Generalizable Seizure Prediction With LLMs: Converting EEG to Textual Representations.

Abstract

Seizure prediction through scalp electroencephalogram (EEG) holds considerable practical potential. The primary challenge faced by existing algorithms lies in the individual heterogeneity, which hinders the generalizability of models to new patients. Additionally, inconsistencies in channel settings across various epilepsy centers further limit the applicability of models to diverse datasets. To address these challenges, we incorporate large language models (LLMs) into EEG analysis and propose a novel seizure prediction method based on LLMs (SPLLM), significantly enhancing both model generalizability and applicability. Specifically, this approach reprograms LLMs by transforming EEG signals into textual representations compatible with LLMs via a single-channel pre-training strategy. The method integrates cross-domain knowledge from both text and EEG data through a cross-attention mechanism, utilizing autoregressive pretrained LLMs to capture the temporal dependencies inherent in EEG signals. Moreover, the cross-domain generalization ability of LLMs alleviates patient heterogeneity, while the single-channel pre-training strategy enables the model to adapt to diverse channel settings. On two public datasets and one private dataset, SPLLM increases the average AUC by 8.2%, and the average balanced accuracy by 8.4% compared to existing methods. Experimental results demonstrate that the proposed method not only enhances cross-patient prediction accuracy but also adapts to data from different datasets, offering a scalable solution for the clinical application of seizure prediction.