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Automated detection of activity onset after postictal generalized EEG suppression

BACKGROUND: Sudden unexpected death in epilepsy (SUDEP) is a leading cause of premature death in patients with epilepsy. If timely assessment of SUDEP risk can be made, early interventions for optimized treatments might be provided. One of the biomarkers being investigated for SUDEP risk assessment...

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Autores principales: Lamichhane, Bishal, Kim, Yejin, Segarra, Santiago, Zhang, Guoqiang, Lhatoo, Samden, Hampson, Jaison, Jiang, Xiaoqian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7758926/
https://www.ncbi.nlm.nih.gov/pubmed/33357222
http://dx.doi.org/10.1186/s12911-020-01307-7
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author Lamichhane, Bishal
Kim, Yejin
Segarra, Santiago
Zhang, Guoqiang
Lhatoo, Samden
Hampson, Jaison
Jiang, Xiaoqian
author_facet Lamichhane, Bishal
Kim, Yejin
Segarra, Santiago
Zhang, Guoqiang
Lhatoo, Samden
Hampson, Jaison
Jiang, Xiaoqian
author_sort Lamichhane, Bishal
collection PubMed
description BACKGROUND: Sudden unexpected death in epilepsy (SUDEP) is a leading cause of premature death in patients with epilepsy. If timely assessment of SUDEP risk can be made, early interventions for optimized treatments might be provided. One of the biomarkers being investigated for SUDEP risk assessment is postictal generalized EEG suppression [postictal generalized EEG suppression (PGES)]. For example, prolonged PGES has been found to be associated with a higher risk for SUDEP. Accurate characterization of PGES requires correct identification of the end of PGES, which is often complicated due to signal noise and artifacts, and has been reported to be a difficult task even for trained clinical professionals. In this work we present a method for automatic detection of the end of PGES using multi-channel EEG recordings, thus enabling the downstream task of SUDEP risk assessment by PGES characterization. METHODS: We address the detection of the end of PGES as a classification problem. Given a short EEG snippet, a trained model classifies whether it consists of the end of PGES or not. Scalp EEG recordings from a total of 134 patients with epilepsy are used for training a random forest based classification model. Various time-series based features are used to characterize the EEG signal for the classification task. The features that we have used are computationally inexpensive, making it suitable for real-time implementations and low-power solutions. The reference labels for classification are based on annotations by trained clinicians identifying the end of PGES in an EEG recording. RESULTS: We evaluated our classification model on an independent test dataset from 34 epileptic patients and obtained an AUreceiver operating characteristic (ROC) (area under the curve) of 0.84. We found that inclusion of multiple EEG channels is important for better classification results, possibly owing to the generalized nature of PGES. Of among the channels included in our analysis, the central EEG channels were found to provide the best discriminative representation for the detection of the end of PGES. CONCLUSION: Accurate detection of the end of PGES is important for PGES characterization and SUDEP risk assessment. In this work, we showed that it is feasible to automatically detect the end of PGES—otherwise difficult to detect due to EEG noise and artifacts—using time-series features derived from multi-channel EEG recordings. In future work, we will explore deep learning based models for improved detection and investigate the downstream task of PGES characterization for SUDEP risk assessment.
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spelling pubmed-77589262020-12-28 Automated detection of activity onset after postictal generalized EEG suppression Lamichhane, Bishal Kim, Yejin Segarra, Santiago Zhang, Guoqiang Lhatoo, Samden Hampson, Jaison Jiang, Xiaoqian BMC Med Inform Decis Mak Research BACKGROUND: Sudden unexpected death in epilepsy (SUDEP) is a leading cause of premature death in patients with epilepsy. If timely assessment of SUDEP risk can be made, early interventions for optimized treatments might be provided. One of the biomarkers being investigated for SUDEP risk assessment is postictal generalized EEG suppression [postictal generalized EEG suppression (PGES)]. For example, prolonged PGES has been found to be associated with a higher risk for SUDEP. Accurate characterization of PGES requires correct identification of the end of PGES, which is often complicated due to signal noise and artifacts, and has been reported to be a difficult task even for trained clinical professionals. In this work we present a method for automatic detection of the end of PGES using multi-channel EEG recordings, thus enabling the downstream task of SUDEP risk assessment by PGES characterization. METHODS: We address the detection of the end of PGES as a classification problem. Given a short EEG snippet, a trained model classifies whether it consists of the end of PGES or not. Scalp EEG recordings from a total of 134 patients with epilepsy are used for training a random forest based classification model. Various time-series based features are used to characterize the EEG signal for the classification task. The features that we have used are computationally inexpensive, making it suitable for real-time implementations and low-power solutions. The reference labels for classification are based on annotations by trained clinicians identifying the end of PGES in an EEG recording. RESULTS: We evaluated our classification model on an independent test dataset from 34 epileptic patients and obtained an AUreceiver operating characteristic (ROC) (area under the curve) of 0.84. We found that inclusion of multiple EEG channels is important for better classification results, possibly owing to the generalized nature of PGES. Of among the channels included in our analysis, the central EEG channels were found to provide the best discriminative representation for the detection of the end of PGES. CONCLUSION: Accurate detection of the end of PGES is important for PGES characterization and SUDEP risk assessment. In this work, we showed that it is feasible to automatically detect the end of PGES—otherwise difficult to detect due to EEG noise and artifacts—using time-series features derived from multi-channel EEG recordings. In future work, we will explore deep learning based models for improved detection and investigate the downstream task of PGES characterization for SUDEP risk assessment. BioMed Central 2020-12-24 /pmc/articles/PMC7758926/ /pubmed/33357222 http://dx.doi.org/10.1186/s12911-020-01307-7 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Lamichhane, Bishal
Kim, Yejin
Segarra, Santiago
Zhang, Guoqiang
Lhatoo, Samden
Hampson, Jaison
Jiang, Xiaoqian
Automated detection of activity onset after postictal generalized EEG suppression
title Automated detection of activity onset after postictal generalized EEG suppression
title_full Automated detection of activity onset after postictal generalized EEG suppression
title_fullStr Automated detection of activity onset after postictal generalized EEG suppression
title_full_unstemmed Automated detection of activity onset after postictal generalized EEG suppression
title_short Automated detection of activity onset after postictal generalized EEG suppression
title_sort automated detection of activity onset after postictal generalized eeg suppression
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7758926/
https://www.ncbi.nlm.nih.gov/pubmed/33357222
http://dx.doi.org/10.1186/s12911-020-01307-7
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