Multi-center validation study of automated classification of pathological slowing in adult scalp electroencephalograms via frequency features

TL;DR

This study develops and validates automated EEG slowing detection systems using frequency features, demonstrating that deep learning approaches outperform traditional methods and match expert agreement levels across multiple international datasets.

Contribution

The paper introduces three automated EEG slowing detection systems, with the deep learning-based system achieving superior accuracy and rapid processing, validated across multi-center datasets.

Findings

Deep learning system achieved up to 82.0% accuracy at EEG level.

Performance comparable to expert intra-rater agreement.

System processes a 30-minute EEG in 4 seconds.

Abstract

Pathological slowing in the electroencephalogram (EEG) is widely investigated for the diagnosis of neurological disorders. Currently, the gold standard for slowing detection is the visual inspection of the EEG by experts, which is time-consuming and subjective. To address those issues, we propose three automated approaches to detect slowing in EEG: Threshold-based Detecting System (TDS), Shallow Learning-based Detecting System (SLDS), and Deep Learning-based Detecting System (DLDS). These systems are evaluated on channel-, segment- and EEG-level. The TDS, SLDS, and DLDS performs prediction via detecting slowing at individual channels, and those detections are arranged in histograms for detection of slowing at the segment- and EEG-level. We evaluate the systems through Leave-One-Subject-Out (LOSO) cross-validation (CV) and Leave-One-Institution-Out (LOIO) CV on four datasets from the US, Singapore, and India. The DLDS achieved the best overall results: LOIO CV mean balanced accuracy (BAC) of 71.9%, 75.5%, and 82.0% at channel-, segment- and EEG-level, and LOSO CV mean BAC of 73.6%, 77.2%, and 81.8% at channel-, segment-, and EEG-level. The channel- and segment-level performance is comparable to the intra-rater agreement (IRA) of an expert of 72.4% and 82%. The DLDS can process a 30-minutes EEG in 4 seconds and can be deployed to assist clinicians in interpreting EEGs.