.8%, specificity and precision of 99.9% and F1 score of 99.6%. Our approach can contribute to the accurate and optimized detection of seizures while scaling the design rules and increasing performance without changing the network's depth.

EEG datasets for seizure detection and prediction- A review

Electroencephalogram (EEG) datasets from epilepsy patients have been used to develop seizure detection and prediction algorithms using machine learning (ML) techniques with the aim of implementing the learned model in a device. However, the format and structure of publicly available datasets are different from each other, and there is a lack of guidelines on the use of these datasets. This impacts the generatability, generalizability, and reproducibility of the results and findings produced by the studies. In this narrative review, we compiled and compared the different characteristics of the publicly available EEG datasets that are commonly used to develop seizure detection and prediction algorithms. We investigated the advantages and limitations of the characteristics of the EEG datasets. Based on our study, we identified 17 characteristics that make the EEG datasets unique from each other. We also briefly looked into how certain characteristics of the publicly available datasets affect the performance and outcome of a study, as well as the influences it has on the choice of ML techniques and preprocessing steps required to develop seizure detection and prediction algorithms. In conclusion, this study provides a guideline on the choice of publicly available EEG datasets to both clinicians and scientists working to develop a reproducible, generalizable, and effective seizure detection and prediction algorithm.

EEG biomarker candidates for the identification of epilepsy

Electroencephalography (EEG) is one of the main pillars used for the diagnosis and study of epilepsy, readily employed after a possible first seizure has occurred. The most established biomarker of epilepsy, in case seizures are not recorded, are interictal epileptiform discharges (IEDs). In clinical practice, however, IEDs are not always present and the EEG may appear completely normal despite an underlying epileptic disorder, often leading to difficulties in the diagnosis of the disease. Thus, finding other biomarkers that reliably predict whether an individual suffers from epilepsy even in the absence of evident epileptic activity would be extremely helpful, since they could allow shortening the period of diagnostic uncertainty and consequently decreasing the risk of seizure. To date only a few EEG features other than IEDs seem to be promising candidates able to distinguish between epilepsy, i.e. > 60 % risk of recurrent seizures, or other (pathological) conditions. The aim of this narrative review is to provide an overview of the EEG-based biomarker candidates for epilepsy and the techniques employed for their identification.

Graph-generative neural network for EEG-based epileptic seizure detection via discovery of dynamic brain functional connectivity

Dynamic complexity in brain functional connectivity has hindered the effective use of signal processing or machine learning methods to diagnose neurological disorders such as epilepsy. This paper proposed a new graph-generative neural network (GGN) model for the dynamic discovery of brain functional connectivity via deep analysis of scalp electroencephalogram (EEG) signals recorded from various regions of a patient's scalp. Brain functional connectivity graphs are generated for the extraction of spatial-temporal resolution of various onset epilepsy seizure patterns. Our supervised GGN model was substantiated by seizure detection and classification experiments. We train the GGN model using a clinically proven dataset of over 3047 epileptic seizure cases. The GGN model achieved a 91% accuracy in classifying seven types of epileptic seizure attacks, which outperformed the 65%, 74%, and 82% accuracy in using the convolutional neural network (CNN), graph neural networks (GNN), and transformer models, respectively. We present the GGN model architecture and operational steps to assist neuroscientists or brain specialists in using dynamic functional connectivity information to detect neurological disorders. Furthermore, we suggest to merge our spatial-temporal graph generator design in upgrading the conventional CNN and GNN models with dynamic convolutional kernels for accuracy enhancement.

Deep Cellular Recurrent Network for Efficient Analysis of Time-Series Data With Spatial Information

Efficient processing of large-scale time-series data is an intricate problem in machine learning. Conventional sensor signal processing pipelines with hand-engineered feature extraction often involve huge computational costs with high dimensional data. Deep recurrent neural networks have shown promise in automated feature learning for improved time-series processing. However, generic deep recurrent models grow in scale and depth with the increased complexity of the data. This is particularly challenging in presence of high dimensional data with temporal and spatial characteristics. Consequently, this work proposes a novel deep cellular recurrent neural network (DCRNN) architecture to efficiently process complex multidimensional time-series data with spatial information. The cellular recurrent architecture in the proposed model allows for location-aware synchronous processing of time-series data from spatially distributed sensor signal sources. Extensive trainable parameter sharing due to cellularity in the proposed architecture ensures efficiency in the use of recurrent processing units with high-dimensional inputs. This study also investigates the versatility of the proposed DCRNN model for the classification of multiclass time-series data from different application domains. Consequently, the proposed DCRNN architecture is evaluated using two time-series data sets: a multichannel scalp electroencephalogram (EEG) data set for seizure detection, and a machine fault detection data set obtained in-house. The results suggest that the proposed architecture achieves state-of-the-art performance while utilizing substantially less trainable parameters when compared to comparable methods in the literature.

An Efficient Signal Processing Algorithm for Detecting Abnormalities in EEG Signal Using CNN

Electroencephalography (EEG) is crucial for epilepsy detection; however, detecting abnormalities takes experience and knowledge. The electroencephalogram (EEG) is a technology that measures brain motion and represents the brain's function. EEG is an effective instrument for deciphering the brain's complicated activity. The information contained in the EEG signal pertains to the electric functioning of the brain. Neurologists have typically used direct visual inspection to detect epileptogenic abnormalities. This method is time-consuming, restricted by technical artifacts, produces varying findings depending on the reader's level of experience, and is ineffective at detecting irregularities. As a result, developing automated algorithms for detecting anomalies in EEGs associated with epilepsy is critical. The construction of a novel class of convolutional neural networks (CNNs) for detecting aberrant waveforms and sensors in epilepsy EEGs is described in this research. In this study, EEG signals are analyzed using a convolutional neural network (CNN). For the automatic detection of abnormal and normal EEG indications, a novel deep one-dimensional convolutional neural network (1D CNN) model is suggested in this paper. The regular, pre-ictal, and seizure categories are detected using this approach. The proposed model achieves an accuracy of 85.48% and a reduced categorization error rate of 14.5%.

Estimation of seizure onset zone from ictal scalp EEG using independent component analysis in extratemporal lobe epilepsy

OBJECTIVE

The purpose of this study is to localize the seizure onset zone of patients suffering from drug-resistant epilepsy. During the last two decades, multiple studies proposed the use of Independent Component Analysis (ICA) to analyze ictal electroencephalogram (EEG) recordings. This study aims at evaluating ICA potential with quantitative measurements. In particular, we address the challenging step where the components extracted by ICA of an ictal nature must be selected.

APPROACH

We considered a cohort of 10 patients suffering from extratemporal lobe epilepsy who were rendered seizure-free after surgery. Different sets of pre-processing parameters were compared and component features were explored to help distinguish ictal components from others. Quantitative measurements were implemented to determine whether some of the components returned by ICA were located within the resection zone and thus likely to be ictal. Finally, an assistance to the component selection was proposed based on the implemented features.

MAIN RESULTS

For every seizure, at least one component returned by ICA was localized within the resection zone, with the optimal pre-processing parameters. Three features were found to distinguish components localized within the resection zone: the dispersion of their active brain sources, the ictal rhythm power and the contribution to the EEG variance. Using the implemented component selection assistance based on the features, the probability that the first proposed component yields an accurate estimation reaches 51.43% (without assistance: 24.74%). The accuracy reaches 80% when considering the best result within the first five components.

SIGNIFICANCE

This study confirms the utility of ICA for ictal EEG analysis in extratemporal lobe epilepsy, and suggests relevant features to analyze the components returned by ICA. A component selection assistance is proposed to guide clinicians in their choice for ictal components.

Covid19-Mexican-Patients' Dataset (Covid19MPD) Classification and Prediction Using Feature Importance

Coronavirus disease, Covid19, pandemic has a great effect on human heath worldwide since it was first detected in late 2019. A clear understanding of the structure of the available Covid19 datasets might give the healthcare provider a better understanding of identifying some of the cases at an early stage. In this article, we will be looking into a Covid19 Mexican Patients' Dataset (Covid109MPD), and we will apply number of machine learning algorithms on the dataset to select the best possible classification algorithm for the death and survived cases in Mexico, then we will study the performance of the enhancement of the specified classifiers in term of their features selection in order to be able to predict sever, and or death, cases from the available dataset. Results show that J48 classifier gives the best classification accuracy with 94.41% and RMSE = 0.2028 and ROC = 0.919, compared to other classifiers, and when using feature selection method, J48 classifier can predict a surviving Covid19MPD case within 94.88% accuracy, and by using only 10 out of the total 19 features.

EEG-Based Multiword Imagined Speech Classification for Persian Words

This study focuses on providing a simple, extensible, and multiclass classifier for imagined words using EEG signals. Six Persian words, along with the silence (or idle state), were selected as input classes. The words can be used to control a mouse/robot movement or fill a simple computer form. The data set of this study was 10 recordings of five participants collected in five sessions. Each record had 20 repetitions of all words and the silence. Feature sets consist of normalized, 1 Hz resolution frequency spectrum of 19 EEG channels in 1 to 32 Hz bands. Majority rule on a bank of binary SVM classifiers was used to determine the corresponding class of a feature set. Mean accuracy and confusion matrix of the classifiers were estimated by Monte-Carlo cross-validation. According to recording the time difference of inter- and intraclass samples, three classification modes were defined. In the long-time mode, where all instances of a word in the whole database are involved, average accuracies were about 58% for Word-Silence, 60% for Word-Word, 40% for Word-Word-Silence, and 32% for the seven-class classification (6 Words+Silence). For the short-time mode, when only instances of the same record are used, the accuracies were 96, 75, 79, and 55%, respectively. Finally, in the mixed-time classification, where samples of every class are taken from a different record, the highest performance achieved with average accuracies was about 97, 97, 92, and 62%. These results, even in the worst case of the long-time mode, are meaningfully better than random and are comparable with the best reported results of previously conducted studies in this area.

Neural Decoding of EEG Signals with Machine Learning: A Systematic Review

Electroencephalography (EEG) is a non-invasive technique used to record the brain's evoked and induced electrical activity from the scalp. Artificial intelligence, particularly machine learning (ML) and deep learning (DL) algorithms, are increasingly being applied to EEG data for pattern analysis, group membership classification, and brain-computer interface purposes. This study aimed to systematically review recent advances in ML and DL supervised models for decoding and classifying EEG signals. Moreover, this article provides a comprehensive review of the state-of-the-art techniques used for EEG signal preprocessing and feature extraction. To this end, several academic databases were searched to explore relevant studies from the year 2000 to the present. Our results showed that the application of ML and DL in both mental workload and motor imagery tasks has received substantial attention in recent years. A total of 75% of DL studies applied convolutional neural networks with various learning algorithms, and 36% of ML studies achieved competitive accuracy by using a support vector machine algorithm. Wavelet transform was found to be the most common feature extraction method used for all types of tasks. We further examined the specific feature extraction methods and end classifier recommendations discovered in this systematic review.

Essentials of Predicting Epileptic Seizures Based on EEG Using Machine Learning: A Review

Objective:

Epilepsy is one of the chronic diseases, which requires exceptional attention. The unpredictability of the seizures makes it worse for a person suffering from epilepsy.

Methods:

The challenge to predict seizures using modern machine learning algorithms and computing resources would be a boon to a person with epilepsy and its caregivers. Researchers have shown great interest in the task of epileptic seizure prediction for a few decades. However, the results obtained have not clinical applicability because of the high false-positive ratio. The lack of standard practices in the field of epileptic seizure prediction makes it challenging for novice ones to follow the research. The chances of reproducibility of the result are negligible due to the unavailability of implementation environment-related details, use of standard datasets, and evaluation parameters.

Results:

Work here presents the essential components required for the prediction of epileptic seizures, which includes the basics of epilepsy, its treatment, and the need for seizure prediction algorithms. It also gives a detailed comparative analysis of datasets used by different researchers, tools and technologies used, different machine learning algorithm considerations, and evaluation parameters.

Conclusion:

The main goal of this paper is to synthesize different methodologies for creating a broad view of the state-of-the-art in the field of seizure prediction.

Automated Epileptic Seizure Detection in Pediatric Subjects of CHB-MIT EEG Database-A Survey

Epilepsy is a neurological disorder of the brain that causes frequent occurrence of seizures. Electroencephalography (EEG) is a tool that assists neurologists in detecting epileptic seizures caused by an unexpected flow of electrical activities in the brain. Automated detection of an epileptic seizure is a crucial task in diagnosing epilepsy which overcomes the drawback of a visual diagnosis. The dataset analyzed in this article, collected from Children's Hospital Boston (CHB) and the Massachusetts Institute of Technology (MIT), contains long-term EEG records from 24 pediatric patients. This review paper focuses on various patient-dependent and patient-independent personalized medicine approaches involved in the computer-aided diagnosis of epileptic seizures in pediatric subjects by analyzing EEG signals, thus summarizing the existing body of knowledge and opening up an enormous research area for biomedical engineers. This review paper focuses on the features of four domains, such as time, frequency, time-frequency, and nonlinear features, extracted from the EEG records, which were fed into several classifiers to classify between seizure and non-seizure EEG signals. Performance metrics such as classification accuracy, sensitivity, and specificity were examined, and challenges in automatic seizure detection using the CHB-MIT database were addressed.

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.

Artificial Intelligence shaping the future of neurology practice

Neurology practice has faced many challenges since Jean-Martin Charcot established its sacred tenets. Artificial Intelligence (AI) promises to revolutionize the time-tested neurology practice in unimaginable ways. AI can now diagnose stroke from CT/MRI scans, detect papilledema and diabetic retinopathy from retinal scans, interpret electroencephalogram (EEG) to prognosticate coma, detect seizure well before ictus, predict conversion of mild cognitive impairment to Alzheimer's dementia, classify neurodegenerative diseases based on gait and handwriting. Clinical practice would likely change in near future to accommodate AI as a complementary tool. The clinician should be prepared to change the perception of AI from nemesis to opportunity.

Automatic detection of epileptic seizures using Riemannian geometry from scalp EEG recordings

This paper proposes a new framework for epileptic seizure detection using non-invasive scalp electroencephalogram (sEEG) signals. The major innovation of the current study is using the Riemannian geometry for transforming the covariance matrices estimated from the EEG channels into a feature vector. The spatial covariance matrices are considered as features in order to extract the spatial information of the sEEG signals without applying any spatial filtering. Since these matrices are symmetric and positive definite (SPD), they belong to a special manifold called the Riemannian manifold. Furthermore, a kernel based on Riemannian geometry is proposed. This kernel maps the SPD matrices onto the Riemannian tangent space. The SPD matrices, obtained from all channels of the segmented sEEG signals, have high dimensions and extra information. For these reasons, the sequential forward feature selection method is applied to select the best features and reduce the computational burden in the classification step. The selected features are fed into a support vector machine (SVM) with an RBF kernel to classify the feature vectors into seizure and non-seizure classes. The performance of the proposed method is evaluated using two long-term scalp EEG (CHB-MIT benchmark and private) databases. Experimental results on all 23 subjects of the CHB-MIT database reveal an accuracy of 99.87%, a sensitivity of 99.91%, and a specificity of 99.82%. In addition, the introduced algorithm is tested on the private sEEG signals recorded from 20 patients, having 1380 seizures. The proposed approach achieves an accuracy, a sensitivity, and a specificity of 98.14%, 98.16%, and 98.12%, respectively. The experimental results on both sEEG databases demonstrate the effectiveness of the proposed method for automated epileptic seizure detection, especially for the private database which has noisier signals in comparison to the CHB-MIT database. Graphical Abstract Block diagram of the proposed epileptic seizure detection algorithm.

Classifying epilepsy pragmatically: Past, present, and future

The classification of epilepsy is essential for people with epilepsy and their families, healthcare providers, physicians and researchers. The International League Against Epilepsy proposed updated seizure and epilepsy classifications in 2017, while another four-dimensional epilepsy classification was updated in 2019. An Integrated Epilepsy Classification system was proposed in 2020. Existing classifications, however, lack consideration of important pragmatic factors relevant to the day-to-day life of people with epilepsy and stakeholders. Despite promising developments, consideration of comorbidities in brain development, genetic causes, and environmental triggers of epilepsy remains largely user-dependent in existing classifications. Demographics of epilepsy have changed over time, while existing classification schemes exhibit caveats. A pragmatic classification scheme should incorporate these factors to provide a nuanced classification. Validation across disparate contexts will ensure widespread applicability and ease of use. A team-based approach may simplify communication between healthcare personnel, while an individual-centred perspective may empower people with epilepsy. Together, incorporating these elements into a modern but pragmatic classification scheme may ensure optimal care for people with epilepsy by emphasising cohesiveness among its myriad users. Technological advancements such as 7T MRI, next-generation sequencing, and artificial intelligence may affect future classification efforts.

Automatic seizure detection using orthogonal matching pursuit, discrete wavelet transform, and entropy based features of EEG signals

BACKGROUND AND OBJECTIVE

Epilepsy is a prevalent disorder that affects the central nervous system, causing seizures. In the current study, a novel algorithm is developed using electroencephalographic (EEG) signals for automatic seizure detection from the continuous EEG monitoring data.

METHODS

In the proposed methods, the discrete wavelet transform (DWT) and orthogonal matching pursuit (OMP) techniques are used to extract different coefficients from the EEG signals. Then, some non-linear features, such as fuzzy/approximate/sample/alphabet and correct conditional entropy, along with some statistical features are calculated using the DWT and OMP coefficients. Three widely-used EEG datasets were utilized to assess the performance of the proposed techniques.

RESULTS

The proposed OMP-based technique along with the support vector machine classifier yielded an average specificity of 96.58%, an average accuracy of 97%, and an average sensitivity of 97.08% for different types of classification tasks. Moreover, the proposed DWT-based technique provided an average sensitivity of 99.39%, an average accuracy of 99.63%, and an average specificity of 99.72%.

CONCLUSIONS

The experimental findings indicated that the proposed algorithms outperformed other existing techniques. Therefore, these algorithms can be implemented in relevant hardware to help neurologists with seizure detection.

Integrating old and new complexity measures toward automated seizure detection from long-term video EEG recordings

Automated seizure detection in long-term video-EEG recordings is far from being integrated into common clinical practice. Here, we leverage classical and state-of-the-art complexity measures to robustly and automatically detect seizures from scalp recordings. Brain activity is scored through eight features, encompassing traditional time domain and novel measures of recurrence. A binary classification algorithm tailored to treat unbalanced dataset is used to determine whether a time window is ictal or non-ictal from its features. The application of the algorithm on a cohort of ten adult patients with focal refractory epilepsy indicates sensitivity, specificity, and accuracy of 90%, along with a true alarm rate of 95% and less than four false alarms per day. The proposed approach emphasizes ictal patterns against noisy background without the need of data preprocessing. Finally, we benchmark our approach against previous studies on two publicly available datasets, demonstrating the good performance of our algorithm.

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Complexity measures are formulated to enhance classical time-domain statistics of EEG

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The detection algorithm does not need ad-hoc data preprocessing to address artifacts

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Focal seizures are detected 95% of the time with less than four false alarms per day

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The approach offers a visual representation of a seizure as a time-evolving network

Seizure detection and epileptogenic zone localisation on heavily skewed MEG data using RUSBoost machine learning technique

Background: Epilepsy is a neurological disorder which is characterised by recurrent and involuntary seizures. Magnetoencephalography (MEG) is clinically used as a presurgical tool in locating the epileptogenic zone by localising either interictal epileptic discharges (IEDs) or ictal activities. The localisation of ictal onset provides reliable and more accurate seizure onset zones rather than localising the IEDs. Ictals or seizures are presently detected during MEG analysis by manually inspecting the recorded data. This is laborious when the duration of recordings is longer. Methods: We propose a novel method which uses statistical features such as short-time permutation entropy (STPE), gradient of STPE (GSTPE), short-time energy (STE) and short-time mean (STM) extracted from the ictal and interictal MEG data of drug resistant epilepsy patients group. Since the data is heavily skewed, the RUSBoost algorithm with k-fold cross-validation is used to classify the data into ictal and interictal by using the four feature vectors. This method is further used for localising the epileptogenic region using region-specific classifications by means of the RUSBoost algorithm. Results: The accuracy obtained for seizure detection is 93.4%. The specificity and sensitivity for the same are 93%. The localisation accuracies for each lobe are in the range of 88.1-99.1%. Discussion: Through this ictus detection method, the current scenario of laborious inspection of the ictal MEG can be reduced. The proposed system, thus, can be implemented in real-time as a better and more efficient method for seizure detection and further it can prove to be highly beneficial for patients and health-care professionals during real-time MEG recording. Furthermore, the identification of the epileptogenic lobe can provide clinicians with useful insights, and a pre-cursor for source localisation.

Electroencephalography source localization analysis in epileptic children during a visual working-memory task

We localize the sources of brain activity of children with epilepsy based on electroencephalograph (EEG) recordings acquired during a visual discrimination working memory task. For the numerical solution of the inverse problem, with the aid of age-specific MRI scans processed from a publicly available database, we use and compare three regularization numerical methods, namely the standardized low resolution brain electromagnetic tomography (sLORETA), the weighted minimum norm estimation (wMNE) and the dynamic statistical parametric mapping (dSPM). We show that all three methods provide the same spatio-temporal patterns of differences between the groups of epileptic and control children. In particular, our analysis reveals statistically significant differences between the two groups in regions of the parietal cortex indicating that these may serve as "biomarkers" for diagnostic purposes and ultimately localized treatment.

Allopregnanolone and perampanel as adjuncts to midazolam for treating diisopropylfluorophosphate-induced status epilepticus in rats

Combinations of midazolam, allopregnanolone, and perampanel were assessed for antiseizure activity in a rat diisopropylfluorophosphate (DFP) status epilepticus model. Animals receiving DFP followed by atropine and pralidoxime exhibited continuous high-amplitude rhythmical electroencephalography (EEG) spike activity and behavioral seizures for more than 5 hours. Treatments were administered intramuscularly 40 min after DFP. Seizures persisted following midazolam (1.8 mg/kg). The combination of midazolam with either allopregnanolone (6 mg/kg) or perampanel (2 mg/kg) terminated EEG and behavioral status epilepticus, but the onset of the perampanel effect was slow. The combination of midazolam, allopregnanolone, and perampanel caused rapid and complete suppression of EEG and behavioral seizures. In the absence of DFP, animals treated with the three-drug combination were sedated but not anesthetized. Animals that received midazolam alone exhibited spontaneous recurrent EEG seizures, whereas those that received the three-drug combination did not, demonstrating antiepileptogenic activity. All combination treatments reduced neurodegeneration as assessed with Fluoro-Jade C staining to a greater extent than midazolam alone, and most reduced astrogliosis as assessed by GFAP immunoreactivity but had mixed effects on markers of microglial activation. We conclude that allopregnanolone, a positive modulator of the GABAA receptor, and perampanel, an AMPA receptor antagonist, are potential adjuncts to midazolam in the treatment of benzodiazepine-refractory organophosphate nerve agent-induced status epilepticus.

Epileptic Seizure Detection Using Multi-Channel EEG Wavelet Power Spectra and 1-D Convolutional Neural Networks

The use of feature extraction and selection from EEG signals has shown to be useful in the detection of epileptic seizure segments. However, these traditional methods have more recently been surpassed by deep learning techniques, forgoing the need for complex feature engineering. This work aims to extend the conventional approach of epileptic seizure detection utilizing raw power spectra of EEG signals and convolutional neural networks (CNN). The proposed technique utilizes wavelet transform to compute the frequency characteristics of multi-channel EEG signals. The EEG signals are divided into 2 second epochs and frequency spectrum up to a cutoff frequency of 45 Hz is computed. This multi-channel raw spectral data forms the input to a one-dimensional CNN (1-D CNN). Spectral data from the current, previous, and next epochs is utilized for predicting the label of the current epoch. The performance of the technique is evaluated using a dataset of EEG signals from 24 cases. The proposed method achieves an accuracy of 97.25% in detecting epileptic seizure segments. This result shows that multi-channel EEG wavelet power spectra and 1-D CNN are useful in detecting epileptic seizures.

Real-time Inference and Detection of Disruptive EEG Networks for Epileptic Seizures

Recent studies in brain science and neurological medicine paid a particular attention to develop machine learning-based techniques for the detection and prediction of epileptic seizures with electroencephalogram (EEG). As a noninvasive monitoring method to record brain electrical activities, EEG has been widely used for capturing the underlying dynamics of disruptive neuronal responses across the brain in real-time to provide clinical guidance in support of epileptic seizure treatments in practice. In this study, we introduce a novel dynamic learning method that first infers a time-varying network constituted by multivariate EEG signals, which represents the overall dynamics of the brain network, and subsequently quantifies its topological property using graph theory. We demonstrate the efficacy of our learning method to detect relatively strong synchronization (characterized by the algebraic connectivity metric) caused by abnormal neuronal firing during a seizure onset. The computational results for a realistic scalp EEG database show a detection rate of 93.6% and a false positive rate of 0.16 per hour (FP/h); furthermore, our method observes potential pre-seizure phenomena in some cases.

Technology Use for Adolescent Health and Wellness

As avid users of technology, adolescents are a key demographic to engage when designing and developing technology applications for health. There are multiple opportunities for improving adolescent health, from promoting preventive behaviors to providing guidance for adolescents with chronic illness in supporting treatment adherence and transition to adult health care systems. This article will provide a brief overview of current technologies and then highlight new technologies being used specifically for adolescent health, such as artificial intelligence, virtual and augmented reality, and machine learning. Because there is paucity of evidence in this field, we will make recommendations for future research.

Machine learning applications for electroencephalograph signals in epilepsy: a quick review

Machine learning (ML) is a fundamental concept in the field of state-of-the-art artificial intelligence (AI). Over the past two decades, it has evolved rapidly and been employed wildly in many fields. In medicine the widespread usage of ML has been observed in recent years. The present review examines various ML approaches for electroencephalograph (EEG) signal procession in epilepsy research, highlighting applications in the aspect of automated seizure detection, prediction and orientation. The present review also presents advantage, challenge and future direction of ML techniques in the analysis of EEG signals in epilepsy.

Applications of Artificial Intelligence in Ophthalmology: General Overview

With the emergence of unmanned plane, autonomous vehicles, face recognition, and language processing, the artificial intelligence (AI) has remarkably revolutionized our lifestyle. Recent studies indicate that AI has astounding potential to perform much better than human beings in some tasks, especially in the image recognition field. As the amount of image data in imaging center of ophthalmology is increasing dramatically, analyzing and processing these data is in urgent need. AI has been tried to apply to decipher medical data and has made extraordinary progress in intelligent diagnosis. In this paper, we presented the basic workflow for building an AI model and systematically reviewed applications of AI in the diagnosis of eye diseases. Future work should focus on setting up systematic AI platforms to diagnose general eye diseases based on multimodal data in the real world.

Time-domain exponential energy for epileptic EEG signal classification

Automatic classification and prediction of epileptic electroencephalogram (EEG) signal are of great concern to the research community due to its non-stationary and non-linear properties. Features with minimal computation cost are highly needed for the rapid real-time precise diagnosis and implementation in the EEG scanning devices. Even though energy is a well-known feature for the analysis of signals, it is very rarely used in EEG analysis. An exponential energy feature in the time domain is proposed in this study. The proposed exponential energy feature provides a classification accuracy of 89% in the Bern-Barcelona EEG dataset and 99.5% in the Ralph Andrzejak EEG dataset. The promising results open a wide applicability of exponential energy in biomedical signal analysis.

Aetiological Features of Elderly Patients with Newly Diagnosed Symptomatic Epilepsy in Western China

Aims

Recent epidemiological studies have indicated that the incidence of epilepsy peaks after 60 years old, and epilepsy has become increasingly prevalent in elderly populations. The aim of this study is to identify the aetiologic characteristics of epilepsy in the elderly.

Methods

We retrospectively recruited elderly patients with newly diagnosed epilepsy identified in three epilepsy centres in western China; elderly patients were defined as individuals aged 60 years or older. Demographic characteristics, clinical epilepsy data, and the diagnosis and aetiology of epilepsy were recorded.

Results

A total of 760 patients with newly diagnosed epilepsy were enrolled in our study. Of these patients, 25% had experienced one or more episodes of status epilepticus, and 62.4% were confirmed as symptomatic. Among the symptomatic cohort, stroke and traumatic brain injury (TBI) were the two most common causes of epilepsy, followed by cerebral tumour, dementia, hippocampal sclerosis (HS), and central nervous system (CNS) infection. When analysed by residence and age, ischaemic stroke was the most common cause of epilepsy in urban patients, whereas traumatic brain injury was the leading cause of epilepsy in rural patients.

Conclusion

More than three-fifths of newly diagnosed epilepsy cases in elderly patients were confirmed as symptomatic, and stroke and traumatic brain injury were the primary aetiologies in elderly epileptic patients.

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.

Artificial neural network detects human uncertainty

Artificial neural networks (ANNs) are known to be a powerful tool for data analysis. They are used in social science, robotics, and neurophysiology for solving tasks of classification, forecasting, pattern recognition, etc. In neuroscience, ANNs allow the recognition of specific forms of brain activity from multichannel EEG or MEG data. This makes the ANN an efficient computational core for brain-machine systems. However, despite significant achievements of artificial intelligence in recognition and classification of well-reproducible patterns of neural activity, the use of ANNs for recognition and classification of patterns in neural networks still requires additional attention, especially in ambiguous situations. According to this, in this research, we demonstrate the efficiency of application of the ANN for classification of human MEG trials corresponding to the perception of bistable visual stimuli with different degrees of ambiguity. We show that along with classification of brain states associated with multistable image interpretations, in the case of significant ambiguity, the ANN can detect an uncertain state when the observer doubts about the image interpretation. With the obtained results, we describe the possible application of ANNs for detection of bistable brain activity associated with difficulties in the decision-making process.