首个评估脑电基础模型在重症监护中爆发抑制检测的论文,效果优于传统方法。
Evaluation of EEG Foundation Models for Event-Based Burst-Suppression Detection in ICU

- 用基础模型直接检测重症患者脑电爆发抑制,无需个体化调参。
- 最佳模型REVE-base事件级F1达0.868,误报率降低超一半。
- 预训练模型在小样本下仍表现优异,适合临床快速部署。
爆发抑制(BS)是危重病人(尤其是诱导昏迷时)用于监测镇静深度和脑活动的重要脑电图(EEG)模式。自动爆发检测仍具挑战性,因患者间差异大且标注数据稀缺。近期脑电基础模型(FMs)在多个下游任务中展现出潜力,但其在爆发抑制检测中的应用尚未探索。本研究首次评估了三种脑电基础模型(REVE-base、LUNA-large、LuMamba-Tiny)在少导联重症监护脑电图中无患者特异性校准下的爆发检测性能,并与自适应阈值法和专用的EEGNet基线进行对比。此外,采用基于事件的爆发检测评估方式,可更准确评估临床实际中爆发段是否被正确识别,降低标注变异影响。最优模型REVE-base在事件级上取得最高F1分数(0.868 ± 0.167),相比EEGNet和自适应阈值法,每分钟爆发误差分别降低52.1%和36.2%,支持基础模型在重症监护中实现可扩展的脑电监测。消融实验表明,全量微调是最有效的适配策略,相比冻结主干训练,使LUNA-large的事件级F1提升最高达+0.102。在仅使用25%标注数据时,预训练的REVE-base仍比随机初始化高出0.723的事件级F1,证明了预训练表征在小样本场景下的显著优势。
原文摘要 · Abstract (English)
Burst suppression (BS) is a clinically relevant electroencephalographic (EEG) pattern used to monitor sedation depth and brain activity in critically ill patients, particularly during induced coma in Intensive Care Units (ICUs). Automatic burst detection remains challenging because BS patterns vary substantially between patients and annotated datasets are scarce. Recently, EEG Foundation Models (FMs) have shown promise across several downstream EEG applications, but their usefulness for BS detection remains unexplored. We present the first study to evaluate EEG FMs for burst detection in reduced-montage ICU EEG without patient-specific calibration. We compare REVE-base, LUNA-large and LuMamba-Tiny with an adaptive thresholding baseline and a task-specific EEGNet baseline. Additionally, we complement conventional EEG window-based classification with event-based burst detection evaluation. This helps assessing clinically whether burst episodes are correctly detected, reducing the impact of expected annotation variability. The best model, REVE-base, achieved the highest event-based F1-score ($0.868 \pm 0.167$) and reduced burst-per-minute error by 52.1% and 36.2% compared to EEGNet and adaptive thresholding respectively, supporting FMs for scalable EEG monitoring in ICU. Ablation experiments showed that full fine-tuning was the most effective adaptation strategy with respect to frozen-backbone training, two-step fine-tuning, and LoRA-based adaptation, improving event-based F1-score over frozen-backbone training by up to $+0.102$ for LUNA-large. With reduced labeled datasets, pretrained REVE-base outperformed random initialization by $+0.723$ event-based F1 points at 25% of the cohort, demonstrating the benefit of pretraining FM representations when adapted to burst detection with limited labeled data.
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