A comparative study of AI systems for epileptic seizure recognition based on EEG or ECG

The majority of studies for automatic epileptic seizure (ictal) detection are based on electroencephalogram (EEG) data, but electrocardiogram (ECG) presents a simpler and more wearable alternative for long-term ambulatory monitoring. To assess the performance of EEG and ECG signals, AI systems offer a promising way forward for developing high performing models in securing both a reasonable sensitivity and specificity. There are crucial needs for these AI systems to be developed with more clinical relevance and inference generalization. In this work, we implement an ECG-specific convolutional neural network (CNN) model with residual layers and an EEG-specific convolutional long short-term memory (ConvLSTM) model. We trained, validated, and tested these models on a publicly accessible Temple University Hospital (TUH) dataset for reproducibility and performed a non-patient-specific inference-only test on patient EEG and ECG data of The Royal Prince Alfred Hospital (RPAH) in Sydney, Australia. We selected 31 adult patients to balance groups with the following seizure types: generalized, frontal, frontotemporal, temporal, parietal, and unspecific focal epilepsy. Our tests on both EEG and ECG of these patients achieve an AUC score of 0.75. Our results show ECG outperforms EEG with an average improvement of 0.21 and 0.11 AUC score in patients with frontal and parietal focal seizures, respectively.Clinical relevance-Prior research has demonstrated the value of using ECG for seizure documentation. It is believed that specific epileptic foci (seizure origin) may involve network inputs to the autonomic nervous system. Our result indicates that ECG could outperform EEG for individuals with specific seizure origin, particularly in the frontal and parietal lobes.