Discriminating between bipolar and major depressive disorder using a machine learning approach and resting-state EEG data.

OBJECTIVE: Distinguishing major depressive disorder (MDD) from bipolar disorder (BD) is a crucial clinical challenge as effective treatment is quite different for each condition. In this study electroencephalography (EEG) was explored as an objective biomarker for distinguishing MDD from BD using an efficient machine learning algorithm (MLA) trained by a relatively large and balanced dataset. METHODS: A 3 step MLA was applied: (1) a multi-step preprocessing method was used to improve the quality of the EEG signal, (2) symbolic transfer entropy (STE), an effective connectivity measure, was applied to the resultant EEG and (3) the MLA used the extracted STE features to distinguish MDD (N = 71) from BD (N = 71) subjects. RESULTS: 14 connectivity features were selected by the proposed algorithm. Most of the selected features were related to the frontal, parietal, and temporal lobe electrodes. The major involved regions were the Broca region in the frontal lobe and the somatosensory association cortex in the parietal lobe. These regions are near electrodes FC5 and CPz and are involved in processing language and sensory information, respectively. The resulting classifier delivered an evaluation accuracy of 88.5% and a test accuracy of 89.3%, using 80% of the data for training and evaluation and the remaining 20% for testing, respectively. CONCLUSIONS: The high evaluation and test accuracies of our algorithm, derived from a large balanced training sample suggests that this method may hold significant promise as a clinical tool. SIGNIFICANCE: The proposed MLA may provide an inexpensive and readily available tool that clinicians may use to enhance diagnostic accuracy and shorten time to effective treatment.