Rapid Annotation of Seizures and Interictal-ictal Continuum EEG Patterns

Seizures, status epilepticus, and seizure-like rhythmic or periodic activities are common, pathological, harmful states of brain electrical activity seen in the electroencephalogram (EEG) of patients during critical medical illnesses or acute brain injury. Accumulating evidence shows that these states, when prolonged, cause neurological injury. In this study we developed a valid method to automatically discover a small number of homogeneous pattern clusters, to facilitate efficient interactive labelling by EEG experts. 592 time domain and spectral features were extracted from continuous EEG (cEEG) data of 369 ICU (intensive care unit) patients. For each patient, feature dimensionality was reduced using principal component analysis (PCA), retaining 95% of the variance. K-medoids clustering was applied to learn a local dictionary from each patient, consisting of k=100 exemplars/words. Changepoint detection (CPD) was utilized to break each EEG into segments. A bag-of-words (BoW) representation was computed for each segment, specifically, a normalized histogram of the words found within each segment. Segments were further clustered using the BoW histograms by Affinity Propagation (AP) using a χ2 distance to measure similarities between histograms. The resulting 30 50 clusters for each patient were scored by EEG experts through labeling only the cluster medoids. Embedding methods t-SNE (t-distributed stochastic neighbor embedding) and PCA were used to provide a 2D representation for visualization and exploration of the data. Our results illustrate that it takes approximately 3 minutes to annotate 24 hours of cEEG by experts, which is at least 60 times faster than unaided manual review.