Deep Neural Network-Based Segmentation of Epileptiform Activity Patterns in EEG Approaches Inter-Expert Agreement for a Pediatric Test Cohort

Automatic analysis of electroencephalography (EEG) recordings relies on large, high-quality labeled datasets. Manual segmentation by medical experts is resource-intensive and time-consuming. Moreover, to overcome potential subjectivity in labeling, independent annotation by at least two experts is required. Therefore, reliable automatic data labeling is essential for obtaining the large datasets needed to train robust AI models. In this paper, we show that a properly trained state-of-the-art deep neural network (DNN) achieves labeling performance comparable to inter-expert agreement in the task of segmenting epileptiform activity patterns. To this end, we first compiled a custom database of EEG recordings containing such patterns. Second, five experts based on part of these recordings independently assessed spike-wave index (SWI), which is a key diagnostic criterion that indicates the percentage of the EEG recording during which epileptic discharges are observed. Third, we compared the expert assessments with SWI calculated based on automatic segmentation by the trained DNN. Our results demonstrate that the 1D U-Net architecture achieves competitive overall performance and aligns well with both expert assessments and expert-derived SWI values. Thus, automated segmentation and analysis of EEG recordings holds great promise for accelerating diagnosis and developing targeted therapeutic strategies for epilepsy.