67 research outputs found
EpiGauss : caracterização espacio-temporal da actividade cerebral em epilepsia
Doutoramento em Engenharia ElectrotĂ©cnicaA epilepsia Ă© uma patologia cerebral que afecta cerca de 0,5% da população mundial. Nas epilepsias focais, o principal objectivo clĂnico Ă© a localização da zona epileptogĂ©nica (área responsável pelas crises), uma informação crucial para uma terapĂŞutica adequada. Esta tese Ă© centrada na caracterização da actividade cerebral electromagnĂ©tica do cĂ©rebro epilĂ©ptico. As contribuições nesta área, entre a engenharia e neurologia clĂnica, sĂŁo em duas direcções. Primeiro, mostramos que os conceitos associados Ă s pontas podem ser imprecisos e nĂŁo ter uma definição objectiva, tornando necessária uma reformulação de forma a definir uma referĂŞncia fiável em estudos relacionados com a análise de pontas. Mostramos que as caracterĂsticas das pontas em EEG sĂŁo estatisticamente diferentes das pontas em MEG. Esta constatação leva a concluir que a falta de objectividade na definição de ponta na literatura pode induzir utilizações erradas de conceitos associados ao EEG na análise de MEG. TambĂ©m verificamos que o uso de conjuntos de detecções de pontas efectuadas por especialistas (MESS) como referĂŞncia pode fornecer resultados enganadores quando apenas baseado em critĂ©rios de consenso clĂnico, nomeadamente na avaliação da sensibilidade e especificidade de mĂ©todos computorizados de detecção de pontas Em segundo lugar, propomos o uso de mĂ©todos estatĂsticos para ultrapassar a falta de precisĂŁo e objectividade das definições relacionadas com pontas. Propomos um novo mĂ©todo de neuroimagem suportado na caracterização de geradores electromagnĂ©ticos – EpiGauss – baseado na análise individual dos geradores de eventos do EEG que explora as suas estruturas espacio-temporais atravĂ©s da análise de “clusters”. A aplicação de análise de “clusters” Ă análise geradores de eventos do EEG tem como objectivo usar um mĂ©todo nĂŁo supervisionado, para encontrar estruturas espacio-temporais dps geradores relevantes. Este mĂ©todo, como processo nĂŁo supervisionado, Ă© orientado a utilizadores clĂnicos e apresenta os resultados sob forma de imagens mĂ©dicas com interpretação similar a outras tĂ©cnicas de imagiologia cerebral. Com o EpiGauss, o utilizador pode determinar a localização estatisticamente mais provável de geradores, a sua estabilidade espacial e possĂveis propagações entre diferente áreas do cĂ©rebro. O mĂ©todo foi testado em dois estudos clĂnicos envolvendo doentes com epilepsia associada aos hamartomas hipotalâmicos e o outro com doentes com diagnĂłstico de epilepsia occipital. Em ambos os estudos, o EpiGauss foi capaz de identificar a zona epileptogĂ©nica clĂnica, de forma consistente com a histĂłria e avaliação clĂnica dos neurofisiologistas, fornecendo mais informação relativa Ă estabilidade dos geradores e possĂveis percursos de propagação da actividade epileptogĂ©nica contribuindo para uma melhor caracterização clĂnica dos doentes. A conclusĂŁo principal desta tese Ă© que o uso de tĂ©cnicas nĂŁo supervisionadas, como a análise de “clusters”, associadas as tĂ©cnicas nĂŁo-invasivas de EMSI, pode contribuir com um valor acrescido no processo de diagnĂłstico clĂnico ao fornecer uma caracterização objectiva e representação visual de padrões complexos espaciotemporais da actividade elĂ©ctrica epileptogĂ©nica.Epilepsy is a brain pathology that affects 0.5% of the world population. In focal epilepsies, the main clinical objective is the localization of the epileptogenic zone (brain area responsible for the epileptic seizures – EZ), a key information to decide an adequate therapeutic approach. This thesis is centred on electromagnetic activity characterization of the epileptic brain. Our contribution to this boundary area between engineering and clinical neurology is two-folded. First we show that spike related clinical concepts can be unprecise and some do not have objective definitions making necessary a reformulation in order to have a reliable reference in spike related studies. We show that EEG spike wave quantitative features are statistically different from their MEG counterparts. This finding leads to the conclusion that the lack of objective spike feature definitions in the literature can induce the wrong usage of EEG feature definition in MEG analysis. We also show that the use of multi-expert spike selections sets (MESS) as gold standard, although clinically useful, may be misleading whenever defined solely in terms of clinical agreement criteria, namely as references for automatic spike detection algorithms in sensitivity and specificity method analysis. Second, we propose the use of statistical methods to overcome some lack of precision and objectivity in spike related definitions. In this context, we propose a new ElectroMagnetic Source Imaging (EMSI) method – EpiGauss – based on cluster analysis that explores both spatial and temporal information contained in individual events sources analysis characterisation. This automatic cluster method for the analysis of spike related electric generators based in EEG is used to provide an unsupervised tool to find their relevant spatio-temporal structures. This method enables a simple unsupervised procedure aimed for clinical users and presents its results in an intuitive representation similar to other brain imaging techniques. With EpiGauss, the user is able to determine statistically probable source locations, their spatial stability and propagation patterns between different brain areas. The method was tested in two different clinical neurophysiology studies, one with a group of Hypothalamic Hamartomas and another with a group of Occipital Epilepsy patients. In both studies EpiGauss identified the clinical epileptogenic zone, consistent with the clinical background and evaluation of neurophysiologists, providing further information on stability of source locations and their probable propagation pathways that enlarges their clinical interpretation. This thesis main conclusion is that the use of unsupervised techniques, such as clustering, associated with EMSI non-invasive techniques, can bring an added value in clinical diagnosis process by providing objective and visual representation of complex epileptic brain spatio-temporal activity patterns
The Value of Seizure Semiology in Epilepsy Surgery: Epileptogenic-Zone Localisation in Presurgical Patients using Machine Learning and Semiology Visualisation Tool
Background
Eight million individuals have focal drug resistant epilepsy worldwide. If their epileptogenic focus is identified and resected, they may become seizure-free and experience significant improvements in quality of life. However, seizure-freedom occurs in less than half of surgical resections.
Seizure semiology - the signs and symptoms during a seizure - along with brain imaging and electroencephalography (EEG) are amongst the mainstays of seizure localisation. Although there have been advances in algorithmic identification of abnormalities on EEG and imaging, semiological analysis has remained more subjective.
The primary objective of this research was to investigate the localising value of clinician-identified semiology, and secondarily to improve personalised prognostication for epilepsy surgery.
Methods
I data mined retrospective hospital records to link semiology to outcomes. I trained machine learning models to predict temporal lobe epilepsy (TLE) and determine the value of semiology compared to a benchmark of hippocampal sclerosis (HS).
Due to the hospital dataset being relatively small, we also collected data from a systematic review of the literature to curate an open-access Semio2Brain database. We built the Semiology-to-Brain Visualisation Tool (SVT) on this database and retrospectively validated SVT in two separate groups of randomly selected patients and individuals with frontal lobe epilepsy.
Separately, a systematic review of multimodal prognostic features of epilepsy surgery was undertaken.
The concept of a semiological connectome was devised and compared to structural connectivity to investigate probabilistic propagation and semiology generation.
Results
Although a (non-chronological) list of patients’ semiologies did not improve localisation beyond the initial semiology, the list of semiology added value when combined with an imaging feature. The absolute added value of semiology in a support vector classifier in diagnosing TLE, compared to HS, was 25%. Semiology was however unable to predict postsurgical outcomes. To help future prognostic models, a list of essential multimodal prognostic features for epilepsy surgery were extracted from meta-analyses and a structural causal model proposed.
Semio2Brain consists of over 13000 semiological datapoints from 4643 patients across 309 studies and uniquely enabled a Bayesian approach to localisation to mitigate TLE publication bias. SVT performed well in a retrospective validation, matching the best expert clinician’s localisation scores and exceeding them for lateralisation, and showed modest value in localisation in individuals with frontal lobe epilepsy (FLE).
There was a significant correlation between the number of connecting fibres between brain regions and the seizure semiologies that can arise from these regions.
Conclusions
Semiology is valuable in localisation, but multimodal concordance is more valuable and highly prognostic. SVT could be suitable for use in multimodal models to predict the seizure focus
Mining Biomarkers Of Epilepsy From Large-Scale Intracranial Electroencephalography
Epilepsy is a chronic neurological disorder characterized by seizures. Affecting over 50 million people worldwide, the quality of life of a patient with uncontrolled epilepsy is degraded by medical, social, cognitive, and psychological dysfunction. Fortunately, two-thirds of these patients can achieve adequate seizure control through medications. Unfortunately, one-third cannot.
Improving treatment for this patient population depends upon improving our understanding of the underlying epileptic network. Clinical therapies modulate this network to some degree of success, including surgery to remove the seizure onset zone or neuromodulation to alter the brain\u27s dynamics. High resolution intracranial EEG (iEEG) is often employed to study the dynamics of cortical networks, from interictal patterns to more complex quantitative features. These interictal patterns include epileptiform biomarkers whose detection and mapping, along with seizures and neuroimaging, form the mainstay of data for clinical decision making around drug therapy, surgery, and devices. They are also increasingly important to assess the effects of epileptic physiology on brain functions like behavior and cognition, which are not well characterized.
In this work, we investigate the significance and trends of epileptiform biomarkers in animal and human models of epilepsy. We develop reliable methods to quantify interictal patterns, applying state of the art techniques from machine learning, signal processing, and EEG analysis. We then validate these tools in three major applications: 1. We study the effect of interictal spikes on human cognition, 2. We assess trends of interictal epileptiform bursts and their relationship to seizures in prolonged recordings from canines and rats, and 3. We assess the stability of long-term iEEG spanning several years. These findings have two main impacts: (1) they inform the interpretation of interictal iEEG patterns and elucidate the timescale of post-implantation changes. These findings have important implications for research and clinical care, particularly implantable devices and evaluating patients for epilepsy surgery. (2) They provide an analytical framework to enable others to mine large-scale iEEG datasets. In this way we hope to make a lasting contribution to accelerate collaborative research not only in epilepsy, but also in the study of animal and human electrophysiology in acute and chronic conditions
Towards Accurate Forecasting of Epileptic Seizures: Artificial Intelligence and Effective Connectivity Findings
L’épilepsie est une des maladies neurologiques les plus fréquentes, touchant près d’un
pourcent de la population mondiale. De nos jours, bien qu’environ deux tiers des patients
épileptiques répondent adéquatement aux traitements pharmacologiques, il reste qu’un tiers des
patients doivent vivre avec des crises invalidantes et imprévisibles. Quoique la chirurgie
d’épilepsie puisse être une autre option thérapeutique envisageable, le recours à la chirurgie de
résection demeure très faible en partie pour des raisons diverses (taux de réussite modeste, peur
des complications, perceptions négatives). D’autres avenues de traitement sont donc souhaitables.
Une piste actuellement explorĂ©e par des groupes de chercheurs est de tenter de prĂ©dire les crises Ă
partir d’enregistrements de l’activité cérébrale des patients. La capacité de prédire la survenue de
crises permettrait notamment aux patients, aidants naturels ou personnels médical de prendre des
mesures de précaution pour éviter les désagréments reliés aux crises voire même instaurer un
traitement pour les faire avorter. Au cours des dernières années, d’importants efforts ont été
déployés pour développer des algorithmes de prédiction de crises et d’en améliorer les
performances.
Toutefois, le manque d’enregistrements électroencéphalographiques intracrâniens (iEEG) de
longue durée de qualité, la quantité limitée de crises, ainsi que la courte durée des périodes
interictales constituaient des obstacles majeurs à une évaluation adéquate de la performance des
algorithmes de prédiction de crises. Récemment, la disponibilité en ligne d’enregistrements iEEG
continus avec échantillonnage bilatéral (des deux hémisphères) acquis chez des chiens atteints
d’épilepsie focale à l’aide du dispositif de surveillance ambulatoire implantable NeuroVista a
partiellement facilité cette tâche. Cependant, une des limitations associées à l’utilisation de ces
données durant la conception d’un algorithme de prédiction de crises était l’absence
d’information concernant la zone exacte de début des crises (information non fournie par les
gestionnaires de cette base de données en ligne). Le premier objectif de cette thèse était la mise
en oeuvre d’un algorithme précis de prédiction de crises basé sur des enregistrements iEEG canins
de longue durée. Les principales contributions à cet égard incluent une localisation quantitative
de la zone d’apparition des crises (basée sur la fonction de transfert dirigé –DTF), l’utilisation
d’une nouvelle fonction de coût via l’algorithme génétique proposé, ainsi qu’une évaluation
quasi-prospective des performances de prédiction (données de test d’un total de 893 jours). Les résultats ont montré une amélioration des performances de prédiction par rapport aux études
antérieures, atteignant une sensibilité moyenne de 84.82 % et un temps en avertissement de 10 %.
La DTF, utilisée précédemment comme mesure de connectivité pour déterminer le réseau
épileptique (objectif 1), a été préalablement validée pour quantifier les relations causales entre les
canaux lorsque les exigences de quasi-stationnarité sont satisfaites. Ceci est possible dans le cas
des enregistrements canins en raison du nombre relativement faible de canaux. Pour faire face
aux exigences de non-stationnarité, la fonction de transfert adaptatif pondérée par le spectre
(Spectrum weighted adaptive directed transfer function - swADTF) a été introduit en tant qu’une
version variant dans le temps de la DTF. Le second objectif de cette thèse était de valider la
possibilité d’identifier les endroits émetteurs (ou sources) et récepteurs d’activité épileptiques en
appliquant la swADTF sur des enregistrements iEEG de haute densité provenant de patients
admis pour évaluation pré-chirurgicale au CHUM. Les générateurs d’activité épileptique étaient
dans le volume réséqué pour les patients ayant des bons résultats post-chirurgicaux alors que
différents foyers ont été identifiés chez les patients ayant eu de mauvais résultats postchirurgicaux.
Ces résultats démontrent la possibilité d’une identification précise des sources et
récepteurs d’activités épileptiques au moyen de la swADTF ouvrant la porte à la possibilité d’une
meilleure sélection d’électrodes de manière quantitative dans un contexte de développement
d’algorithme de prédiction de crises chez l’humain.
Dans le but d’explorer de nouvelles avenues pour la prédiction de crises épileptiques, un
nouveau précurseur a aussi été étudié combinant l’analyse des spectres d’ordre supérieur et les
réseaux de neurones artificiels (objectif 3). Les résultats ont montré des différences
statistiquement significatives (p<0.05) entre l’état préictal et l’état interictal en utilisant chacune
des caractéristiques extraites du bi-spectre. Utilisées comme entrées à un perceptron multicouche,
l’entropie bispectrale normalisée, l’entropie carré normalisée, et la moyenne ont atteint des
précisions respectives de 78.11 %, 72.64% et 73.26%.
Les résultats de cette thèse confirment la faisabilité de prédiction de crises à partir
d’enregistrements d’électroencéphalographie intracrâniens. Cependant, des efforts
supplémentaires en termes de sélection d’électrodes, d’extraction de caractéristiques, d’utilisation
des techniques d’apprentissage profond et d’implémentation Hardware, sont nécessaires avant
l’intégration de ces approches dans les dispositifs implantables commerciaux.----------ABSTRACT
Epilepsy is a chronic condition characterized by recurrent “unpredictable” seizures. While
the first line of treatment consists of long-term drug therapy about one-third of patients are said to
be pharmacoresistant. In addition, recourse to epilepsy surgery remains low in part due to
persisting negative attitudes towards resective surgery, fear of complications and only moderate
success rates. An important direction of research is to investigate the possibility of predicting
seizures which, if achieved, can lead to novel interventional avenues.
The paucity of intracranial electroencephalography (iEEG) recordings, the limited number of
ictal events, and the short duration of interictal periods have been important obstacles for an
adequate assessment of seizure forecasting. More recently, long-term continuous bilateral iEEG
recordings acquired from dogs with naturally occurring focal epilepsy, using the implantable
NeuroVista ambulatory monitoring device have been made available on line for the benefit of
researchers. Still, an important limitation of these recordings for seizure-prediction studies was
that the seizure onset zone was not disclosed/available. The first objective of this thesis was to
develop an accurate seizure forecasting algorithm based on these canine ambulatory iEEG
recordings. Main contributions include a quantitative, directed transfer function (DTF)-based,
localization of the seizure onset zone (electrode selection), a new fitness function for the
proposed genetic algorithm (feature selection), and a quasi-prospective assessment of seizure
forecasting on long-term continuous iEEG recordings (total of 893 testing days). Results showed
performance improvement compared to previous studies, achieving an average sensitivity of
84.82% and a time in warning of 10 %.
The DTF has been previously validated for quantifying causal relations when quasistationarity
requirements are met. Although such requirements can be fulfilled in the case of
canine recordings due to the relatively low number of channels (objective 1), the identification of
stationary segments would be more challenging in the case of high density iEEG recordings. To
cope with non-stationarity issues, the spectrum weighted adaptive directed transfer function
(swADTF) was recently introduced as a time-varying version of the DTF. The second objective
of this thesis was to validate the feasibility of identifying sources and sinks of seizure activity
based on the swADTF using high-density iEEG recordings of patients admitted for pre-surgical monitoring at the CHUM. Generators of seizure activity were within the resected volume for
patients with good post-surgical outcomes, whereas different or additional seizure foci were
identified in patients with poor post-surgical outcomes. Results confirmed the possibility of
accurate identification of seizure origin and propagation by means of swADTF paving the way
for its use in seizure prediction algorithms by allowing a more tailored electrode selection.
Finally, in an attempt to explore new avenues for seizure forecasting, we proposed a new
precursor of seizure activity by combining higher order spectral analysis and artificial neural
networks (objective 3). Results showed statistically significant differences (p<0.05) between
preictal and interictal states using all the bispectrum-extracted features. Normalized bispectral
entropy, normalized squared entropy and mean of magnitude, when employed as inputs to a
multi-layer perceptron classifier, achieved held-out test accuracies of 78.11%, 72.64%, and
73.26%, respectively.
Results of this thesis confirm the feasibility of seizure forecasting based on iEEG recordings;
the transition into the ictal state is not random and consists of a “build-up”, leading to seizures.
However, additional efforts in terms of electrode selection, feature extraction, hardware and deep
learning implementation, are required before the translation of current approaches into
commercial devices
UNSUPERVISED CLASSIFICATION OF HIGH-FREQUENCY OSCILLATIONS IN NEOCORTICAL EPILEPSY AND CONTROL PATIENTS
Quality of life for the more than 15 million people with drug-resistant epilepsy is tied to how precisely the brain areas responsible for generating their seizures can be localized. High-frequency (100-500 Hz) field-potential oscillations (HFOs) are emerging as a candidate biomarker for epileptogenic networks, but quantitative HFO studies are hampered by selection bias arising out of the need to reduce large volumes of data in the absence of capable automated processing methods. In this thesis, I introduce and evaluate an algorithm for the automatic detection and classification of HFOs that can be deployed without human intervention across long, continuous data records from large numbers of patients. I then use the algorithm in analyzing unique macro- and microelectrode intracranial electroencephalographic recordings from human neocortical epilepsy patients and controls. A central finding is that one class of HFOs discovered by the algorithm (median bandpassed spectral centroid ~140 Hz) is more prevalent in the seizure onset zone than outside. The outcomes of this work add to our understanding of epileptogenic networks and are suitable for near-term translation into improved surgical and device-based treatments
The spatiotemporal dynamics of human focal seizures
Spontaneous human focal seizures can present with a plethora of behavioral manifestations that vary according to the affected cortical regions; however, several key features have been consistently observed. During my doctoral studies, I applied both theoretical and experimental methods to study mechanisms underpinning these consistently seen dynamics. I first analyzed human intracranial EEG recordings, describing statistical methods for measuring their electrophysiological signatures. I next proposed several neurophysiological hypotheses that could explain seizure dynamics and verified them in rodent seizure models. Finally, a computational model was developed, successfully explaining how the complex spatiotemporal evolution of focal seizures emerges from simple neurophysiological principles.
In Chapter 1, the long-standing behavioral manifestations and the most up-to-date electrophysiology findings are reviewed. This section details the inspiration for the studies reported in the subsequent chapters.
In Chapter 2, I describe several statistical methods for estimating traveling wave velocities. I show most ictal discharges can be described as traveling waves whose velocities contain rich information about the stages of seizure evolution. I compare performance of various statistical methods and propose a robust approach to boost the quality of each method’s estimation results.
In Chapter 3, I show how inhibition modulates seizure propagation patterns. Surround inhibition spatially restrains focal seizures and masks excitatory projections of ictal activities. When compromised, two patterns of seizure propagation emerge according to the position of inhibition defects relative to the ictal focus. I show that two distant ictal foci can communicate via physiological connectivity without any chronic rewiring processes – confirming the existence of long-range propagation pathways that could lead to epileptic network formation.
In Chapter 4, I show that thalamic inputs might be necessary for interictal epileptiform discharges (IEDs). The relative positions between IEDs and ictal foci indicate that surround inhibition, shown in the previous chapter, can be exhausted by repetitive exposure to ictal projections.
In Chapter 5, I propose a neural network model that can explain both long-standing behavioral observations of seizures and account for the most up-to-date electrophysiological recordings of spontaneous human focal seizures. The model relies on few assumptions, all of which are proved or supported in earlier chapters of this thesis. The model explains phasic evolution of seizure dynamics – how the commonly observed patterns arise from simple neurophysiological principles, as well as seizure onset subtypes, traveling wave directions and speeds. The model also predicts how spontaneous seizures might arise from synaptic plasticity. The chapter ends with a discussion of the model’s implications and future work.
The thesis is organized in a way that each chapter can be read independently, with Chapter 5 summarizing the central theory spanning the whole study. Each chapter is also tightly linked to a clinically relevant question. In sum, the dissertation’s goal is to provide an in-principle understanding of focal seizure dynamics. With rapid advancement of clinical and experimental tools, I believe this work provides a roadmap for future therapies for epilepsy patients
An overview of deep learning techniques for epileptic seizures detection and prediction based on neuroimaging modalities: Methods, challenges, and future works
Epilepsy is a disorder of the brain denoted by frequent seizures. The symptoms of seizure include confusion,
abnormal staring, and rapid, sudden, and uncontrollable hand movements. Epileptic seizure detection methods
involve neurological exams, blood tests, neuropsychological tests, and neuroimaging modalities. Among these,
neuroimaging modalities have received considerable attention from specialist physicians. One method to facilitate
the accurate and fast diagnosis of epileptic seizures is to employ computer-aided diagnosis systems (CADS)
based on deep learning (DL) and neuroimaging modalities. This paper has studied a comprehensive overview of
DL methods employed for epileptic seizures detection and prediction using neuroimaging modalities. First, DLbased
CADS for epileptic seizures detection and prediction using neuroimaging modalities are discussed. Also,
descriptions of various datasets, preprocessing algorithms, and DL models which have been used for epileptic
seizures detection and prediction have been included. Then, research on rehabilitation tools has been presented,
which contains brain-computer interface (BCI), cloud computing, internet of things (IoT), hardware implementation
of DL techniques on field-programmable gate array (FPGA), etc. In the discussion section, a comparison
has been carried out between research on epileptic seizure detection and prediction. The challenges in
epileptic seizures detection and prediction using neuroimaging modalities and DL models have been described. In
addition, possible directions for future works in this field, specifically for solving challenges in datasets, DL,
rehabilitation, and hardware models, have been proposed. The final section is dedicated to the conclusion which
summarizes the significant findings of the paper
Learning more with less data using domain-guided machine learning: the case for health data analytics
The United States is facing a shortage of neurologists with severe consequences: a) average wait-times to see neurologists are increasing, b) patients with chronic neurological disorders are unable to receive diagnosis and care in a timely fashion, and c) there is an increase in neurologist burnout leading to physical and emotional exhaustion. Present-day neurological care relies heavily on time-consuming visual review of patient data (e.g., neuroimaging and electroencephalography (EEG)), by expert neurologists who are already in short supply. As such, the healthcare system needs creative solutions that can increase the availability of neurologists to patient care. To meet this need, this dissertation develops a machine-learning (ML)-based decision support framework for expert neurologists that focuses the experts’ attention to actionable information extracted from heterogeneous patient data and reduces the need for expert visual review. Specifically, this dissertation introduces a novel ML framework known as domain-guided machine learning (DGML) and demonstrates its usefulness by improving the clinical treatments of two major neurological diseases, epilepsy and Alzheimer’s disease. In this dissertation, the applications of this framework are illustrated through several studies conducted in collaboration with the Mayo Clinic, Rochester, Minnesota. Chapters 3, 4, and 5 describe the application of DGML to model the transient abnormal discharges in the brain activity of epilepsy patients. These studies utilized the intracranial EEG data collected from epilepsy patients to delineate seizure generating brain regions without observing actual seizures; whereas, Chapters 6, 7, 8, and 9 describe the application of DGML to model the subtle but permanent changes in brain function and anatomy, and thereby enable the early detection of chronic epilepsy and Alzheimer’s disease. These studies utilized the scalp EEG data of epilepsy patients and two population-level multimodal imaging datasets collected from elderly individuals
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