RESUMO
OBJECTIVE: Despite advances, analysis and interpretation of EEG still essentially rely on visual inspection by a super-specialized physician. Considering the vast amount of data that composes the EEG, much of the detail inevitably escapes ordinary human scrutiny. Significant information may not be evident and is missed, and misinterpretation remains a serious problem. Can we develop an artificial intelligence system to accurately and efficiently classify EEG and even reveal novel information? In this study, deep learning techniques and, in particular, Convolutional Neural Networks, have been used to develop a model (which we have named eDeeplepsy) for distinguishing different brain states in children with epilepsy. METHODS: A novel EEG database from a homogenous pediatric population with epileptic spasms beyond infancy was constituted by epileptologists, representing a particularly intriguing seizure type and challenging EEG. The analysis was performed on such samples from long-term video-EEG recordings, previously coded as images showing how different parts of the epileptic brain are distinctly activated during varying states within and around this seizure type. RESULTS: Results show that not only could eDeeplepsy differentiate ictal from interictal states but also discriminate brain activity between spasms within a cluster from activity away from clusters, usually undifferentiated by visual inspection. Accuracies between 86 % and 94 % were obtained for the proposed use cases. SIGNIFICANCE: We present a model for computer-assisted discrimination that can consistently detect subtle differences in the various brain states of children with epileptic spasms, and which can be used in other settings in epilepsy with the purpose of reducing workload and discrepancies or misinterpretations. The research also reveals previously undisclosed information that allows for a better understanding of the pathophysiology and evolving characteristics of this particular seizure type. It does so by documenting a different state (interspasms) that indicates a potentially non-standard signal with distinctive epileptogenicity at that period.
Assuntos
Encéfalo , Eletroencefalografia , Redes Neurais de Computação , Humanos , Eletroencefalografia/métodos , Encéfalo/fisiopatologia , Criança , Masculino , Feminino , Pré-Escolar , Epilepsia/fisiopatologia , Epilepsia/diagnóstico , Lactente , Adolescente , Aprendizado ProfundoRESUMO
Physiotherapy is a critical area of healthcare that involves the assessment and treatment of physical disabilities and injuries. The use of Artificial Intelligence (AI) in physiotherapy has gained significant attention due to its potential to enhance the accuracy and effectiveness of clinical decision-making and treatment outcomes. Nevertheless, it is still a rather innovative field of application of these techniques and there is a need to find what aspects are highly developed and what possible job niches can be exploited. This systematic review aims to evaluate the current state of research on the use of a particular AI called deep learning models in physiotherapy and identify the key trends, challenges, and opportunities in this field. The findings of this review, conducted following the PRISMA guidelines, provide valuable insights for researchers and clinicians. The most relevant databases included were PubMed, Web of Science, Scopus, Astrophysics Data System, and Central Citation Export. Inclusion and exclusion criteria were established to determine which items would be considered for further review. These criteria were used to screen the items during the first and second peer review processes. A set of quality criteria was developed to select the papers obtained after the second screening. Finally, of the 214 initial papers, 23 studies were selected. From our analysis of the selected articles, we can draw the following conclusions: Concerning deep learning models, innovation is primarily seen in the adoption of hybrid models, with convolutional models being extensively utilized. In terms of data, it's unsurprising that body signals and images are predominantly used. However, texts and structured data present promising avenues for groundbreaking work in the field. Additionally, medical tests that involve the collection of 3D images, Functional Movement Screening, or thermographies emerge as novel areas to explore applications within the scope of physiotherapy.
Assuntos
Aprendizado Profundo , Medicina , Inteligência Artificial , Tomada de Decisão Clínica , Bases de Dados Factuais , HumanosRESUMO
BACKGROUND AND OBJECTIVE: Epilepsy is a brain disorder consisting of abnormal electrical discharges of neurons resulting in epileptic seizures. The nature and spatial distribution of these electrical signals make epilepsy a field for the analysis of brain connectivity using artificial intelligence and network analysis techniques since their study requires large amounts of data over large spatial and temporal scales. For example, to discriminate states that would otherwise be indistinguishable from the human eye. This paper aims to identify the different brain states that appear concerning the intriguing seizure type of epileptic spasms. Once these states have been differentiated, an attempt is made to understand their corresponding brain activity. METHODS: The representation of brain connectivity can be done by graphing the topology and intensity of brain activations. Graph images from different instants within and outside the actual seizure are used as input to a deep learning model for classification purposes. This work uses convolutional neural networks to discriminate the different states of the epileptic brain based on the appearance of these graphs at different times. Next, we apply several graph metrics as an aid to interpret what happens in the brain regions during and around the seizure. RESULTS: Results show that the model consistently finds distinctive brain states in children with epilepsy with focal onset epileptic spasms that are indistinguishable under the expert visual inspection of EEG traces. Furthermore, differences are found in brain connectivity and network measures in each of the different states. CONCLUSIONS: Computer-assisted discrimination using this model can detect subtle differences in the various brain states of children with epileptic spasms. The research reveals previously undisclosed information regarding brain connectivity and networks, allowing for a better understanding of the pathophysiology and evolving characteristics of this particular seizure type. From our data, we speculate that the prefrontal, premotor, and motor cortices could be more involved in a hypersynchronized state occurring in the few seconds immediately preceding the visually evident EEG and clinical ictal features of the first spasm in a cluster. On the other hand, a disconnection in centro-parietal areas seems a relevant feature in the predisposition and repetitive generation of epileptic spasms within clusters.
Assuntos
Aprendizado Profundo , Epilepsia , Humanos , Criança , Inteligência Artificial , Benchmarking , Eletroencefalografia/métodos , Encéfalo/diagnóstico por imagem , Convulsões/diagnóstico , Epilepsia/diagnóstico por imagem , EspasmoRESUMO
Artificial intelligence is a broad field that comprises a wide range of techniques, where deep learning is presently the one with the most impact. Moreover, the medical field is an area where data both complex and massive and the importance of the decisions made by doctors make it one of the fields in which deep learning techniques can have the greatest impact. A systematic review following the Cochrane recommendations with a multidisciplinary team comprised of physicians, research methodologists and computer scientists has been conducted. This survey aims to identify the main therapeutic areas and the deep learning models used for diagnosis and treatment tasks. The most relevant databases included were MedLine, Embase, Cochrane Central, Astrophysics Data System, Europe PubMed Central, Web of Science and Science Direct. An inclusion and exclusion criteria were defined and applied in the first and second peer review screening. A set of quality criteria was developed to select the papers obtained after the second screening. Finally, 126 studies from the initial 3493 papers were selected and 64 were described. Results show that the number of publications on deep learning in medicine is increasing every year. Also, convolutional neural networks are the most widely used models and the most developed area is oncology where they are used mainly for image analysis.