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Retrospective Study
Copyright: ©Author(s) 2026.
World J Psychiatry. Oct 19, 2026; 16(10): 123156
Published online Oct 19, 2026. doi: 10.5498/wjp.123156
Table 1 Comparison of selected electroencephalography-based studies on anxiety detection and severity assessment
Ref.
Task and cohort
EEG setting and representation
Model
Validation strategy
Best reported result
Relevance and main limitation
Baghdadi et al[34], 2019Two-level and four-level anxious-state classification; DASPS dataset with 23 participantsEEG was recorded with an Emotiv EPOC system during anxiety-inducing psychological stimulation. Handcrafted time-, frequency-, and nonlinear-domain features were usedStacked sparse autoencoder and conventional classifiersThe participant-level validation protocol was not clearly reported83.50% accuracy for two levels and 74.60% for four levelsThe study introduced the DASPS dataset and evaluated several EEG features. However, the cohort was small, and spatial topographic-map learning was not used
Chen et al[10], 2021Anxious-state classification in a closed neurofeedback settingFrontal frequency-domain EEG features were extracted in an affective BCI-based neurofeedback paradigmRBF-SVM with a one-vs-one strategyThe participant-level validation procedure was not clearly described92% accuracyThe study addressed anxiety in a specific neurofeedback paradigm. It did not use band-specific topographic maps or deep spatial learning
Mokatren et al[35], 2021Binary SAD vs HC classification; 32 SAD and 32 HC participantsApproximately 4 minutes of resting-state EEG; 34 channels; 1024 Hz. Wavelet-packet energy and entropy from five frequency bands were mapped to a 15 × 15 image-like representationCNN, RBF-SVM, and kNNStratified subject-independent eight-fold cross-validation; eight participants were used for testing in each fold92.19% accuracy with CNN and the 2D image representationElectrode geometry was preserved in an image-like structure. However, the individual contribution of alpha, beta, and theta topographic maps was not assessed
Shikha et al[36], 2021Anxiety classification; DASPS dataset with 23 participantsTime-, frequency-, and time-frequency-domain EEG features were extracted and subjected to feature selectionStacked sparse autoencoder and conventional machine-learning classifiersThe participant-level validation strategy was not clearly reported83.93% accuracy with the stacked sparse autoencoderThe study evaluated complementary handcrafted features but did not use topographic maps or end-to-end spatial feature learning
Al-Ezzi et al[37], 2021Four-class SAD severity assessment; severe, moderate, mild, and HC groups with 22 participants per groupSix-minute eyes-closed resting-state EEG; 32 channels; 2048 Hz, downsampled to 256 Hz. PDC-based effective-connectivity matrices were produced for five frequency rangesCNN, LSTM, and CNN-LSTMTen-fold cross-validation was reported. An additional 60-subject training and 28-subject testing analysis was presented93% average accuracy, 95% sensitivity, and 85% specificity with CNN-LSTMClinical SAD severity was assessed through effective connectivity. However, no external cohort was used, and the reported validation procedures were not fully uniform
Li et al[38], 2022Recognition of four anxiety levelsComprehensive EEG features were extracted. Beta-band activity and frontal regions were reported as importantSVMParticipant-level fold construction was not clearly described62.56% accuracyThe study examined multiple anxiety levels but relied on handcrafted EEG features rather than image-based spatial representations
Muhammad and Al-Ahmadi[39], 2022Two-level and four-level state-anxiety classification; DASPS dataset with 23 participantsChannel-based mean power, RASM, and asymmetry features were extracted, mainly from theta and beta bandsRF, DT, kNN, SVM, and MLPLeave-one-participant-out evaluation; samples from the test participant were excluded from training94.90% accuracy for two levels and 92.74% for four levels with RFA participant-separated protocol and band-related features were used. However, topographic-map representation and deep spatial learning were not evaluated
Al-Ezzi et al[40], 2022Four-class SAD severity classification; 22 severe, 22 moderate, 22 mild, and 22 HC participantsFuzzy entropy features were extracted from delta, theta, alpha, and beta bandsNB and other machine-learning classifiersThe participant-level validation procedure was not clearly documented86.93% accuracy, 92.46% sensitivity, and 95.32% specificityNonlinear EEG complexity was evaluated across several bands. The approach did not preserve electrode topology or use image-based learning
Shen et al[27], 2022Binary GAD vs HC classification; 45 GAD and 36 HC participantsTen-minute eyes-closed resting-state EEG; 16 channels; 250 Hz. Four-second segments with 50% overlap were represented by PSD, fuzzy entropy, and PLI connectivity featuresSVM, RF, and BP-baggingTen repetitions of an 80/20 hold-out split. Participant grouping was not clearly reported97.83 ± 0.40% accuracy and 97.95% F1-score with SVMSpectral, nonlinear, and connectivity features were combined. Overlapping segments and unclear participant-level separation restrict direct comparison
Al-Ezzi et al[41], 2023Four-class SAD severity assessment; 66 SAD and 22 HC participantsFour-to-six-minute eyes-closed resting-state EEG; 32 channels; 2048 Hz, downsampled to 256 Hz. PDC and graph-theory features were extracted from four bandsSVM, kNN, LDA, NB, and DTExplicitly reported subject-dependent ten-fold cross-validation92.78% accuracy, 95.25% sensitivity, and 94.12% specificity with SVMDirected connectivity and network topology were assessed. Subject-dependent validation limits evidence for unseen-participant generalization
Liu et al[42], 2023Binary GAD vs HC classification; 45 GAD and 36 HC participantsTen-minute resting-state EEG. High-frequency representations covering 4-30 Hz and 10-30 Hz were evaluatedMSTCNN with squeeze-and-excitation attentionThe participant-level validation protocol was not clearly reported99.48% accuracy for 4-30 Hz and 99.47% for 10-30 HzVery high performance was reported for broad high-frequency EEG intervals. Controlled, separate alpha-, beta-, and theta-map comparisons were not performed
Ghonchi et al[43], 2024Binary normal vs anxious classification and four-class normal, light, moderate, and severe classification; DASPS dataset with 23 participantsSix anxiety-induction trials per participant; 14 electrodes. Beta-band EEG was transformed into sequences of 11 × 11 scalp maps2D CNN, squeeze-and-excitation attention, and LSTMFive-fold cross-validation; participant-wise fold construction was not reported94.24% ± 0.33% accuracy for two classes and 92.58% ± 0.52% for four classesThis study is closely related because spatiotemporal scalp maps were used. However, only the beta band was evaluated, and participant-independent validation was not documented
Luo et al[28], 2024Four-level GAD grading; 39 controls, 9 mild, 38 moderate, and 33 severe GAD participantsTen-minute eyes-closed resting-state EEG; 16 channels; 250 Hz. PLI connectivity features were extracted from theta, alpha1, alpha2, and beta bandsLightGBM, XGBoost, and CatBoostThree repetitions of five-fold cross-validation with CCR resampling. Participant-wise fold construction was not reported98.1% ± 0.6% accuracy with CatBoostA clinically relevant severity task was addressed. However, resampling was used, the validation unit was unclear, and the representation was connectivity-based rather than topographic
Adochiei et al[44], 2026HAM-A-based non-anxious, moderate, and severe categories; 16 in-house participants and 23 DASPS participantsData from two EEG systems were harmonized to eight common channels. Spectral power, entropy, Hjorth, and DWT features were extractedLogistic regression, MLP, and kNNNested cross-validation; five-fold inner model selection. Preprocessing, feature selection, PCA, scaling, and SMOTE were restricted to training folds87.5% accuracy and 0.859 F1-score with MLP; no severe case was correctly identifiedA portable-EEG setting and a structured validation pipeline were used. However, the sample was small, two data sources were combined, and severe anxiety was substantially underrepresented
Table 2 Distribution of participants, 15-second electroencephalography segments, and topographic-map images in the internal data split
Data split
Class
Unique participants represented in the partition
Number of 15-second EEG segments
Topographic-map images per band
Topographic-map images across the three bands
TrainAnxiety441370685020550
TrainControl43833416512495
TestAnxiety4334217105130
TestControl4120810403120
TotalAnxiety441712856025680
TotalControl441041520515615
TotalAll8827531376541295
Table 3 Training configuration used in all band-specific experiments
Parameter
Value
Input size224 × 224 × 3
Experimental bandsAlpha, beta, theta
OptimizerAdam
Mini-batch size64
Maximum number of epochs12
Initial learning rate3 × 10-5
L2 regularization5 × 10-4
Model selection criterionBest validation loss
Class balancingClass-weighted classification
Table 4 Stage-wise structure of the FusedNeXt architecture
Stage
Block A (spatial-mixing)
Block B (channel-mixing)
Output channels
Transition operation
Functional role
Stem4 × 4 Conv (stride 4), BN, GELU-96- (integrated 4 × downsampling)Initial patch embedding (224 → 56)
Stage 1(3 × 3 DWConv → GELU → 1 × 1 GConv) ‖ (1 × 1 GConv → GELU) → ⊕ → BN[1 × 1 GConv (× 4 expand) → GELU → 1 × 1 Conv (project)] ‖ [3 × 3 GConv → GELU → 3 × 3 GConv] → ⊕ → BN962 × 2 GConv, stride 2Low-level local topographic patterns
Stage 2Same structure as stage 1Same structure as stage 11922 × 2 GConv, stride 2Intermediate spatial representations
Stage 3Same structure as stage 1Same structure as stage 13842 × 2 GConv, stride 2High-level discriminative spatial patterns
Stage 4Same structure as stage 1Same structure as stage 1768Global average poolingFinal deep feature representation
Classification headBN → GAP → FC (768 → 2) → Softmax-2-Anxiety/control class probabilities
Table 5 Parameter count and computational cost of the proposed FusedNeXt model
Architectural component
Configuration
Value
Input sizeTopographic map image224 × 224 × 3
Number of stagesHierarchical FusedNeXt blocks4
Channel widthsStage 1 - stage 496/192/384/768
Trainable parametersTotal≈ 7.17 M
Computational costForward pass per image≈ 1.95 GFLOPs
Inference timePer topographic map image≈ 3 milliseconds
Table 6 Overall classification performance of the FusedNeXt model for alpha, beta, and theta bands
Band
Accuracy (%)
Balanced accuracy (%)
Macro precision (%)
Macro recall (%)
Macro specificity (%)
Macro F1-score (%)
AUC
Alpha81.2480.9480.0280.9480.9480.380.8958
Beta84.5884.8383.5184.8384.8383.960.9296
Theta85.2484.9384.1684.9384.9384.490.9297
Table 7 Class-wise performance results of the FusedNeXt model for each frequency band
Band
Class
Support
Precision (%)
Recall/sensitivity (%)
Specificity (%)
F1-score (%)
AlphaAnxiety171086.9482.1679.7184.49
AlphaControl104073.1079.7182.1676.26
BetaAnxiety171090.7083.8085.8787.11
BetaControl104076.3285.8783.8080.81
ThetaAnxiety171089.6686.2083.6587.90
ThetaControl104078.6683.6586.2081.08
Table 8 Error distribution obtained from the confusion matrices for alpha, beta, and theta bands
Band
Correct predictions
Incorrect predictions
Anxiety → control
Control → anxiety
Error rate (%)
Alpha223451630521118.76
Beta232642427714715.42
Theta234440623617014.76
Table 9 Training and testing time analysis of the FusedNeXt model for each frequency band
Band
Training time (seconds)
Training time (minutes)
Testing time (seconds)
Test images
Average inference time per image (milliseconds)
Alpha633.8410.568.5527503.11
Beta578.019.638.5327503.10
Theta581.939.709.1427503.32
Table 10 Focused comparison of the present study with representative electroencephalography-based anxiety studies
Ref.
Task and cohort
EEG representation and model
Validation strategy
Best reported result
Relation to the present study
Mokatren et al[35], 2021Binary SAD vs HC classification; 32 SAD and 32 HC participantsWavelet-packet energy and entropy values from five frequency bands were mapped to a 15 × 15 image-like electrode representation. CNN, RBF-SVM, and kNN were evaluatedStratified subject-independent eight-fold cross-validation92.19% accuracy with CNNElectrode geometry was retained in an image-like representation. However, separate alpha-, beta-, and theta-band topographic maps were not compared under identical experimental conditions
Muhammad and Al-Ahmadi[39], 2022Two-level and four-level state-anxiety classification; DASPS dataset with 23 participantsMean power, RASM, and asymmetry features were extracted mainly from theta and beta bands. RF, DT, kNN, SVM, and MLP were evaluatedLeave-one-participant-out evaluation94.90% accuracy for two levels and 92.74% for four levelsThe results support the relevance of theta- and beta-band information. However, topographic maps and end-to-end spatial feature learning were not used
Shen et al[27], 2022Binary GAD vs HC classification; 45 GAD and 36 HC participantsPSD, fuzzy entropy, and PLI connectivity features were combined. SVM, RF, and BP-bagging were evaluatedTen repetitions of an 80:20 hold-out split; participant grouping was not clearly reported97.83% ± 0.40% accuracy and 97.95% F1-score with SVMSpectral, nonlinear, and connectivity information was combined. However, overlapping segments and unclear participant-level separation limit direct comparison
Al-Ezzi et al[41], 2023Four-class SAD severity assessment; 66 SAD and 22 HC participantsPDC and graph-theory features were extracted from four frequency bands. SVM, kNN, LDA, NB, and DT were evaluatedSubject-dependent ten-fold cross-validation92.78% accuracy with SVMFrequency-specific connectivity and network topology were evaluated. The subject-dependent protocol did not establish performance on unseen participants
Liu et al[42], 2023Binary GAD vs HC classification; 45 GAD and 36 HC participantsBroad high-frequency EEG intervals of 4-30 Hz and 10-30 Hz were processed by an MSTCNN with squeeze-and-excitation attentionParticipant-level validation was not clearly reported99.48% accuracy for 4-30 Hz and 99.47% for 10-30 HzVery high results were obtained from broad frequency intervals. However, separate alpha-, beta-, and theta-band topographic maps were not evaluated
Ghonchi et al[43], 2024Binary and four-class anxiety classification; DASPS dataset with 23 participantsBeta-band EEG was converted into temporal sequences of 11 × 11 scalp maps. A 2D CNN, squeeze-and-excitation attention, and LSTM were usedFive-fold cross-validation; participant-wise fold construction was not reported94.24% ± 0.33% accuracy for two classes and 92.58% ± 0.52% for four classesThis study is closely related because scalp-map representations were used. However, only the beta band was examined, and participant-independent validation was not documented
Luo et al[28], 2024Four-level GAD grading; 39 controls, 9 mild, 38 moderate, and 33 severe GAD participantsPLI connectivity features were extracted from theta, alpha1, alpha2, and beta bands. LightGBM, XGBoost, and CatBoost were evaluatedThree repetitions of five-fold cross-validation with CCR resampling; participant-wise fold construction was not reported98.1% ± 0.6% accuracy with CatBoostSeveral frequency bands were evaluated through connectivity features. However, the validation unit was unclear, resampling was used, and spatial topographic maps were not examined
Adochiei et al[44], 2026HAM-A-based non-anxious, moderate, and severe categories; 16 in-house and 23 DASPS participantsSpectral power, entropy, Hjorth, and DWT features were extracted from eight common channels. Logistic regression, MLP, and kNN were evaluatedNested cross-validation; preprocessing and model-selection steps were restricted to training folds87.5% accuracy and 0.859 F1-score with MLPA structured validation pipeline was used. However, the cohort was small and heterogeneous, and severe anxiety was underrepresented
Present studyBinary anxiety vs control classification; 44 anxiety and 44 control participantsAlpha-, beta-, and theta-band powers were separately converted into EEG topographic maps. The proposed FusedNeXt architecture was used for classificationFixed 80:20 hold-out split at the 15-second EEG-segment level. Windows from one segment remained in the same partition, but different segments from the same participant could occur in both partitionsTheta: 85.24% accuracy, 84.93% balanced accuracy, 84.49% macro F1-score, and 0.9297 AUCThe three bands were compared with the same data split, architecture, training configuration, and test protocol. However, the results represent window-level internal estimates and do not establish subject-independent generalization
Table 11 Comparison of FusedNeXt with baseline deep-learning architectures under participant-grouped five-fold cross-validation
Band
Model
Parameters (M)
GFLOPs
Window accuracy, %
Participant accuracy, %
Participant balanced accuracy, %
Participant macro F1, %
Participant AUC
95%CI for participant AUC
AlphaShallow CNN1.420.3172.48 ± 1.8368.45 ± 2.6468.37 ± 2.5868.11 ± 2.710.7416 ± 0.02640.6468-0.8219
AlphaResNet-1811.691.8275.93 ± 1.4772.31 ± 2.1872.24 ± 2.0971.98 ± 2.220.7857 ± 0.02190.6947-0.8586
AlphaMobileNetV22.230.3275.16 ± 1.6171.80 ± 2.3671.72 ± 2.2871.46 ± 2.410.7789 ± 0.02370.6862-0.8537
AlphaConvNeXt-Tiny27.824.4776.84 ± 1.4273.20 ± 2.0473.13 ± 1.9772.91 ± 2.100.7982 ± 0.02050.7086-0.8694
AlphaFusedNeXt7.171.9578.21 ± 1.3674.66 ± 1.9274.58 ± 1.8774.31 ± 1.980.8104 ± 0.01880.7237-0.8796
BetaShallow CNN1.420.3175.66 ± 1.7271.20 ± 2.5271.14 ± 2.4770.88 ± 2.580.7794 ± 0.02470.6880-0.8532
BetaResNet-1811.691.8279.18 ± 1.3975.42 ± 2.0675.36 ± 2.0175.11 ± 2.130.8281 ± 0.01980.7461-0.8901
BetaMobileNetV22.230.3278.64 ± 1.4874.90 ± 2.2174.83 ± 2.1574.57 ± 2.260.8197 ± 0.02120.7356-0.8841
BetaConvNeXt-Tiny27.824.4780.03 ± 1.3176.55 ± 1.9376.50 ± 1.8876.28 ± 1.970.8369 ± 0.01850.7568-0.8966
BetaFusedNeXt7.171.9581.37 ± 1.2477.84 ± 1.7677.79 ± 1.7277.62 ± 1.810.8448 ± 0.01730.7669-0.9028
ThetaShallow CNN1.420.3176.42 ± 1.6972.10 ± 2.4772.02 ± 2.4171.80 ± 2.520.7923 ± 0.02390.7022-0.8642
ThetaResNet-1811.691.8280.36 ± 1.3476.58 ± 1.9876.51 ± 1.9276.27 ± 2.030.8396 ± 0.01890.7600-0.8991
ThetaMobileNetV22.230.3279.74 ± 1.4375.62 ± 2.1375.55 ± 2.0775.30 ± 2.180.8318 ± 0.02010.7501-0.8934
ThetaConvNeXt-Tiny27.824.4781.14 ± 1.2677.90 ± 1.8377.84 ± 1.7877.67 ± 1.870.8472 ± 0.01770.7698-0.9049
ThetaFusedNeXt7.171.9582.48 ± 1.1879.10 ± 1.6979.05 ± 1.6478.88 ± 1.730.8563 ± 0.01650.7817-0.9110
Table 12 Component-level ablation analysis of the FusedNeXt architecture
Configuration
Spatial dual path
Channel dual path
Expansion × 4
Parameters (M)
GFLOPs
Alpha balanced accuracy, %
Beta balanced accuracy, %
Theta balanced accuracy, %
Mean balanced accuracy, %
Mean macro F1, %
Mean AUC
Full FusedNeXt√√√7.171.9574.58 ± 1.8777.79 ± 1.7279.05 ± 1.6477.14 ± 1.7476.94 ± 1.840.8372 ± 0.0175
Without additional spatial path×√√6.841.8172.96 ± 2.0176.10 ± 1.8677.28 ± 1.7975.45 ± 1.8975.20 ± 1.970.8196 ± 0.0191
Without parallel channel path√×√6.221.6972.41 ± 2.0975.32 ± 1.9476.84 ± 1.8774.86 ± 1.9774.60 ± 2.050.8118 ± 0.0200
Without inverted-bottleneck expansion√√×3.961.0373.65 ± 1.9576.74 ± 1.7978.12 ± 1.7276.17 ± 1.8275.92 ± 1.910.8283 ± 0.0184
Table 13 Paired statistical comparisons between frequency bands and model architectures
Comparison
Metric
Difference
95%CI of difference
Raw P value
Holm-adjusted P value
Statistical interpretation
Beta - alphaBalanced accuracy3.210.86-5.720.01100.0220Significant
Theta - alphaBalanced accuracy4.471.98-7.180.00200.0060Significant
Theta - betaBalanced accuracy1.26-0.94 to 3.460.23800.2380Not significant
Beta - alphaMacro F13.310.91-5.830.01000.0200Significant
Theta - alphaMacro F14.572.02-7.310.00200.0060Significant
Theta - betaMacro F11.26-1.01 to 3.510.25100.2510Not significant
Beta - alphaAUC0.03440.0081-0.06170.01300.0260Significant
Theta - alphaAUC0.04590.0180-0.07450.00300.0090Significant
Theta - betaAUC0.0115-0.0128 to 0.03540.33700.3370Not significant
FusedNeXt - ConvNeXt-Tiny (beta band)Balanced accuracy1.290.21-2.410.02100.0420Significant
FusedNeXt - ConvNeXt-Tiny (beta band)Macro F11.180.09-2.320.03600.0720Not significant after correction
FusedNeXt - ConvNeXt-Tiny (beta band)AUC0.0107-0.0019 to 0.02340.09700.0970Not significant


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