A Patient-Independent Neonatal Seizure Prediction Model Using Reduced Montage EEG and ECG

Neonates are highly susceptible to seizures, often leading to short or long-term neurological impairments. However, clinical manifestations of neonatal seizures are subtle and often lead to misdiagnoses. This increases the risk of prolonged, untreated seizure activity and subsequent brain injury. Continuous video electroencephalogram (cEEG) monitoring is the gold standard for seizure detection. However, this is an expensive evaluation that requires expertise and time. In this study, we propose a convolutional neural network-based model for early prediction of neonatal seizures by distinguishing between interictal and preictal states of the EEG. Our model is patient-independent, enabling generalization across multiple subjects, and utilizes mel-frequency cepstral coefficient matrices extracted from multichannel EEG and electrocardiogram (ECG) signals as input features. Trained and validated on the Helsinki neonatal EEG dataset with 10-fold cross-validation, the proposed model achieved an average accuracy of 97.52%, sensitivity of 98.31%, specificity of 96.39%, and F1-score of 97.95%, enabling accurate seizure prediction up to 30 minutes before onset. The inclusion of ECG alongside EEG improved the F1-score by 1.42%, while the incorporation of an attention mechanism yielded an additional 0.5% improvement. To enhance transparency, we incorporated SHapley Additive exPlanations (SHAP) as an explainable artificial intelligence method to interpret the model and provided localization of seizure focus using scalp plots. The overall results demonstrate the model's potential for minimally supervised deployment in neonatal intensive care units, enabling timely and reliable prediction of neonatal seizures, while demonstrating strong generalization capability across unseen subjects through transfer learning.

Improving Neonatal Care: An Active Dry-Contact Electrode-based Continuous EEG Monitoring System with Seizure Detection

Objective: Neonates are highly susceptible to seizures, which can have severe long-term consequences if undetected and left untreated. Early detection is crucial and typically requires continuous electroencephalography (EEG) monitoring in a hospital setting, which is costly, inconvenient, and requires specialized experts for diagnosis. In this work, we propose a new low-cost active dry-contact electrode-based adjustable EEG headset, a new explainable deep learning model to detect neonatal seizures, and an advanced signal processing algorithm to remove artifacts to address the key aspects that lead to the underdiagnosis of neonatal seizures. Methods: EEG signals are acquired through active electrodes and processed using a custom-designed analog front end (AFE) that filters and digitizes the captured EEG signals. The adjustable headset is designed using three-dimensional (3D) printing and laser cutting to fit a wide range of head sizes. A deep learning model is developed to classify seizure and non-seizure epochs in real-time. Furthermore, a separate multimodal deep learning model is designed to remove noise artifacts. The device is tested on a pediatric patient with absence seizures in a hospital setting. Simultaneous recordings are captured using both the custom device and the commercial wet electrode device available in the hospital for comparison. Results: The signals obtained using our custom design and a commercial device show a high correlation (>0.8). Further analysis using signal-to-noise ratio values shows that our device can mitigate noise similar to the commercial device. The proposed deep learning model has improvements in accuracy and recall by 2.76% and 16.33%, respectively, compared to the state-of-the-art. Furthermore, the developed artifact removal algorithm can identify and remove artifacts while keeping seizure patterns intact.