Lukas Gemein

Lukas AW Gemein, Robin T Schirrmeister, Joschka Boedecker et al.

The brain's biological age has been considered as a promising candidate for a neurologically significant biomarker. However, recent results based on longitudinal magnetic resonance imaging data have raised questions on its interpretation. A central question is whether an increased biological age of the brain is indicative of brain pathology and if changes in brain age correlate with diagnosed pathology (state hypothesis). Alternatively, could the discrepancy in brain age be a stable characteristic unique to each individual (trait hypothesis)? To address this question, we present a comprehensive study on brain aging based on clinical EEG, which is complementary to previous MRI-based investigations. We apply a state-of-the-art Temporal Convolutional Network (TCN) to the task of age regression. We train on recordings of the Temple University Hospital EEG Corpus (TUEG) explicitly labeled as non-pathological and evaluate on recordings of subjects with non-pathological as well as pathological recordings, both with examinations at a single point in time and repeated examinations over time. Therefore, we created four novel subsets of TUEG that include subjects with multiple recordings: I) all labeled non-pathological; II) all labeled pathological; III) at least one recording labeled non-pathological followed by at least one recording labeled pathological; IV) similar to III) but with opposing transition (first pathological then non-pathological). The results show that our TCN reaches state-of-the-art performance in age decoding with a mean absolute error of 6.6 years. Our extensive analyses demonstrate that the model significantly underestimates the age of non-pathological and pathological subjects (-1 and -5 years, paired t-test, p <= 0.18 and p <= 0.0066). Furthermore, the brain age gap biomarker is not indicative of pathological EEG.

Lukas Alexander Wilhelm Gemein, Robin Tibor Schirrmeister, Patryk Chrabąszcz et al.

Machine learning (ML) methods have the potential to automate clinical EEG analysis. They can be categorized into feature-based (with handcrafted features), and end-to-end approaches (with learned features). Previous studies on EEG pathology decoding have typically analyzed a limited number of features, decoders, or both. For a I) more elaborate feature-based EEG analysis, and II) in-depth comparisons of both approaches, here we first develop a comprehensive feature-based framework, and then compare this framework to state-of-the-art end-to-end methods. To this aim, we apply the proposed feature-based framework and deep neural networks including an EEG-optimized temporal convolutional network (TCN) to the task of pathological versus non-pathological EEG classification. For a robust comparison, we chose the Temple University Hospital (TUH) Abnormal EEG Corpus (v2.0.0), which contains approximately 3000 EEG recordings. The results demonstrate that the proposed feature-based decoding framework can achieve accuracies on the same level as state-of-the-art deep neural networks. We find accuracies across both approaches in an astonishingly narrow range from 81--86\%. Moreover, visualizations and analyses indicated that both approaches used similar aspects of the data, e.g., delta and theta band power at temporal electrode locations. We argue that the accuracies of current binary EEG pathology decoders could saturate near 90\% due to the imperfect inter-rater agreement of the clinical labels, and that such decoders are already clinically useful, such as in areas where clinical EEG experts are rare. We make the proposed feature-based framework available open source and thus offer a new tool for EEG machine learning research.

Robin Tibor Schirrmeister, Lukas Gemein, Katharina Eggensperger et al.

We apply convolutional neural networks (ConvNets) to the task of distinguishing pathological from normal EEG recordings in the Temple University Hospital EEG Abnormal Corpus. We use two basic, shallow and deep ConvNet architectures recently shown to decode task-related information from EEG at least as well as established algorithms designed for this purpose. In decoding EEG pathology, both ConvNets reached substantially better accuracies (about 6% better, ~85% vs. ~79%) than the only published result for this dataset, and were still better when using only 1 minute of each recording for training and only six seconds of each recording for testing. We used automated methods to optimize architectural hyperparameters and found intriguingly different ConvNet architectures, e.g., with max pooling as the only nonlinearity. Visualizations of the ConvNet decoding behavior showed that they used spectral power changes in the delta (0-4 Hz) and theta (4-8 Hz) frequency range, possibly alongside other features, consistent with expectations derived from spectral analysis of the EEG data and from the textual medical reports. Analysis of the textual medical reports also highlighted the potential for accuracy increases by integrating contextual information, such as the age of subjects. In summary, the ConvNets and visualization techniques used in this study constitute a next step towards clinically useful automated EEG diagnosis and establish a new baseline for future work on this topic.