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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Dance of the Neurons: Unraveling Sex from Brain Signals</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Mohammad-Javad Darvishi-Bayazi</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff1">1</xref>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Mohammad Sajjad Ghaemi</string-name>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Jocelyn Faubert</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Irina Rish</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Faubert Lab</institution>
          ,
          <addr-line>Montréal, QC</addr-line>
          ,
          <country country="CA">Canada</country>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>Mila - Québec AI Institute</institution>
          ,
          <addr-line>Montréal, QC</addr-line>
          ,
          <country country="CA">Canada</country>
        </aff>
        <aff id="aff2">
          <label>2</label>
          <institution>National Research Council Canada</institution>
          ,
          <addr-line>Toronto, ON</addr-line>
          ,
          <country country="CA">Canada</country>
        </aff>
        <aff id="aff3">
          <label>3</label>
          <institution>Université de Montréal</institution>
          ,
          <addr-line>Montréal, QC</addr-line>
          ,
          <country country="CA">Canada</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>Previous studies have shown that machine learning can predict biological sex from EEG data with high accuracy. However, the validity and generalizability of these findings across diferent datasets and tasks still need to be clarified. In this paper, we investigated the robustness and transferability of sex-related patterns in EEG data using a Convolutional neural network (CNN) trained on several corpora of EEG recordings ranging from 221 to 12, 000 participants from healthy and diseased subjects. We evaluated the CNN on datasets from various sources and groups, with varying degrees of shift in their distributions. We found that CNNs can detect sex from EEG data accurately on datasets without fine-tuning or adaptation when the shift is low. However, performance drops where the shift is drastic. These results suggest that sex-related patterns in EEG data are robust and transferable across diverse datasets and relevant tasks. We discuss the implications of these findings for EEG analysis, machine learning applications, and best practices to avoid sex biases that enhance personalized mental health interventions.</p>
      </abstract>
      <kwd-group>
        <kwd>eol&gt;EEG</kwd>
        <kwd>Sex Prediction</kwd>
        <kwd>Artificial Neural Network</kwd>
        <kwd>Machine Learning</kwd>
        <kwd>Robustness</kwd>
        <kwd>Transfer Learning</kwd>
        <kwd>Mental Health</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>Machine Learning for Cognitive and Mental Health Workshop
(ML4CMH), AAAI 2024, Vancouver, BC, Canada
* Corresponding author.
$ mohammad.bayazi@mila.quebec (M. Darvishi-Bayazi)
 https://www.linkedin.com/in/mjdarvishi/ (M. Darvishi-Bayazi)
0000-0002-3251-8491 (M. Darvishi-Bayazi)
© 2024 Copyright for this paper by its authors. Use permitted under Creative Commons License</p>
      <p>
        Attribution 4.0 International (CC BY 4.0).
varying sample sizes and populations, including both steps to the EEG data, including 21 common channels,
normal and abnormal 1 populations. Also, we examined which were selected across the datasets. We used Artifact
the performance of classifiers under the distribution shift Subspace Reconstruction (ASR) [
        <xref ref-type="bibr" rid="ref15">15</xref>
        ] to remove artifacts
on unseen data. Ultimately, our findings contribute to from the EEG. We z-scored the EEG signals to each
chanmore robust and applicable insights for targeted and per- nel’s statistics. We used predefined test sets to report the
sonalized mental health interventions. accuracy of our models and 15% of the training splits for
model selection.
2.2. Model
      </p>
    </sec>
    <sec id="sec-2">
      <title>2. Material and Methods</title>
      <sec id="sec-2-1">
        <title>2.1. Datasets</title>
        <p>
          We used ShallowNet [
          <xref ref-type="bibr" rid="ref16">16</xref>
          ] as our model for all experiments,
as it is a simple and eficient Convolutional Neural
network (CNN) that can perform well on various EEG tasks.
        </p>
        <p>
          ShallowNet consists of only one convolutional layer
followed by a fully connected layer, which reduces the
number of parameters and the computational cost compared
to deeper networks. We implemented ShallowNet in
BrainDecode [
          <xref ref-type="bibr" rid="ref17">17</xref>
          ] and trained it using the AdamW
optimizer with a learning rate of 0.000625, weight decay of
0, drop probability of 0.5, and a batch size of 64. We used
binary cross-entropy as the loss function and balanced
accuracy (BAC) as the evaluation metric.
        </p>
        <p>We used three publicly available EEG datasets with
diferent sample sizes and conditions to investigate the efect
of sex on EEG signals. The datasets are:</p>
        <p>
          NMT (NUST-MH-TUKL EEG): This dataset contains
2, 417 recordings from healthy and pathological subjects,
with a total duration of 625 hours. The recordings are
labelled as normal or abnormal by qualified neurologists
and also include demographic information, such as sex
and age [
          <xref ref-type="bibr" rid="ref11">11</xref>
          ].
        </p>
        <p>
          TUAB (Temple University Hospital Abnormal
EEG Corpus): This dataset is a subset of the TUEG
corpus that contains 1, 985 recordings from 1, 652 subjects,
with a total duration of 453 hours. The recordings are 2.3. Training and Evaluation
labelled as normal or abnormal by qualified neurologists
[
          <xref ref-type="bibr" rid="ref12 ref13 ref14">12, 13, 14</xref>
          ]. The training and evaluation of the model were conducted
        </p>
        <p>
          TUEG (Temple University Hospital EEG Corpus): with the primary objective of classifying sex from EEG
This dataset is a large open-source corpus of EEG data, signals. Our focus extended beyond the training dataset
containing over 69, 000 recordings from 14, 987 subjects, to include a comprehensive analysis of model
perforwith a total duration of 27, 062 hours. The recordings mance on both the test split of the training dataset and
are de-identified and annotated with clinical information, other unseen datasets. The overarching goal was to assess
such as age and sex [
          <xref ref-type="bibr" rid="ref13 ref14">13, 14</xref>
          ]. the Sex Detectability (SD) from EEG signals and evaluate
        </p>
        <p>We utilize patient sex information, encoded as 0 or 1 the model’s robustness to distribution shifts in unseen
as our neural network target. We focus on sex instead data. We investigated detectability and transferability
unof gender due to the dataset’s clinical origin, assuming der various conditions to investigate the model’s
capabilpatients’ records reflected assigned birth sex rather than ities. Specifically, we explored the model’s performance
self-identified gender. We applied several preprocessing when trained and tested on subsets of the data,
considering scenarios where only Normal participants were
included, only Abnormal participants were included, or
when the entire dataset was utilized. This approach
allowed us to understand how well the model generalizes
across diferent participant profiles.
1The term “Normal/Abnormal” is used in original datasets to describe
EEG recordings that contain pathological features, such as epileptic
spikes, periodic discharges, or other abnormal patterns. It does
not imply any value judgment or stigma but rather reflects the
quality of the EEG signal. In this paper, we adhered to the same
terminology.</p>
        <p>Normal participants</p>
        <p>Al participants</p>
        <p>Test dataset</p>
        <p>TUAB
NMT
TUEG
TUAB</p>
        <p>NMT
Train dataset</p>
        <p>TUEG</p>
        <p>TUAB</p>
        <p>NMT
Train dataset</p>
        <p>TUEG</p>
        <p>TUAB</p>
        <p>NMT
Train dataset</p>
        <p>TUEG</p>
        <p>Furthermore, we conducted experiments to understand
the impact of SD on pathology detection. To achieve this,
we trained the model on the NMT dataset, which features
imbalances in diferent aspects. Our analysis focused on
diferent subgroups within the dataset, including Male
Normal, Female Normal, Male Abnormal, and Female
Abnormal participants. We aimed to elucidate any
potential associations between SD and pathology detection by
examining the model’s performance on these subgroups.</p>
        <p>We ran each experiment with three random seeds. All
error bars show the standard error of the metrics of the
three seeds.</p>
      </sec>
    </sec>
    <sec id="sec-3">
      <title>3. Results</title>
      <p>
        One of the objectives of this study is to investigate if
the biological sex of the subjects is detectable from their
scalp EEG recordings. This question is relevant for
understanding the sex-specific diferences in brain activity
and their implications for the diagnosis and treatment of
various neurological and psychiatric disorders. Moreover,
this question is also essential for evaluating the
potential biases and limitations of machine learning classifiers
trained on EEG data.
3.1. Sex Detectability (SD) from EEG
To address SD from EEG, we experimented with several
datasets of diferent sizes and compositions, including
the TUEG EEG dataset, the world’s most extensive
opensource corpus of EEG data. We also considered the
normal and abnormal populations of the subjects. We used a
shallow and deep convolutional neural network (CNN) as
our classifier, Previous studies have shown that this CNN
can achieve competitive accuracy with larger models in
predicting pathology from EEG data [
        <xref ref-type="bibr" rid="ref18 ref19">18, 19</xref>
        ].
      </p>
      <p>The results of our experiments are summarized in
Figure 1 and Table 2, which show the BAC of the CNN
classifier for each dataset. The figure shows the BAC
when we train the model on a dataset and test on its own
test split, which is in distribution. It also shows the BAC
of a model trained on a dataset and tested on another
dataset, which is out of distribution performance. The
results indicate that the sex of the subjects is detectable
from their EEG recordings in all of the distribution
scenarios, with accuracy ranging from 60% to 80%. The
results also show that the sex detection performance is
slightly higher for the normal population than for the
abnormal population. It is worth noting that the TUEG
dataset does not have pathology (Normal/Abnormal)
labels, therefore, we do not show the results for normal
and abnormal participants.</p>
      <sec id="sec-3-1">
        <title>3.2. Performance on Unseen Data (Zero-Shot)</title>
        <p>To evaluate the model’s adaptability to unseen data, we
conducted zero-shot performance assessments across
various datasets. Zero-shot performance means that the
model can predict the class of a sample from an unseen
dataset without having seen any examples from that
dataset during training. Notably, the highest accuracy
of 79.11% was achieved when training on TUEG and
testing on TUAB EEG datasets. Conversely, the lowest
accuracies were observed when the model was evaluated
across the TUH datasets and the NMT Scalp EEG Dataset.</p>
        <p>Our investigation extended beyond the original
training and testing datasets to explore out-of-distribution
accuracy, mainly focusing on the abnormal population.
Strikingly, the model exhibited higher accuracy in
out-ofdistribution scenarios when dealing with the abnormal
population. To comprehensively gauge the
generalization of learned features, each model was tested on other
datasets to evaluate zero-shot performance. This
analysis provided insights into how well the model leverages
learned features when confronted with entirely new data.</p>
        <p>In table 2, we compare our models with previous work
on sex detection on the TUAB dataset, which has a
moderate sample size compared to two other datasets in our
study. The results show that ShallowNet archives
comparable results in the distribution scenario and outperforms
by a high margin on the zero-shot scenario. The reason
for this improvement might be that the TUEG dataset
has seven times more unique participants, and the data
A
Percentage
relative to the
entire dataset</p>
        <p>NMT data distribution</p>
        <p>Performance in subgroups
Abnormal
Normal
Train</p>
        <p>Test
Female</p>
        <p>Train</p>
        <p>Test
Male</p>
        <p>Female</p>
        <p>Male
distribution is close to TUAB. Therefore, it improves the
performance of the TUAB dataset by 7%.</p>
        <p>These results demonstrate that the biological sex of
the subjects is a significant factor that machine learning
methods could capture. However, these results also may
imply that the sex of the subjects should be taken into
account when developing and evaluating machine
learning classifiers for EEG pathology detection, as the sex
distribution of the training and testing data may afect
the generalization and robustness of the models.</p>
      </sec>
      <sec id="sec-3-2">
        <title>3.3. Sex Imbalance’s Impact on EEG Pathology Detection</title>
        <p>Table 2 and Figure 1). We then evaluated the
pathology detection models on the NMT dataset for diferent
subgroups.</p>
        <p>Figure 2 shows how the sex imbalance in the NMT
dataset does not afect the pathology detection
performance. Although the NMT dataset has twice as many
male samples as female samples, as shown in panel A.
However, this does not lead to a significant diference in
the accuracy of the pathology detection models for the
male and female subgroups, as shown in panel B. This
suggests that the sex imbalance in the NMT dataset does
not hurt the pathology detection quality.</p>
        <p>One possible reason for this finding is that the NMT
dataset has a balanced ratio of normal and abnormal
samples in each sex subgroup, as shown in Figure 2A.
This means that the models can learn the features related
to the pathology, not the sex, of the subjects. Therefore,
even though the sex is detectable from the EEG signals,
it does not interfere with the pathology detection task.</p>
      </sec>
    </sec>
    <sec id="sec-4">
      <title>4. Discussion and conclusion</title>
      <p>
        Historically documented sex diferences in EEG patterns
As we see in the previous sections (SD and Zero-Shot), and the successful application of machine learning for
sex is detectable from the EEG signals and is an important automatic sex detection suggest that sex-related patterns
biological factor that can influence human brain activity can act as confounders in machine learning-based EEG
and behaviour. Therefore, considering it in the analysis assessments [
        <xref ref-type="bibr" rid="ref8 ref9">8, 9</xref>
        ]. In our experimentation on potential
is essential, especially when the datasets are imbalanced. confounding factors within the NMT dataset, we explored
In this section, we aim to investigate the efect of sex on a scenario involving an imbalance in male and female
parpathology detection from EEG signals using the NMT ticipants. Our findings indicate that, in this dataset, sex
Scalp EEG Dataset. The NMT dataset has a significant does not function as a confounder due to an equal
distrisex imbalance, as men are two times more frequent than bution of abnormal participants in the male/female splits.
women in the dataset. This raises the question of whether However, as demonstrated in the SD section, we reveal
the sex imbalance and the SD from the EEG signals can that sex remains detectable. Consequently,
acknowledgafect the performance of the pathology detection models. ing sex as a factor is essential for precision medicine in
      </p>
      <p>
        To address this question, we conducted several exper- mental health.
iments using diferent deep-learning architectures. We A key takeaway from an extensive review spanning
ifrst verified that sex is detectable from the EEG signals three decades of research on human brain sex diferences
using a simple convolutional neural network (CNN) that is that, despite evident behavioural distinctions between
achieved a good accuracy on the sex classification task men and women, disparities in brain structure and
funcon several EEG datasets with diferent sample sizes (see tion are minimal and inconsistent when adjusted for
individual brain size and ineficient participant numbers
[
        <xref ref-type="bibr" rid="ref4">4</xref>
        ]. In contrast, our study employs EEG, which has high
temporal but low spatial resolution, to assess functional
brain activity. Our findings reveal distinct patterns across
datasets with varying subject numbers, highlighting the
unique insights provided by EEG in uncovering
diferences.
      </p>
      <p>
        Brain connectivity and topography research has
yielded diverse perspectives, providing a rich field for
future investigations. For instance, Ingalhalikar et al.
[
        <xref ref-type="bibr" rid="ref20">20</xref>
        ] found that male brains exhibit enhanced
connectivity between perception and coordinated action, while
female brains are structured to facilitate communication
between analytical and intuitive processing modes. Their
study, involving 949 youths, demonstrated distinct
patterns in supratentorial connections, with stronger
intrahemispheric connections in males and stronger
interhemispheric connections in females. Jochmann et al. [
        <xref ref-type="bibr" rid="ref9">9</xref>
        ]
highlighted the significance of EEG topographies in sex
detection, revealing that even with disrupted waveforms,
the sex could be accurately identified. On the other hand,
Bučková et al. [
        <xref ref-type="bibr" rid="ref8">8</xref>
        ] observed that the incorporation of
multivariate classification models did not consistently
improve performance. Also, Eliot et al. [
        <xref ref-type="bibr" rid="ref4">4</xref>
        ] argues that
despite decades of examining sex efects on lateralized brain
function, there is no substantial evidence supporting the
widely held belief that male brains are significantly more
lateralized than female brains. The diversity of findings
in the literature underscores the complexity of brain
connectivity and topography, making it an intriguing and
promising avenue for future research. One could examine
where the trained neural network looks when classifying
brain signals.
      </p>
      <p>
        Frequency bands are widely recognized as critical
features in quantitative EEG analysis. Despite their
prominence, the significance of these features in sex detection
remains unclear. Some studies assert that brain rhythms
exhibit sex-specific patterns [
        <xref ref-type="bibr" rid="ref10 ref21">21, 10</xref>
        ], while others argue
that none of the traditional frequency bands play a
particularly crucial role in sex detection [
        <xref ref-type="bibr" rid="ref9">9</xref>
        ]. A potential avenue
for future research would be to explore and substantiate
these claims using an extensive dataset, such as TUEG.
      </p>
      <p>In summary, our training and evaluation process
thoroughly explored the model’s performance in classifying
sex from EEG signals. We systematically assessed its
ability to generalize to unseen data, examined detectability
and generalization under varying conditions, and
investigated potential implications for pathology detection
using a diverse and imbalanced dataset. The results of
these analyses contribute to a nuanced understanding
of the model’s capabilities and potential applications in
clinical settings.</p>
    </sec>
    <sec id="sec-5">
      <title>5. Acknowledgements</title>
      <p>We extend our sincere appreciation to Mathilde Besson
for their valuable comments, which greatly contributed
to the refinement of this paper. This work was funded
by Canada CIFAR AI Chair Program and from the
Canada Excellence Research Chairs (CERC) program,
National Research Council Canada, Natural Sciences
and Engineering Research Council
(NSERC-CAE-CRIACCARIQ, NSERC discovery grant RGPIN-2022-05122),
Doctoral Research Microsoft Diversity Award
(MicrosoftMila), Faculty of medicine-UdeM, and Faculté des études
supérieures et postdoctorales. We thank Compute
Canada for providing computational resources.</p>
    </sec>
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