Clinician's road map to wavelet EEG as an Alzheimer's disease biomarker

Fusing convolutional learning and attention-based Bi-LSTM networks for early Alzheimer's diagnosis from EEG signals towards IoMT

The Internet of Medical Things (IoMT) is poised to play a pivotal role in future medical support systems, enabling pervasive health monitoring in smart cities. Alzheimer's disease (AD) afflicts millions globally, and this paper explores the potential of electroencephalogram (EEG) data in addressing this challenge. We propose the Convolutional Learning Attention-Bidirectional Time-Aware Long-Short-Term Memory (CL-ATBiLSTM) model, a deep learning approach designed to classify different AD phases through EEG data analysis. The model utilizes Discrete Wavelet Transform (DWT) to decompose EEG data into distinct frequency bands, allowing for targeted analysis of AD-related brain activity patterns. Additionally, the data is segmented into smaller windows to handle the dynamic nature of EEG signals, and these segments are transformed into spectrogram images, visually depicting brain activity distribution over time and frequency. The CL-ATBiLSTM model incorporates convolutional layers to capture spatial features, attention mechanisms to emphasize crucial data, and BiLSTM networks to explore temporal relationships within the sequences. To optimize the model's performance, Bayesian optimization is employed to fine-tune the hyperparameters of the ATBiLSTM network, enhancing its ability to generalize and accurately classify AD stages. Incorporating Bayesian learning ensures the most effective model configuration, improving sensitivity and specificity for identifying AD-related patterns. Our model extracts discriminative features from EEG data to differentiate between AD, Mild Cognitive Impairment (MCI), and healthy controls (CO), offering a more comprehensive approach than existing two-class detection algorithms. By including the MCI category, our method facilitates earlier identification and potentially more impactful therapy interventions. Achieving a 96.52% accuracy on Figshare datasets containing AD, MCI, and CO groups, our approach demonstrates strong potential for practical use, accelerating AD identification, enhancing patient care, and contributing to the development of targeted treatments for this debilitating condition.

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.

Comparative analysis of weka-based classification algorithms on medical diagnosis datasets

BACKGROUND

With the advent of 5G and the era of Big Data, the rapid development of medical information technology around the world, the massive application of electronic medical records and cases, and the digitization of medical equipment and instruments, a large amount of data has accumulated in the database system of hospitals, which includes clinical diagnosis data and hospital management data.

OBJECTIVE

This study aimed to examine the classification effects of different machine learning algorithms on medical datasets so as to better explore the value of machine learning methods in aiding medical diagnosis.

METHODS

The classification datasets of four different medical fields in the University of California Irvine machine learning database were used as the research object. Also, six categories of classification models based on the Bayesian theorem idea, integrated learning idea, and rule-based and tree-based idea were constructed using the Weka platform.

RESULTS

The between-group experiments showed that the Random Forest algorithm achieved the best results on the Indian liver disease patient dataset (ILPD), delivery cardiotocography (CADG), and lymphatic tractography (LYMP) datasets, followed by Bagging and partition and regression tree. In the within-group algorithm comparison experiments, the Bagging algorithm achieved better results than other algorithms based on the integration idea for 11 metrics on all datasets, mainly focusing on 2 binary datasets. Logit Boost had only 7 metrics with significant performance, and the best algorithm was Rotation Forest, with 28 metrics achieving optimal values. Among the algorithms based on tree ideas, the logistic model tree algorithm achieved optimal results on all metrics on the mammographic dataset (MAGR). The classification performance of BFTree, J48, and Random Tree was poor on each dataset. The best algorithm was Random Forest on the ILPD, CADG, and LYMP datasets with 27 metrics reaching the optimum.

CONCLUSION

Machine learning algorithms have good application value in disease prediction and can provide a reference basis for disease diagnosis.

Routine magnetoencephalography in memory clinic patients: A machine learning approach

INTRODUCTION

We report the routine application of magnetoencephalography (MEG) in a memory clinic, and its value in the discrimination of patients with Alzheimer's disease (AD) dementia from controls.

METHODS

Three hundred sixty-six patients visiting our memory clinic underwent MEG recording. Source-reconstructed MEG data were visually assessed and evaluated in the context of clinical findings and other diagnostic markers. We analyzed the diagnostic accuracy of MEG spectral measures in the discrimination of individual AD dementia patients (n = 40) from subjective cognitive decline (SCD) patients (n = 40) using random forest models.

RESULTS

Best discrimination was obtained using a combination of relative theta and delta power (accuracy 0.846, sensitivity 0.855, specificity 0.837). The results were validated in an independent cohort. Hippocampal and thalamic regions, besides temporal-occipital lobes, contributed considerably to the model.

DISCUSSION

MEG has been implemented successfully in the workup of memory clinic patients and has value in diagnostic decision-making.

Machine Learning Algorithms and Statistical Approaches for Alzheimer's Disease Analysis Based on Resting-State EEG Recordings: A Systematic Review

Alzheimer's Disease (AD) is a neurodegenerative disorder and the most common type of dementia with a great prevalence in western countries. The diagnosis of AD and its progression is performed through a variety of clinical procedures including neuropsychological and physical examination, Electroencephalographic (EEG) recording, brain imaging and blood analysis. During the last decades, analysis of the electrophysiological dynamics in AD patients has gained great research interest, as an alternative and cost-effective approach. This paper summarizes recent publications focusing on (a) AD detection and (b) the correlation of quantitative EEG features with AD progression, as it is estimated by Mini Mental State Examination (MMSE) score. A total of 49 experimental studies published from 2009 until 2020, which apply machine learning algorithms on resting state EEG recordings from AD patients, are reviewed. Results of each experimental study are presented and compared. The majority of the studies focus on AD detection incorporating Support Vector Machines, while deep learning techniques have not yet been applied on large EEG datasets. Promising conclusions for future studies are presented.

A newly developed free software tool set for averaging electroencephalogram implemented in the Perl programming language

Background

Considering the need for daily activity analysis of older adults, development of easy-to-use, free electroencephalogram (EEG) analysis tools are desired in order to decrease barriers to accessing this technology and increase the entry of a wide range of new researchers.

New method

We describe a newly developed tool set for EEG analysis, enabling import, average, waveform display and iso-potential scalp topographies, utilizing the programming language Perl.

Results

The basic processing, including average, display waveforms, and isopotential scalp topography was implemented in the current system. The validation was examined by making difference waveforms between the results using the current analysis system and a commercial software.

Comparison with Existing Method(s): The current software tool set consists of free software. The scripts are easily editable by any user and there are no black boxes.

Conclusions

The currently reported procedures provide an easy-to-begin, flexible, readable, easy-to-modify basic tool set for EEG analysis and is expected to recruit new EEG researchers.

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.

Early diagnosis of mild cognitive impairment and Alzheimer's with event-related potentials and event-related desynchronization in N-back working memory tasks

BACKGROUND AND OBJECTIVE

In this study we investigate whether or not event-related potentials (ERP) and/or event-related (de)synchronization (ERD/ERS) can be used to differentiate between 27 healthy elderly (HE), 21 subjects diagnosed with mild cognitive impairment (MCI) and 15 mild Alzheimer's disease (AD) patients.

METHODS

Using 32-channel EEG recordings, we measured ERP responses to a three-level (N-back, N = 0,1,2) visual working memory task. We also performed ERD analysis over the same EEG data, dividing the full-band signal into the well-known delta, theta, alpha, beta and gamma bands. Both ERP and ERD analyses were followed by cluster analysis with correction for multicomparisons whenever significant differences were found between groups.

RESULTS

Regarding ERP (full-band analysis), our findings have shown both patient groups (MCI and AD) with reduced P450 amplitude (compared to HE controls) in the execution of the non-match 1-back task at many scalp electrodes, chiefly at parietal and centro-parietal areas. However, no significant differences were found between MCI and AD in ERP analysis whatever was the task. As for sub-band analyses, ERD/ERS measures revealed that HE subjects elicited consistently greater alpha ERD responses than MCI and AD patients during the 1-back task in the match condition, with all differences located at frontal, central and occipital regions. Moreover, in the non-match condition, it was possible to distinguish between MCI and AD patients when they were performing the 0-back task, with MCI presenting more desynchronization than AD on the theta band at temporal and fronto-temporal areas. In summary, ERD analyses have revealed themselves more valuable than ERP, since they showed significant differences in all three group comparisons: HE vs. MCI, HE vs. AD, and MCI vs. AD.

CONCLUSIONS

Based on these findings, we conclude that ERD responses to working memory (N-back) tasks could be useful not only for early MCI diagnosis or for improved AD diagnosis, but probably also for assessing the likelihood of MCI progression to AD, after further validated by a longitudinal study.

Spinal cord stimulation modulates frontal delta and gamma in patients of minimally consciousness state

Spinal cord stimulation (SCS) has been suggested as a therapeutic technique for treating patients with disorder of consciousness (DOC). Although studies have reported its benefits for patients, the underlying pathophysiological mechanisms remain unclear. The aim of this study was to measure the effects of SCS on the EEG of patients in a minimally conscious state (MCS), which would allow us to explore the possible workings underpinning of the approach. Resting state EEG was recorded before and immediately after SCS, using various frequencies (5Hz, 20Hz, 50Hz, 70Hz and 100Hz), for 11 patients in MCS. Relative power, coherence, S-estimator and bicoherence were calculated to assess the EEG changes. Five frequency bands (delta, theta, alpha, beta and gamma) and three regions (frontal, central and posterior) were divided in the calculation. The main findings of this study were that: (1) significantly altered relative power and synchronisation was found in delta and gamma bands after one SCS stimulation using 5Hz, 70Hz or 100Hz; (2) bicoherence showed that coupling within delta was significantly decreased after stimulation using 70Hz, while reduction of coupling between delta and gamma was found when using 5Hz and 100Hz. However, SCS of 20Hz, 50Hz and sham stimulation did not induce changes in any frequency band at any region. This study showed EEG evidence that SCS can modulate the brain function of MCS patients, speculatively by activating the formation-thalamus-cortex network.

EEG epochs with less alpha rhythm improve discrimination of mild Alzheimer's

BACKGROUND AND OBJECTIVE

Eyes-closed-awake electroencephalogram (EEG) is a useful tool in the diagnosis of Alzheimer's. However, there is eyes-closed-awake EEG with dominant or rare alpha rhythm. In this paper, we show that random selection of EEG epochs disregarding the alpha rhythm will lead to bias concerning EEG-based Alzheimer's Disease diagnosis.

METHODS

We compared EEG epochs with more than 30% and with less than 30% alpha rhythm of mild Alzheimer's Disease patients and healthy elderly. We classified epochs as dominant alpha scenario and rare alpha scenario according to alpha rhythm (8-13 Hz) percentage in O1, O2 and Oz channels. Accordingly, we divided the probands into four groups: 17 dominant alpha scenario controls, 15 mild Alzheimer's patients with dominant alpha scenario epochs, 12 rare alpha scenario healthy elderly and 15 mild Alzheimer's Disease patients with rare alpha scenario epochs. We looked for group differences using one-way ANOVA tests followed by post-hoc multiple comparisons (p < 0.05) over normalized energy values (%) on the other four well-known frequency bands (delta, theta, beta and gamma) using two different electrode configurations (parieto-occipital and central).

RESULTS

After carrying out post-hoc multiple comparisons, for both electrode configurations we found significant differences between mild Alzheimer's patients and healthy elderly on beta- and theta-energy (%) only for the rare alpha scenario. No differences were found for the dominant alpha scenario in any of the five frequency bands.

CONCLUSIONS

This is the first study of Alzheimer's awake-EEG reporting the influence of alpha rhythm on epoch selection, where our results revealed that, contrarily to what was most likely expected, less synchronized EEG epochs (rare alpha scenario) better discriminated mild Alzheimer's than those presenting abundant alpha (dominant alpha scenario). In addition, we find out that epoch selection is a very sensitive issue in qEEG research. Consequently, for Alzheimer's studies dealing with resting state EEG, we propose that epoch selection strategies should always be cautiously designed and thoroughly explained.

Regularized Linear Discriminant Analysis of EEG Features in Dementia Patients

The present study explores if EEG spectral parameters can discriminate between healthy elderly controls (HC), Alzheimer's disease (AD) and vascular dementia (VaD) using. We considered EEG data recorded during normal clinical routine with 114 healthy controls (HC), 114 AD, and 114 VaD patients. The spectral features extracted from the EEG were the absolute delta power, decay from lower to higher frequencies, amplitude, center and dispersion of the alpha power and baseline power of the entire frequency spectrum. For discrimination, we submitted these EEG features to regularized linear discriminant analysis algorithm with a 10-fold cross-validation. To check the consistency of the results obtained by our classifiers, we applied bootstrap statistics. Four binary classifiers were used to discriminate HC from AD, HC from VaD, AD from VaD, and HC from dementia patients (AD or VaD). For each model, we measured the discrimination performance using the area under curve (AUC) and the accuracy of the cross-validation (cv-ACC). We applied this procedure using two different sets of predictors. The first set considered all the features extracted from the 22 channels. For the second set of features, we automatically rejected features poorly correlated with their labels. Fairly good results were obtained when discriminating HC from dementia patients with AD or VaD (AUC = 0.84). We also obtained AUC = 0.74 for discrimination of AD from HC, AUC = 0.77 for discrimination of VaD from HC, and finally AUC = 0.61 for discrimination of AD from VaD. Our models were able to separate HC from dementia patients, and also and to discriminate AD from VaD above chance. Our results suggest that these features may be relevant for the clinical assessment of patients with dementia.

Integrative Frequency Power of EEG Correlates with Progression of Mild Cognitive Impairment to Dementia in Parkinson's Disease

Clinically, predicting the progression of mild cognitive impairment (MCI) and diagnosing dementia in Parkinson's disease (PD) are difficult. This study aims to explore an integrative electroencephalography (EEG) frequency power that could be used to predict the progression of MCI in PD patients. Twenty-six PD patients, in this study, were divided into the mild cognitive impairment group (PDMCI, 17 patients) and dementia group (PDD, 9 patients) according to cognitive performance. Beta peak frequency, alpha relative power, and alpha/theta power were recorded and analyzed for the prediction. Mini Mental State Examination (MMSE) scores at initiation, in the first year, and in the second year were examined. The sensitivity, specificity, positive predictive value, Matthew correlation coefficient, and positive likelihood ratio were calculated in both the integrative EEG biomarkers and single best biomarker. Of the 17 patients with MCI for 2 years, 6 progressed to dementia. Integrative EEG biomarkers, mainly associated with beta peak frequency, can predict conversion from MCI to dementia. These biomarkers had sensitivity of 82% and specificity of 78%, compared with sensitivity of 61% and specificity of 58% of the beta peak frequency. In conclusion, the integrative EEG frequency powers were more sensitive and specific to MCI progression in PD patients.

The effects of automated artifact removal algorithms on electroencephalography-based Alzheimer's disease diagnosis

Over the last decade, electroencephalography (EEG) has emerged as a reliable tool for the diagnosis of cortical disorders such as Alzheimer's disease (AD). EEG signals, however, are susceptible to several artifacts, such as ocular, muscular, movement, and environmental. To overcome this limitation, existing diagnostic systems commonly depend on experienced clinicians to manually select artifact-free epochs from the collected multi-channel EEG data. Manual selection, however, is a tedious and time-consuming process, rendering the diagnostic system “semi-automated.” Notwithstanding, a number of EEG artifact removal algorithms have been proposed in the literature. The (dis)advantages of using such algorithms in automated AD diagnostic systems, however, have not been documented; this paper aims to fill this gap. Here, we investigate the effects of three state-of-the-art automated artifact removal (AAR) algorithms (both alone and in combination with each other) on AD diagnostic systems based on four different classes of EEG features, namely, spectral, amplitude modulation rate of change, coherence, and phase. The three AAR algorithms tested are statistical artifact rejection (SAR), blind source separation based on second order blind identification and canonical correlation analysis (BSS-SOBI-CCA), and wavelet enhanced independent component analysis (wICA). Experimental results based on 20-channel resting-awake EEG data collected from 59 participants (20 patients with mild AD, 15 with moderate-to-severe AD, and 24 age-matched healthy controls) showed the wICA algorithm alone outperforming other enhancement algorithm combinations across three tasks: diagnosis (control vs. mild vs. moderate), early detection (control vs. mild), and disease progression (mild vs. moderate), thus opening the doors for fully-automated systems that can assist clinicians with early detection of AD, as well as disease severity progression assessment.