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

Electrocardiogram (ECG) recordings, lasting hours before epileptic seizures, have been studied in the search for evidence of the existence of a preictal interval that follows a normal ECG trace and precedes the seizure's clinical manifestation. The preictal interval has not yet been clinically parametrized. Furthermore, the duration of this interval varies for seizures both among patients and from the same patient. In this study, we performed a heart rate variability (HRV) analysis to investigate the discriminative power of the features of HRV in the identification of the preictal interval. HRV information extracted from the linear time and frequency domains as well as from nonlinear dynamics were analysed. We inspected data from 238 temporal lobe seizures recorded from 41 patients with drug-resistant epilepsy from the EPILEPSIAE database. Unsupervised methods were applied to the HRV feature dataset, thus leading to a new perspective in preictal interval characterization. Distinguishable preictal behaviour was exhibited by 41% of the seizures and 90% of the patients. Half of the preictal intervals were identified in the 40 min before seizure onset. The results demonstrate the potential of applying clustering methods to HRV features to deepen the current understanding of the preictal state.FCT: CISUC -UID/CEC/00326/2020/ SFRH/BD/147862/2019info:eu-repo/semantics/publishedVersio

Computational modelling in source space from scalp EEG to inform presurgical evaluation of epilepsy

This is the author accepted manuscript. The final version is available on open access from Elsevier via the DOI in this recordObjective: The effectiveness of intracranial electroencephalography (iEEG) to inform epilepsy surgery depends on where iEEG electrodes are implanted. This decision is informed by noninvasive recording modalities such as scalp EEG. Herein we propose a framework to interrogate scalp EEG and determine epilepsy lateralization to aid in electrode implantation. Methods: We use eLORETA to map source activities from seizure epochs recorded from scalp EEG and consider 15 regions of interest (ROIs). Functional networks are then constructed using the phase-locking value and studied using a mathematical model. By removing different ROIs from the network and simulating their impact on the network’s ability to generate seizures in silico, the framework provides predictions of epilepsy lateralization. We consider 15 individuals from the EPILEPSIAE database and study a total of 62 seizures. Results were assessed by taking into account actual intracranial implantations and surgical outcome. Results: The framework provided potentially useful information regarding epilepsy lateralization in 12 out of the 15 individuals (p=0.02, binomial test). Conclusions: Our results show promise for the use of this framework to better interrogate scalp EEG to determine epilepsy lateralization. Significance: The framework may aid clinicians in the decision process to define where to implant electrodes for intracranial monitoring.Medical Research CouncilEpilepsy Research UKEngineering and Physical Sciences Research Council (EPSRC)Wellcome TrustEngineering and Physical Sciences Research Council (EPSRC)Innovate UKEuropean Union’s Horizon 2020Alzheimer's SocietyMedical Research Counci

Electroencephalogram data platform for application of reduction methods

Long-term electroencephalogram (EEG) monitoring (≥24-h) is a resourceful tool for properly diagnosis sparse life-threatening events like non-convulsive seizures and status epilepticus in Intensive Care Unit (ICU) inpatients. Such EEG data requires objective methods for data reduction, transmission and analysis. This work aims to assess specificity and sensibility of HaEEG and aEEG methods in combination with conventional multichannel EEG when achieving seizure detection. A database architecture was designed to handle the interoperability, processing, and analysis of EEG data. Using data from CHB-MIT public EEG database, the reduced signal was obtained by EEG envelope segmentation, with 10 and 90 percentiles obtained for each segment. The use of asymmetrical filtering (2-15 Hz) and overall clinical band (1-70 Hz) was compared. The upper and lower margins of compressed segments were used to classify ictal and non-ictal epochs. Such classification was compared with the corresponding specialist seizure annotation for each patient. The difference between medians of instantaneous frequencies of ictal and non-ictal periods were assessed using Wilcoxon Rank Sum Test, which was significant for signals filtered from 2 to 15 Hz (p = 0.0055) but not for signals filtered from 1 to 70 Hz (p = 0.1816).O eletroencefalograma (EEG) de longa duração (≥24-h) em monitoramento contínuo é diferencial no diagnóstico e classificação de eventos epileptiformes, como crises não convulsivas e status epilepticus, em pacientes de Unidades de Tratamento Intensivo (UTI). Este exame requer métodos objetivos de análise, redução e transmissão de dados. O objetivo desse trabalho é avaliar a especificidade e a sensibilidade dos métodos HaEEG e aEEG em combinação com EEG multicanal convencional na detecção de eventos epileptiformes. Uma arquitetura de integração de dados foi projetada para gerir o armazenamento, processamento e análise de dados de EEG. Foram utilizados dados do banco de dados de EEG público do CHB-MIT. O sinal reduzido foi obtido pela segmentação do envelope do EEG, com percentis 10 e 90 obtidos para cada segmento. A aplicação do filtro assimétrico (2-15 Hz) e em bandas clínicas (1-70 Hz) foi comparada. Os limiares superiores e inferiores dos segmentos do aEEG e HaEEG foram usados para classificar épocas ictais e não ictais. A classificação foi comparada com as anotações feitas por um especialista para cada paciente. As medianas das frequências instantâneas para períodos ictais e não ictais foram analisadas com Wilcoxon Rank Sum Test com significância para filtragem assimétrica (p = 0,0055), mas não nas bandas clínicas (p = 0,1816)

Decentralized Federated Learning for Epileptic Seizures Detection in Low-Power Wearable Systems

In healthcare, data privacy of patients regulations prohibits data from being moved outside the hospital, preventing international medical datasets from being centralized for AI training. Federated learning (FL) is a data privacy-focused method that trains a global model by aggregating local models from hospitals. Existing FL techniques adopt a central server-based network topology, where the server assembles the local models trained in each hospital to create a global model. However, the server could be a point of failure, and models trained in FL usually have worse performance than those trained in the centralized learning manner when the patient's data are not independent and identically distributed (Non-IID) in the hospitals. This paper presents a decentralized FL framework, including training with adaptive ensemble learning and a deployment phase using knowledge distillation. The adaptive ensemble learning step in the training phase leads to the acquisition of a specific model for each hospital that is the optimal combination of local models and models from other available hospitals. This step solves the non-IID challenges in each hospital. The deployment phase adjusts the model's complexity to meet the resource constraints of wearable systems. We evaluated the performance of our approach on edge computing platforms using EPILEPSIAE and TUSZ databases, which are public epilepsy datasets.RYC2021-032853-

Big data in epilepsy: Clinical and research considerations. Report from the Epilepsy Big Data Task Force of the International League Against Epilepsy

Epilepsy is a heterogeneous condition with disparate etiologies and phenotypic and genotypic characteristics. Clinical and research aspects are accordingly varied, ranging from epidemiological to molecular, spanning clinical trials and outcomes, gene and drug discovery, imaging, electroencephalography, pathology, epilepsy surgery, digital technologies, and numerous others. Epilepsy data are collected in the terabytes and petabytes, pushing the limits of current capabilities. Modern computing firepower and advances in machine and deep learning, pioneered in other diseases, open up exciting possibilities for epilepsy too. However, without carefully designed approaches to acquiring, standardizing, curating, and making available such data, there is a risk of failure. Thus, careful construction of relevant ontologies, with intimate stakeholder inputs, provides the requisite scaffolding for more ambitious big data undertakings, such as an epilepsy data commons. In this review, we assess the clinical and research epilepsy landscapes in the big data arena, current challenges, and future directions, and make the case for a systematic approach to epilepsy big data

Convolutional Neural Network for Seizure Detection of Nocturnal Frontal Lobe Epilepsy

The Nocturnal Frontal Lobe Epilepsy (NFLE) is a form of epilepsy in which seizures occur predominantly during sleep. In other forms of epilepsy, the commonly used clinical approach mainly involves manual inspection of encephalography (EEG) signals, a laborious and time-consuming process which often requires the contribution of more than one experienced neurologist. In the last decades, numerous approaches to automate this detection have been proposed and, more recently, machine learning has shown very promising performance. In this paper, an original Convolutional Neural Network (CNN) architecture is proposed to develop patient-specific seizure detection models for three patients affected by NFLE. The performances, in terms of accuracy, sensitivity, and specificity, exceed by several percentage points those in the most recent literature. The capability of the patient-specific models has been also tested to compare the obtained seizure onset times with those provided by the neurologists, with encouraging results. Moreover, the same CNN architecture has been used to develop a cross-patient seizure detection system, resorting to the transfer-learning paradigm. Starting from a patient-specific model, few data from a new patient are enough to customize his model. This contribution aims to alleviate the task of neurologists, who may have a robust indication to corroborate their clinical conclusions