Mental Health Screening Using the Heart Rate Variability and Frontal Electroencephalography Features: A Machine Learning-Based Approach.

BACKGROUND: Heart rate variability (HRV) is a physiological marker of the cardiac autonomic modulation and related emotional regulation. Electroencephalography (EEG) is reflective of brain cortical activities and related psychopathology. The HRV and EEG have been employed in machine learning- and deep learning-based algorithms either alone or with other wearable device-based features to classify patients with psychiatric disorder (PT) and healthy controls (HC). Little study examined the utility of wearable device-based physiological markers to discern PT with various psychiatric diagnosis versus HC. OBJECTIVE: This study examined the HRV and prefrontal EEG features most frequently selected in the support vector machine (SVM) having the highest classification accuracy of PT versus HC, contributing to the individual-level initial screening of PT and minimized duration of untreated psychiatric illness. METHODS: A simultaneous acquisition of 5 minute-length PPG (measured on right ear lobe) and resting-state EEG (with eye-closed; using two left/right forehead-located electrodes) of 182 participants [87 PT (including major depressive disorder (70.1%) and panic disorder (12.6%)) and 95 HC] were performed. The PPG-based HRV features were quantified for both time- and frequency-domains. The time-varying EEG signals were converted into frequency-domain signals of the power spectral density. In the feature selection of the Gaussian radial basis function kernel-based support vector machine (SVM) models, estimators were comprised of top N (1£N£22) highest scored HRV/EEG features based on the one-way ANOVA F-value. Classification performance of SVM model (PT vs. HC) having N estimators was assessed using the Leave-one-out cross-validation (LOOCV; N = 182), to confirm those showing the highest balanced accuracy and area under the receiver operating characteristic curve (AUROC) as final classification model. RESULTS: The final SVM model having 13 estimators showed balanced accuracy of 0.76 and AUROC of 0.78. Power spectral density of HRV in the high frequency, very low frequency, low frequency (LF) bands, and total power, a product of the mean of the 5-minute standard deviation of all NN intervals (SDNN) and normalized LF power of HRV, power spectral density of frontal EEG in the high alpha and alpha peak frequency comprised the top 13-scored classification features in > 90% of the LOOCV. CONCLUSIONS: This study showed a possible synergic effect of combining the HRV and prefrontal EEG features in machine learning-based mental health screening. Future studies to predict the treatment response and to propose the preferred treatment regimen based on the baseline physiological markers are required. CLINICALTRIAL: N/A.

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