cs.LGSep 30, 2026

Fusion techniques of time frequency-based images to predict the outcome of rTMS depression therapy

Authors: Wael Korani, Md Fahimul Kabir Chowdhury, Mohammed Aledhari, Reza Rostami, Reza Kazemi

Abstract

Depression is a mental condition that can lead to suicide and self-harm. Predicting the outcome of depression treatment is one of the most difficult tasks for clinicians. Among various treatment options, repetitive Transcranial Magnetic Stimulation (rTMS) is a widely used non-invasive method. Predicting rTMS response using Electroencephalogram (EEG) data is difficult because of high inter-subject variability and limited features from single-domain analysis. We introduce two fusion techniques, montage and blending, to overcome these limitations and extract richer features from EEG-derived Time-Frequency (TF) images. We then propose a lightweight custom Convolutional Neural Network (CNN) trained on fused TF representations. \textcolor{black}{We use a primary dataset of 15 patients and a secondary dataset of 46 patients. We run two sets of experiments. The first set uses segment-level 10-fold cross-validation. In this setup segments from the same patient can appear in both training and testing. The Montage CWT_ST fusion reaches 99.90% accuracy on the primary dataset and 91.90% on the secondary dataset. The second set uses strict subject-disjoint cross-validation. All segments of a patient stay in one fold and no patient appears in both training and testing. Performance collapses. We test four time-frequency methods, six fusion mechanisms, and fourteen model architectures. With one exception, every configuration on both cohorts falls between AUC 0.31 and 0.54 and every 95% confidence interval contains 0.5. A patient-level permutation test on the best standalone method returns p=0.703p = 0.703. The best subject-level result is Montage CWT_ST on the primary cohort, which reaches AUC 0.874±0.1830.874 \pm 0.183 and 82.7% accuracy.

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