Daily Papers

Diagnosing epilepsy is challenging when routine EEGs lack interictal epileptiform discharges (IEDs). Intermittent photic stimulation (IPS) and hyperventilation (HV) can increase diagnostic yield, but their interpretation is subjective. We propose a reproducible pipeline that classifies EEG recordings acquired during stimulation procedures, using machine-learning features spanning temporal, spectral, wavelet, and connectivity domains, and a stacked ensemble to combine complementary feature sets. Performance is evaluated with leave-one-subject-out (LOSO) cross-validation on the TUH Epilepsy Corpus and a clinical Erasmus MC (EMC) cohort, including IED-free analyses on TUH. On TUH, ensembles achieve up to 97.8\% AUC / 93.1\% BAC on IED-free resting-state EEG and 94.1\% AUC / 86.8\% BAC on IED-free IPS. On EMC, IPS provides the strongest discrimination (79.4\% AUC / 73.9\% BAC), while HV performance benefits from stratifying subjects by responsiveness. These results indicate that stimulation-evoked activity, particularly IPS, contains meaningful discriminative information for IED-free epilepsy classification and that multi-domain ensembling improves robustness.

Epilepsy affects over 50 million people worldwide, and one-third of patients suffer drug-resistant seizures where surgery offers the best chance of seizure freedom. Accurate localization of the epileptogenic zone (EZ) relies on intracranial EEG (iEEG). Clinical workflows, however, remain constrained by labor-intensive manual review. At the same time, existing data-driven approaches are typically developed on single-center datasets that are inconsistent in format and metadata, lack standardized benchmarks, and rarely release pathological event annotations, creating barriers to reproducibility, cross-center validation, and clinical relevance. With extensive efforts to reconcile heterogeneous iEEG formats, metadata, and recordings across publicly available sources, we present Omni-iEEG, a large-scale, pre-surgical iEEG resource comprising 302 patients and 178 hours of high-resolution recordings. The dataset includes harmonized clinical metadata such as seizure onset zones, resections, and surgical outcomes, all validated by board-certified epileptologists. In addition, Omni-iEEG provides over 36K expert-validated annotations of pathological events, enabling robust biomarker studies. Omni-iEEG serves as a bridge between machine learning and epilepsy research. It defines clinically meaningful tasks with unified evaluation metrics grounded in clinical priors, enabling systematic evaluation of models in clinically relevant settings. Beyond benchmarking, we demonstrate the potential of end-to-end modeling on long iEEG segments and highlight the transferability of representations pretrained on non-neurophysiological domains. Together, these contributions establish Omni-iEEG as a foundation for reproducible, generalizable, and clinically translatable epilepsy research. The project page with dataset and code links is available at omni-ieeg.github.io/omni-ieeg.

An accurate and efficient epileptic seizure onset detection can significantly benefit patients. Traditional diagnostic methods, primarily relying on electroencephalograms (EEGs), often result in cumbersome and non-portable solutions, making continuous patient monitoring challenging. The video-based seizure detection system is expected to free patients from the constraints of scalp or implanted EEG devices and enable remote monitoring in residential settings. Previous video-based methods neither enable all-day monitoring nor provide short detection latency due to insufficient resources and ineffective patient action recognition techniques. Additionally, skeleton-based action recognition approaches remain limitations in identifying subtle seizure-related actions. To address these challenges, we propose a novel Video-based Seizure detection model via a skeleton-based spatiotemporal Vision Graph neural network (VSViG) for its efficient, accurate and timely purpose in real-time scenarios. Our experimental results indicate VSViG outperforms previous state-of-the-art action recognition models on our collected patients' video data with higher accuracy (5.9% error), lower FLOPs (0.4G), and smaller model size (1.4M). Furthermore, by integrating a decision-making rule that combines output probabilities and an accumulative function, we achieve a 5.1 s detection latency after EEG onset, a 13.1 s detection advance before clinical onset, and a zero false detection rate. The project homepage is available at: https://github.com/xuyankun/VSViG/

Epilepsy diagnosis and treatment require evidence-intensive reasoning across heterogeneous clinical knowledge, including biosignal patterns, genetic mechanisms, pharmacogenomics, treatment strategies, and patient outcomes. In this work, we present EpiGraph, a large-scale epilepsy knowledge graph and benchmark for evaluating knowledge-augmented clinical reasoning. EpiGraph integrates 48,166 peer-reviewed papers and seven clinical resources into a heterogeneous graph containing 24,324 entities and 32,009 evidence-grounded triplets across five clinical layers. Built upon this graph, EpiBench defines five clinically motivated tasks spanning clinical decision-making, EEG report generation, pharmacogenomic precision medicine, treatment recommendation, and deep research planning. We evaluate six LLMs under both standard and Graph-RAG settings. Results show that integrating EpiGraph consistently improves performance across all tasks, with the largest gains observed in pharmacogenomic reasoning (+30--41\%). Our findings demonstrate that structured epilepsy knowledge substantially enhances evidence-grounded clinical reasoning and provides a practical benchmark framework for evaluating knowledge-augmented LLMs in real-world neurological settings. Our code is available at: https://github.com/LabRAI/EEG-KG.

Objective: Forecasting epileptic seizures can reduce uncertainty for patients and allow preventative actions. While many models can predict the occurrence of seizures from features of the EEG, few models incorporate changes in features over time. Long Short-Term Memory (LSTM) neural networks are a machine learning architecture that can display temporal dynamics due to the recurrent connections. In this paper, we used LSTMs to monitor changes in EEG features over time to improve the accuracy of seizure forecasts and to alter the time window of the forecast. Methods: Long-term intracranial EEG recordings from eight patients from the NeuroVista dataset were used. A Fourier transform of 1-minute segments of EEG was fed into a Convolutional Neural Network (CNN). The outputs from the CNN were input to three different LSTM models at different time intervals: 1 minute, 1 hour and 1 day. The LSTM model outputs were used to predict seizure onset within a time window. The prediction and start of the time window were separated by the same length of time as the window. Window sizes tested included 2, 4, 10, 20 and 40 minutes. Results and Conclusion: Our model forecast seizure onsets well above a random predictor. Compared to other models using the same dataset, our model performed better for some patients and worse for others. Monitoring the change in EEG features over time allowed our model to produce good results over a range of different window sizes, which is an improvement on previous models and raises the possibility of altering the forecast to meet individual patient needs. Furthermore, a window size of 40 minutes provides a potential intervention time of 40 minutes, which is the first time an intervention time of more than 5 minutes have been forecast using long-term EEG recordings.

Generating clinical reports that summarize abnormal patterns, diagnostic findings, and clinical interpretations from long-term EEG recordings remains labor-intensive. We curate a large-scale clinical EEG dataset with 9{,}922 reports paired with approximately 11{,}000 hours of EEG recordings from 9{,}048 patients. We therefore develop CELM, the first clinical EEG-to-Language foundation model capable of summarizing long-duration, variable-length EEG recordings and performing end-to-end clinical report generation at multiple scales, including recording description, background activity, epileptiform abnormalities, events/seizures, and impressions. Experimental results show that, with patient history supervision, our method achieves 70%-95% average relative improvements in standard generation metrics (e.g., ROUGE-1 and METEOR) from 0.2-0.3 to 0.4-0.6. In the zero-shot setting without patient history, CELM attains generation scores in the range of 0.43-0.52, compared to baselines of 0.17-0.26. CELM integrates pretrained EEG foundation models with language models to enable scalable multimodal learning. We release our model and benchmark construction pipeline at https://github.com/Jathurshan0330/CELM.

Epilepsy is a common disease of the nervous system. Timely prediction of seizures and intervention treatment can significantly reduce the accidental injury of patients and protect the life and health of patients. This paper presents a neuromorphic Spiking Convolutional Transformer, named Spiking Conformer, to detect and predict epileptic seizure segments from scalped long-term electroencephalogram (EEG) recordings. We report evaluation results from the Spiking Conformer model using the Boston Children's Hospital-MIT (CHB-MIT) EEG dataset. By leveraging spike-based addition operations, the Spiking Conformer significantly reduces the classification computational cost compared to the non-spiking model. Additionally, we introduce an approximate spiking neuron layer to further reduce spike-triggered neuron updates by nearly 38% without sacrificing accuracy. Using raw EEG data as input, the proposed Spiking Conformer achieved an average sensitivity rate of 94.9% and a specificity rate of 99.3% for the seizure detection task, and 96.8%, 89.5% for the seizure prediction task, and needs >10x fewer operations compared to the non-spiking equivalent model.

Implanted devices providing real-time neural activity classification and control are increasingly used to treat neurological disorders, such as epilepsy and Parkinson's disease. Classification performance is critical to identifying brain states appropriate for the therapeutic action. However, advanced algorithms that have shown promise in offline studies, in particular deep learning (DL) methods, have not been deployed on resource-restrained neural implants. Here, we designed and optimized three embedded DL models of commonly adopted architectures and evaluated their inference performance in a case study of seizure detection. A deep neural network (DNN), a convolutional neural network (CNN), and a long short-term memory (LSTM) network were designed to classify ictal, preictal, and interictal phases from the CHB-MIT scalp EEG database. After iterative model compression and quantization, the algorithms were deployed on a general-purpose, off-the-shelf microcontroller. Inference sensitivity, false positive rate, execution time, memory size, and power consumption were quantified. For seizure event detection, the sensitivity and FPR (h-1) for the DNN, CNN, and LSTM models were 87.36%/0.169, 96.70%/0.102, and 97.61%/0.071, respectively. Predicting seizures for early warnings was also feasible. The implemented compression and quantization achieved a significant saving of power and memory with an accuracy degradation of less than 0.5%. Edge DL models achieved performance comparable to many prior implementations that had no time or computational resource limitations. Generic microcontrollers can provide the required memory and computational resources, while model designs can be migrated to ASICs for further optimization. The results suggest that edge DL inference is a feasible option for future neural implants to improve classification performance and therapeutic outcomes.

Reliable automatic seizure detection from long-term EEG remains a challenge, as current machine learning models often fail to generalize across patients or clinical settings. Manual EEG review remains the clinical standard, underscoring the need for robust models and standardized evaluation. To rigorously assess algorithm performance, we organized a challenge using a private dataset of continuous EEG recordings from 65 subjects (4,360 hours). Expert neurophysiologists annotated the data, providing ground truth for seizure events. Participants were required to detect seizure onset and duration, with evaluation based on event-based metrics, including sensitivity, precision, F1-score, and false positives per day. The SzCORE framework ensured standardized evaluation. The primary ranking criterion was the event-based F1-score, reflecting clinical relevance by balancing sensitivity and false positives. The challenge received 30 submissions from 19 teams, with 28 algorithms evaluated. Results revealed wide variability in performance, with a top F1-score of 43% (sensitivity 37%, precision 45%), highlighting the ongoing difficulty of seizure detection. The challenge also revealed a gap between reported performance and real-world evaluation, emphasizing the importance of rigorous benchmarking. Compared to previous challenges and commercial systems, the best-performing algorithm in this contest showed improved performance. Importantly, the challenge platform now supports continuous benchmarking, enabling reproducible research, integration of new datasets, and clinical evaluation of seizure detection algorithms using a standardized framework.

Extracellular recordings are transient voltage fluctuations in the vicinity of neurons, serving as a fundamental modality in neuroscience for decoding brain activity at single-neuron resolution. Spike sorting, the process of attributing each detected spike to its corresponding neuron, is a pivotal step in brain sensing pipelines. However, it remains challenging under low signal-to-noise ratio (SNR), electrode drift and cross-session variability. In this paper, we propose HuiduRep, a robust self-supervised representation learning framework that extracts discriminative and generalizable features from extracellular recordings. By integrating contrastive learning with a denoising autoencoder, HuiduRep learns latent representations that are robust to noise and drift. With HuiduRep, we develop a spike sorting pipeline that clusters spike representations without ground truth labels. Experiments on hybrid and real-world datasets demonstrate that HuiduRep achieves strong robustness. Furthermore, the pipeline outperforms state-of-the-art tools such as KiloSort4 and MountainSort5. These findings demonstrate the potential of self-supervised spike representation learning as a foundational tool for robust and generalizable processing of extracellular recordings. Code is available at: https://github.com/IgarashiAkatuki/HuiduRep

Parkinsons disease (PD) alters cortical neural dynamics, yet reliable non-invasive electrophysiological biomarkers remain elusive. This study examined whether interpretable EEG features capturing complementary aspects of neural dynamics can discriminate Parkinsonian neural states. A comprehensive set of interpretable features was extracted and grouped into Standard descriptors (spectral power, phase synchronization, time-domain statistics) and Dynamical descriptors (aperiodic activity, cross-frequency coupling, scale-free dynamics, neuronal avalanche statistics, and instantaneous frequency measures). A multi-head attention transformer classifier was trained using strict LOSO validation. Group-level comparisons were performed to identify electrophysiological differences associated with disease and medication state. Standard feature sets achieved strongest performance in discriminating medication states (PDoff vs PDon), whereas Dynamical performed competitively in contrasts between PD patients and healthy controls. Random feature ablation analyses indicated that Dynamical descriptors provide complementary information distributed across features while correlation analysis revealed low redundancy within both feature sets. Group-level comparisons revealed medication-sensitive reductions in delta power and voltage variance, modulation of neuronal avalanche statistics, persistent increases in theta phase synchronization in PD patients, and disease-related alterations in cross-frequency interactions. Traditional spectral and synchronization features primarily reflect medication-related neural modulation, whereas dynamical descriptors reveal broader alterations in cortical network organization associated with disease but also with medication. These findings support multivariate EEG representations as a promising framework for developing non-invasive biomarkers of PD.

Forecasting epileptic seizures from multivariate EEG signals represents a critical challenge in healthcare time series prediction, requiring high sensitivity, low false alarm rates, and subject-specific adaptability. We present STAN, an Adversarial Spatio-Temporal Attention Network that jointly models spatial brain connectivity and temporal neural dynamics through cascaded attention blocks with alternating spatial and temporal modules. Unlike existing approaches that assume fixed preictal durations or separately process spatial and temporal features, STAN captures bidirectional dependencies between spatial and temporal patterns through a unified cascaded architecture. Adversarial training with gradient penalty enables robust discrimination between interictal and preictal states learned from clearly defined 15-minute preictal windows. Continuous 90-minute pre-seizure monitoring reveals that the learned spatio-temporal attention patterns enable early detection: reliable alarms trigger at subject-specific times (typically 15-45 minutes before onset), reflecting the model's capacity to capture subtle preictal dynamics without requiring individualized training. Experiments on two benchmark EEG datasets (CHB-MIT scalp: 8 subjects, 46 events; MSSM intracranial: 4 subjects, 14 events) demonstrate state-of-the-art performance: 96.6% sensitivity with 0.011 false detections per hour and 94.2% sensitivity with 0.063 false detections per hour, respectively, while maintaining computational efficiency (2.3M parameters, 45 ms latency, 180 MB memory) for real-time edge deployment. Beyond epilepsy, the proposed framework provides a general paradigm for spatio-temporal forecasting in healthcare and other time series domains where individual heterogeneity and interpretability are crucial.

Generating clinical reports from raw recordings such as X-rays and electroencephalogram (EEG) is an essential and routine task for doctors. However, it is often time-consuming to write accurate and detailed reports. Most existing methods try to generate the whole reports from the raw input with limited success because 1) generated reports often contain errors that need manual review and correction, 2) it does not save time when doctors want to write additional information into the report, and 3) the generated reports are not customized based on individual doctors' preference. We propose {\it CL}inic{\it A}l {\it R}eport {\it A}uto-completion (CLARA), an interactive method that generates reports in a sentence by sentence fashion based on doctors' anchor words and partially completed sentences. CLARA searches for most relevant sentences from existing reports as the template for the current report. The retrieved sentences are sequentially modified by combining with the input feature representations to create the final report. In our experimental evaluation, CLARA achieved 0.393 CIDEr and 0.248 BLEU-4 on X-ray reports and 0.482 CIDEr and 0.491 BLEU-4 for EEG reports for sentence-level generation, which is up to 35% improvement over the best baseline. Also via our qualitative evaluation, CLARA is shown to produce reports which have a significantly higher level of approval by doctors in a user study (3.74 out of 5 for CLARA vs 2.52 out of 5 for the baseline).

Learning from multi-variate time-series with heterogeneous channel configurations remains a fundamental challenge for deep neural networks (DNNs), particularly in clinical domains such as intracranial electroencephalography (iEEG), where channel setups vary widely across subjects. In this work, we introduce multi-variate parallel attention (MVPA), a novel self-attention mechanism that disentangles content, temporal, and spatial attention, enabling flexible, generalizable, and efficient modeling of time-series data with varying channel counts and configurations. We use MVPA to build MVPFormer, a generative foundation model for human electrophysiology, trained to predict the evolution of iEEG signals across diverse subjects. To support this and future effort by the community, we release the SWEC iEEG dataset, the largest publicly available iEEG dataset to date, comprising nearly 10,000 hours of recordings from heterogeneous clinical sources. MVPFormer leverages MVPA to achieve strong generalization across subjects, demonstrating expert-level performance in seizure detection and outperforming state-of-the-art Transformer baselines on our SWEC, the MAYO, and the FNUSA dataset. We further validate MVPA on standard time-series forecasting and classification tasks, where it matches or exceeds existing attention-based models. Together, our contributions establish MVPA as a general-purpose attention mechanism for heterogeneous time-series and MVPFormer as the first open-source, open-weights, and open-data iEEG foundation model with state-of-the-art clinical performance. The code is available at https://github.com/IBM/multi-variate-parallel-transformer. The SWEC iEEG dataset is available at https://mb-neuro.medical-blocks.ch/public_access/databases/ieeg/swec_ieeg.