Preoperative Electroencephalography‐Based Machine Learning Predicts Cognitive Deterioration After Subthalamic Deep Brain Stimulation
Movement Disorders, vol. 36, pp. 2324–2334
Abstract
BACKGROUND: Subthalamic deep brain stimulation (STN DBS) may relieve refractory motor complications in Parkinson's disease (PD) patients. Despite careful screening, it remains difficult to determine severity of alpha-synucleinopathy involvement which influences the risk of postoperative complications including cognitive deterioration. Quantitative electroencephalography (qEEG) reflects cognitive dysfunction in PD and may provide biomarkers of postoperative cognitive decline. OBJECTIVE: To develop an automated machine learning model based on preoperative EEG data to predict cognitive deterioration 1 year after STN DBS. METHODS: Sixty DBS candidates were included; 42 patients had available preoperative EEGs to compute a fully automated machine learning model. Movement Disorder Society criteria classified patients as cognitively stable or deteriorated at 1-year follow-up. A total of 16,674 EEG-features were extracted per patient; a Boruta algorithm selected EEG-features to reflect representative neurophysiological signatures for each class. A random forest classifier with 10-fold cross-validation with Bayesian optimization provided class-differentiation. RESULTS: Tweny-five patients were classified as cognitively stable and 17 patients demonstrated cognitive decline. The model differentiated classes with a mean (SD) accuracy of 0.88 (0.05), with a positive predictive value of 91.4% (95% CI 82.9, 95.9) and negative predictive value of 85.0% (95% CI 81.9, 91.4). Predicted probabilities between classes were highly differential (hazard ratio 11.14 [95% CI 7.25, 17.12]); the risk of cognitive decline in patients with high probabilities of being prognosticated as cognitively stable (>0.5) was very limited. CONCLUSIONS: Preoperative EEGs can predict cognitive deterioration after STN DBS with high accuracy. Cortical neurophysiological alterations may indicate future cognitive decline and can be used as biomarkers during the DBS screening. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Authors 11
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Victor Jacobus Geraedts corresponding Aachen Department of Clinical Epidemiology Leiden University Medical Center Leiden The Netherlands Department of Neurology Leiden University Medical Center Leiden the Netherlands Department of Clinical Epidemiology Department of Neurology, Leiden University Medical Center (LUMC)
Leiden University Medical Center
Affiliation as printed
Department of Clinical Epidemiology Leiden University Medical Center Leiden The Netherlands
Department of Neurology Leiden University Medical Center Leiden The Netherlands
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
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Milan Koch Aachen Leiden Institute of Advanced Computer Science Leiden The Netherlands Leiden Institute of Advanced Computer Science
Affiliation as printed
Leiden Institute of Advanced Computer Science Leiden The Netherlands
Leiden Institute of Advanced Computer Science, Leiden, The Netherlands
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Roy Kuiper Aachen Department of Neurology Leiden University Medical Center Leiden the Netherlands Department of Neurology, Leiden University Medical Center (LUMC)
Leiden University Medical Center · Haga Hospital
Affiliation as printed
Department of Neurology Haga Teaching Hospital Den Haag The Netherlands
Department of Neurology Leiden University Medical Center Leiden The Netherlands
Department of Neurology, Haga Teaching Hospital, Den Haag, The Netherlands
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
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Marios Kefalas Aachen Leiden Institute of Advanced Computer Science Leiden The Netherlands Leiden Institute of Advanced Computer Science
Affiliation as printed
Leiden Institute of Advanced Computer Science Leiden The Netherlands
Leiden Institute of Advanced Computer Science, Leiden, The Netherlands
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Thomas Bäck Aachen Leiden Institute of Advanced Computer Science Leiden The Netherlands Leiden Institute of Advanced Computer Science
Affiliation as printed
Leiden Institute of Advanced Computer Science Leiden The Netherlands
Leiden Institute of Advanced Computer Science, Leiden, The Netherlands
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Jacobus Johannes van Hilten Aachen Department of Neurology Leiden University Medical Center Leiden the Netherlands Department of Neurology, Leiden University Medical Center (LUMC)
Leiden University Medical Center
Affiliation as printed
Department of Neurology Leiden University Medical Center Leiden The Netherlands
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
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Hao Wang Aachen Leiden Institute of Advanced Computer Science Leiden The Netherlands Leiden Institute of Advanced Computer Science
Affiliation as printed
Leiden Institute of Advanced Computer Science Leiden The Netherlands
Leiden Institute of Advanced Computer Science, Leiden, The Netherlands
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Huub A. M. Middelkoop Aachen Department of Neurology Leiden University Medical Center Leiden the Netherlands Department of Neurology, Leiden University Medical Center (LUMC) Neuropsychology Unit
Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Neurology Leiden University Medical Center Leiden The Netherlands
Neuropsychology Unit Leiden University Institute of Psychology Leiden The Netherlands
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
Neuropsychology Unit, Leiden University Institute of Psychology, Leiden, The Netherlands
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Niels Anthony Van Der Gaag Aachen Department of Neurosurgery Leiden University Medical Center Leiden The Netherlands Department of Neurosurgery, Leiden University Medical Center
Leiden University Medical Center · Haga Hospital
Affiliation as printed
Department of Neurosurgery Haga Teaching Hospital Den Haag The Netherlands
Department of Neurosurgery Leiden University Medical Center Leiden The Netherlands
Department of Neurosurgery, Haga Teaching Hospital, Den Haag, The Netherlands
Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands
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Maria Fiorella Contarino Aachen Department of Neurology Leiden University Medical Center Leiden the Netherlands Department of Neurology, Leiden University Medical Center (LUMC)
Leiden University Medical Center · Haga Hospital
Affiliation as printed
Department of Neurology Haga Teaching Hospital Den Haag The Netherlands
Department of Neurology Leiden University Medical Center Leiden The Netherlands
Department of Neurology, Haga Teaching Hospital, Den Haag, The Netherlands
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
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Martijn Rudolf Tannemaat Aachen Department of Neurology Leiden University Medical Center Leiden the Netherlands Department of Neurology, Leiden University Medical Center (LUMC)
Leiden University Medical Center
Affiliation as printed
Department of Neurology Leiden University Medical Center Leiden The Netherlands
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
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