Using interictal seizure-free EEG data to recognise patients with epilepsy based on machine learning of brain functional connectivity

Most seizures in adults with epilepsy occur rather infrequently and as a result, the interictal EEG plays a crucial role in the diagnosis and classification of epilepsy. However, empirical interpretation, of a first EEG in adult patients, has a very low sensitivity ranging between 29–55 %. Useful EEG information remains buried within the signals in seizure-free EEG epochs, far beyond the observational capabilities of any specialised physician in this field. Unlike most of the existing works focusing on either seizure data or single-variate method, we introduce a multi-variate method to characterise sensor level brain functional connectivity from interictal EEG data to identify patients with generalised epilepsy. A total of 9 connectivity features based on 5 different measures in time, frequency and time-frequency domains have been tested. The solution has been validated by the K-Nearest Neighbour algorithm, classifying an epilepsy group (EG) vs healthy controls (HC) and subsequently with another cohort of patients characterised by non-epileptic attacks (NEAD), a psychogenic type of disorder. A high classification accuracy (97 %) was achieved for EG vs HC while revealing significant spatio-temporal deficits in the frontocentral areas in the beta frequency band. For EG vs NEAD, the classification accuracy was only about 73 %, which might be a reflection of the well-described coexistence of NEAD with epileptic attacks. Our work demonstrates that seizure-free interictal EEG data can be used to accurately classify patients with generalised epilepsy from HC and that more systematic work is required in this direction aiming to produce a clinically useful diagnostic method.