DCPat-XFE: an explainable EEG model for psychogenic nonepileptic seizure detection

Abstract

Detecting Psychogenic Nonepileptic Seizures (PNES) is vital because PNES mimics epileptic seizures but has psychological-not electrical-origins, leading to frequent misdiagnosis and ineffective treatment. Electroencephalography (EEG) provides a non-invasive view of brain activity for distinguishing PNES from true epilepsy. Current PNES detection methods remain limited. This study introduces a curated PNES EEG dataset and a novel explainable feature-engineering (XFE) model. Expert neurologists annotated three classes: Normal, PNES with Verbal Suggestion Provocation (VSP+), and PNES without VSP (VSP -). The introduced explainable feature engineering (XFE) framework includes four components: (i) Distance Counter Pattern (DCPat) for channel-pair feature extraction (190 features for 20 channels), (ii) Cumulative Weight-based Neighborhood Component Analysis (CWNCA) for feature selection (threshold = 0.99), (iii) t-algorithm k-Nearest Neighbors (tkNN) ensemble classifier with Iterative Majority Voting (IMV) and greedy optimization, and (iv) Directed Lobish (DLob) for symbolic interpretation and cortical connectome mapping. For this research, we curated an EEG dataset and four cases are created using the curated dataset. These four cases are: Case 1 (Normal vs. PNES VSP+), Case 2 (Normal vs. PNES VSP-), Case 3 (PNES VSP + vs. PNES VSP-), and Case 4 (all three classes).). The introduced DCPat XFE framework reached accuracy above 96.5% in all four cases; Case 2 attained the best overall value (99.11%). DLob strings and connectome diagrams provided clear symbolic explanations of PNES-related patterns. The DCPat-based XFE framework yields high accuracy and interpretable outputs for PNES detection on EEG. These results support its use as a reliable, explainable tool for clinical decision support.