The class imbalance problem in automatic localization of the epileptogenic zone for epilepsy surgery: a systematic review

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Authors

HRTOŇOVÁ Valentina JABER Kassem NEJEDLÝ Petr BLACKWOOD Elizabeth R KLIMES Petr FRAUSCHER Birgit

Year of publication 2025
Type Article in Periodical
Magazine / Source JOURNAL OF NEURAL ENGINEERING
MU Faculty or unit

Faculty of Medicine

Citation
web https://iopscience.iop.org/article/10.1088/1741-2552/ade28c
Doi https://doi.org/10.1088/1741-2552/ade28c
Keywords epileptogenic zone; seizure-onset zone; epilepsy surgery; intracranial electrophysiology; machine learning; class imbalance; cost-sensitive learning
Attached files
Description Objective. Accurate localization of the epileptogenic zone (EZ) is crucial for epilepsy surgery, but the class imbalance of epileptogenic vs. non-epileptogenic electrode contacts in intracranial electroencephalography (iEEG) data poses significant challenges for automatic localization methods. This review evaluates methodologies for handling the class imbalance in EZ localization studies that use machine learning (ML). Approach. We systematically reviewed studies employing ML to localize the EZ from iEEG data, focusing on strategies for addressing class imbalance in data handling, algorithm design, and evaluation. Results. Out of 2,128 screened studies, 35 fulfilled the inclusion criteria. Across the studies, the iEEG contacts annotated as epileptogenic prior to automatic localization constituted a median of 18.34% of all contacts. However, many of these studies did not adequately address the class imbalance problem. Techniques such as data resampling and cost-sensitive learning were used to mitigate the class imbalance problem, but the chosen evaluation metrics often failed to account for it. Significance. Class imbalance significantly impacts the reliability of EZ localization models. More comprehensive management and innovative approaches are needed to enhance the robustness and clinical utility of these models. Addressing class imbalance in ML models for EZ localization will improve both the predictive performance and reliability of these models.
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