Robust EEG-based cross-site and cross-protocol classification of states of consciousness

Determining the state of consciousness in patients with disorders of consciousness is a challenging practical and theoretical problem. Recent findings suggest that multiple markers of brain activity extracted from the EEG may index the state of consciousness in the human brain. Furthermore, machine...

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Publicado: 2018
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Acceso en línea:https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_00068950_v141_n11_p3179_Engemann
http://hdl.handle.net/20.500.12110/paper_00068950_v141_n11_p3179_Engemann
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spelling paper:paper_00068950_v141_n11_p3179_Engemann2023-06-08T14:31:27Z Robust EEG-based cross-site and cross-protocol classification of states of consciousness biomarker diagnosis disorders of consciousness electroencephalography machine learning adult alpha rhythm area under the curve Article clinical protocol consciousness controlled study decision tree disease classification electroencephalography female human major clinical study male middle aged minimally conscious state priority journal theta rhythm wakefulness Determining the state of consciousness in patients with disorders of consciousness is a challenging practical and theoretical problem. Recent findings suggest that multiple markers of brain activity extracted from the EEG may index the state of consciousness in the human brain. Furthermore, machine learning has been found to optimize their capacity to discriminate different states of consciousness in clinical practice. However, it is unknown how dependable these EEG markers are in the face of signal variability because of different EEG configurations, EEG protocols and subpopulations from different centres encountered in practice. In this study we analysed 327 recordings of patients with disorders of consciousness (148 unresponsive wakefulness syndrome and 179 minimally conscious state) and 66 healthy controls obtained in two independent research centres (Paris Pitié-Salpêtrière and Liège). We first show that a non-parametric classifier based on ensembles of decision trees provides robust out-of-sample performance on unseen data with a predictive area under the curve (AUC) of ∼0.77 that was only marginally affected when using alternative EEG configurations (different numbers and positions of sensors, numbers of epochs, average AUC = 0.750 ± 0.014). In a second step, we observed that classifiers based on multiple as well as single EEG features generalize to recordings obtained from different patient cohorts, EEG protocols and different centres. However, the multivariate model always performed best with a predictive AUC of 0.73 for generalization from Paris 1 to Paris 2 datasets, and an AUC of 0.78 from Paris to Liège datasets. Using simulations, we subsequently demonstrate that multivariate pattern classification has a decisive performance advantage over univariate classification as the stability of EEG features decreases, as different EEG configurations are used for feature-extraction or as noise is added. Moreover, we show that the generalization performance from Paris to Liège remains stable even if up to 20% of the diagnostic labels are randomly flipped. Finally, consistent with recent literature, analysis of the learned decision rules of our classifier suggested that markers related to dynamic fluctuations in theta and alpha frequency bands carried independent information and were most influential. Our findings demonstrate that EEG markers of consciousness can be reliably, economically and automatically identified with machine learning in various clinical and acquisition contexts. © The Author(s) (2018). Published by Oxford University Press on behalf of the Guarantors of Brain. 2018 https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_00068950_v141_n11_p3179_Engemann http://hdl.handle.net/20.500.12110/paper_00068950_v141_n11_p3179_Engemann
institution Universidad de Buenos Aires
institution_str I-28
repository_str R-134
collection Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA)
topic biomarker
diagnosis
disorders of consciousness
electroencephalography
machine learning
adult
alpha rhythm
area under the curve
Article
clinical protocol
consciousness
controlled study
decision tree
disease classification
electroencephalography
female
human
major clinical study
male
middle aged
minimally conscious state
priority journal
theta rhythm
wakefulness
spellingShingle biomarker
diagnosis
disorders of consciousness
electroencephalography
machine learning
adult
alpha rhythm
area under the curve
Article
clinical protocol
consciousness
controlled study
decision tree
disease classification
electroencephalography
female
human
major clinical study
male
middle aged
minimally conscious state
priority journal
theta rhythm
wakefulness
Robust EEG-based cross-site and cross-protocol classification of states of consciousness
topic_facet biomarker
diagnosis
disorders of consciousness
electroencephalography
machine learning
adult
alpha rhythm
area under the curve
Article
clinical protocol
consciousness
controlled study
decision tree
disease classification
electroencephalography
female
human
major clinical study
male
middle aged
minimally conscious state
priority journal
theta rhythm
wakefulness
description Determining the state of consciousness in patients with disorders of consciousness is a challenging practical and theoretical problem. Recent findings suggest that multiple markers of brain activity extracted from the EEG may index the state of consciousness in the human brain. Furthermore, machine learning has been found to optimize their capacity to discriminate different states of consciousness in clinical practice. However, it is unknown how dependable these EEG markers are in the face of signal variability because of different EEG configurations, EEG protocols and subpopulations from different centres encountered in practice. In this study we analysed 327 recordings of patients with disorders of consciousness (148 unresponsive wakefulness syndrome and 179 minimally conscious state) and 66 healthy controls obtained in two independent research centres (Paris Pitié-Salpêtrière and Liège). We first show that a non-parametric classifier based on ensembles of decision trees provides robust out-of-sample performance on unseen data with a predictive area under the curve (AUC) of ∼0.77 that was only marginally affected when using alternative EEG configurations (different numbers and positions of sensors, numbers of epochs, average AUC = 0.750 ± 0.014). In a second step, we observed that classifiers based on multiple as well as single EEG features generalize to recordings obtained from different patient cohorts, EEG protocols and different centres. However, the multivariate model always performed best with a predictive AUC of 0.73 for generalization from Paris 1 to Paris 2 datasets, and an AUC of 0.78 from Paris to Liège datasets. Using simulations, we subsequently demonstrate that multivariate pattern classification has a decisive performance advantage over univariate classification as the stability of EEG features decreases, as different EEG configurations are used for feature-extraction or as noise is added. Moreover, we show that the generalization performance from Paris to Liège remains stable even if up to 20% of the diagnostic labels are randomly flipped. Finally, consistent with recent literature, analysis of the learned decision rules of our classifier suggested that markers related to dynamic fluctuations in theta and alpha frequency bands carried independent information and were most influential. Our findings demonstrate that EEG markers of consciousness can be reliably, economically and automatically identified with machine learning in various clinical and acquisition contexts. © The Author(s) (2018). Published by Oxford University Press on behalf of the Guarantors of Brain.
title Robust EEG-based cross-site and cross-protocol classification of states of consciousness
title_short Robust EEG-based cross-site and cross-protocol classification of states of consciousness
title_full Robust EEG-based cross-site and cross-protocol classification of states of consciousness
title_fullStr Robust EEG-based cross-site and cross-protocol classification of states of consciousness
title_full_unstemmed Robust EEG-based cross-site and cross-protocol classification of states of consciousness
title_sort robust eeg-based cross-site and cross-protocol classification of states of consciousness
publishDate 2018
url https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_00068950_v141_n11_p3179_Engemann
http://hdl.handle.net/20.500.12110/paper_00068950_v141_n11_p3179_Engemann
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