Interpretable Multimodal EEG-ECG Framework for Neonatal Seizure Prediction and Patient-Adaptive Transfer Learning

Epileptic seizure prediction from electroencephalographic (EEG) recordings remains challenging due to strong inter-patient variability and the complex temporal structure of neural signals. This paper presents a patient-adaptive transformer framework for short-horizon seizure forecasting. The proposed approach employs a two-stage training strategy: self-supervised pretraining is first used to learn general EEG temporal representations through autoregressive sequence modeling, followed by patient-specific fine-tuning for binary prediction of seizure onset within a 30-second horizon. To enable transformer-based sequence learning, multichannel EEG signals are processed using noise-aware preprocessing and discretized into tokenized temporal sequences. Experiments conducted on subjects from the TUH EEG dataset demonstrate that the proposed method achieves validation accuracies above 90% and F1 scores exceeding 0.80 across evaluated patients, supporting the effectiveness of combining self-supervised representation learning with patient-specific adaptation for individualized seizure prediction.

Epilepsy is one of the most common neurological disorders globally, characterized by recurring seizures and significantly impacting the quality of life. Despite advancements in diagnostic techniques, the mitigation of risks faced by epilepsy patients remains challenging due to the unpredictability of seizure events. An accurate forecast of seizure onset helps to reduce risks in epilepsy patients. In this paper, we propose EEG-FuseFormer, a transformer-based feature fusion framework for seizure-onset prediction that combines intermediate features extracted from Convolutional Neural Networks-Long Short-Term Memory (CNN-LSTM) and ResNet-18 networks. The CNN-LSTM architecture captures both spatial and temporal features directly from the raw signal, whereas the ResNet-18 extracts features from the Short-Time Fourier Transform (STFT) representation of the EEG signals. Fusion is carried out using a transformer encoder, and the final prediction is generated using fully connected dense layers. The CHB-MIT dataset was used to validate the proposed model. The results show that the proposed model achieves a mean recall of 98.85% and outperforms most of the state-of-the-art methods. This study evaluates the ability of the proposed feature fusion model to generalize in cross-patient testing scenarios. Fine-tuning pre-trained models on limited target patient data (target adaptation) within the cross-patient validation framework results in higher recall, precision, and F1-score metrics in comparison to the conventional cross-patient validation approach. Finally, the runtime-based computational complexity of the model is assessed across diverse hardware platforms to highlight the performance-complexity trade-off.

Seizure prediction and detection, essential for clinical treatment of epilepsy, remain the crucial task of this neurological disease. EEG and iEEG are widely used to analyze epilepsy due to its capability of capturing discriminative brain activities at high time resolution. However, existing works generally analyze either EEG or iEEG seizure activity separately, where EEG analysis has been well-researched, while more and more works consider iEEG for its higher specificity at the spatial level and signal quality. Currently, most of the existing seizure prediction systems are single-modal in nature, which limits its application to a variety of clinical conditions. Therefore, a common framework to analyze seizures with both EEG and iEEG signals needs to be developed. This paper presents a new framework of multimodal seizure classification integrating the heterogeneous EEG and iEEG recordings from different subjects and sources. A specific framework, called Unified Multimodal Signal Harmonization (UMSH), is developed for harmonizing signals with varied sampling rates and recording conditions. Moreover, to handle the extremely class-imbalanced problem in the data sets, we use a Conditional Generative Adversarial Network (cGAN) based data augmentation technique to generate synthetic samples to balance the class distribution. The proposed framework uses the EEGNet-Vision Transformer (EEGNet-ViT) as the feature extraction and classification network to learn the local discriminative patterns as well as global contextual information in the multimodal seizure data. Experimental results demonstrate the effectiveness of the proposed framework for robust seizure classification, emphasizing the potential of integrated EEG-iEEG multimodal learning in advancing next-generation epilepsy monitoring and clinical decision-support systems.