Multimodal wearable EEG, EMG and accelerometry measurements improve the accuracy of tonic-clonic seizure detection in-hospital

Objective: Most current wearable tonic-clonic seizure (TCS) detection systems are based on extra-cerebral signals, such as electromyography (EMG) or accelerometry (ACC). Although many of these devices show good sensitivity in seizure detection, their false positive rates (FPR) are still relatively high. Wearable EEG may improve performance; however, studies investigating this remain scarce. This paper aims 1) to investigate the possibility of detecting TCSs with a behind-the-ear, two-channel wearable EEG, and 2) to evaluate the added value of wearable EEG to other non-EEG modalities in multimodal TCS detection. Method: We included 27 participants with a total of 44 TCSs from the European multicenter study SeizeIT2. The multimodal wearable detection system Sensor Dot (Byteflies) was used to measure two-channel, behind-the-ear EEG, EMG, electrocardiography (ECG), ACC and gyroscope (GYR). First, we evaluated automatic unimodal detection of TCSs, using performance metrics such as sensitivity, precision, FPR and F1-score. Secondly, we fused the different modalities and again assessed performance. Algorithm-labeled segments were then provided to a neurologist and a wearable data expert, who reviewed and annotated the true positive TCSs, and discarded false positives (FPs). Results: Wearable EEG outperformed the other modalities in unimodal TCS detection by achieving a sensitivity of 100.0% and a FPR of 10.3/24h (compared to 97.7% sensitivity and 30.9/24h FPR for EMG; 95.5% sensitivity and 13.9 FPR for ACC). The combination of wearable EEG and EMG achieved overall the most clinically useful performance in offline TCS detection with a sensitivity of 97.7%, a FPR of 0.4/24 h, a precision of 43.0%, and a F1-score of 59.7%. Subsequent visual review of the automated detections resulted in maximal sensitivity and zero FPs.

CoRe-Sleep: A Multimodal Fusion Framework for Time Series Robust to Imperfect Modalities

Sleep abnormalities can have severe health consequences. Automated sleep staging, i.e. labelling the sequence of sleep stages from the patient's physiological recordings, could simplify the diagnostic process. Previous work on automated sleep staging has achieved great results, mainly relying on the EEG signal. However, often multiple sources of information are available beyond EEG. This can be particularly beneficial when the EEG recordings are noisy or even missing completely. In this paper, we propose CoRe-Sleep, a Coordinated Representation multimodal fusion network that is particularly focused on improving the robustness of signal analysis on imperfect data. We demonstrate how appropriately handling multimodal information can be the key to achieving such robustness. CoRe-Sleep tolerates noisy or missing modalities segments, allowing training on incomplete data. Additionally, it shows state-of-the-art performance when testing on both multimodal and unimodal data using a single model on SHHS-1, the largest publicly available study that includes sleep stage labels. The results indicate that training the model on multimodal data does positively influence performance when tested on unimodal data. This work aims at bridging the gap between automated analysis tools and their clinical utility.

Early soft and flexible fusion of EEG and fMRI via tensor decompositions

Data fusion refers to the joint analysis of multiple datasets which provide complementary views of the same task. In this preprint, the problem of jointly analyzing electroencephalography (EEG) and functional Magnetic Resonance Imaging (fMRI) data is considered. Jointly analyzing EEG and fMRI measurements is highly beneficial for studying brain function because these modalities have complementary spatiotemporal resolution: EEG offers good temporal resolution while fMRI is better in its spatial resolution. The fusion methods reported so far ignore the underlying multi-way nature of the data in at least one of the modalities and/or rely on very strong assumptions about the relation of the two datasets. In this preprint, these two points are addressed by adopting for the first time tensor models in the two modalities while also exploring double coupled tensor decompositions and by following soft and flexible coupling approaches to implement the multi-modal analysis. To cope with the Event Related Potential (ERP) variability in EEG, the PARAFAC2 model is adopted. The results obtained are compared against those of parallel Independent Component Analysis (ICA) and hard coupling alternatives in both simulated and real data. Our results confirm the superiority of tensorial methods over methods based on ICA. In scenarios that do not meet the assumptions underlying hard coupling, the advantage of soft and flexible coupled decompositions is clearly demonstrated.

Assisted Dictionary Learning for fMRI Data Analysis

Extracting information from functional magnetic resonance (fMRI) images has been a major area of research for more than two decades. The goal of this work is to present a new method for the analysis of fMRI data sets, that is capable to incorporate a priori available information, via an efficient optimization framework. Tests on synthetic data sets demonstrate significant performance gains over existing methods of this kind.

Higher-Order Block Term Decomposition for Spatially Folded fMRI Data

The growing use of neuroimaging technologies generates a massive amount of biomedical data that exhibit high dimensionality. Tensor-based analysis of brain imaging data has been proved quite effective in exploiting their multiway nature. The advantages of tensorial methods over matrix-based approaches have also been demonstrated in the characterization of functional magnetic resonance imaging (fMRI) data, where the spatial (voxel) dimensions are commonly grouped (unfolded) as a single way/mode of the 3-rd order array, the other two ways corresponding to time and subjects. However, such methods are known to be ineffective in more demanding scenarios, such as the ones with strong noise and/or significant overlapping of activated regions. This paper aims at investigating the possible gains from a better exploitation of the spatial dimension, through a higher- (4 or 5) order tensor modeling of the fMRI signal. In this context, and in order to increase the degrees of freedom of the modeling process, a higher-order Block Term Decomposition (BTD) is applied, for the first time in fMRI analysis. Its effectiveness is demonstrated via extensive simulation results.