Application and progress of wearable devices in epilepsy monitoring, prediction, and treatment_Journal of Epilepsy

Authors：

MEI Aoxue , FU Cong , LV Kun ,  LUAN Guoming

Epilepsy center, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China;

Corresponding author：

LUAN Guoming, Email: luangm@ccmu.edu.cn

Keywords：

Epilepsy; Wearables; Seizure detection; Seizure prediction; Treatment

DOI：

10.7507/2096-0247.202408003

Video：

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Epilepsy is a complex and widespread neurological disorder that has become a global public health issue. In recent years, significant progress has been made in the use of wearable devices for seizure monitoring, prediction, and treatment. This paper reviewed the applications of invasive and non-invasive wearable devices in seizure monitoring, such as subcutaneous EEG, ear-EEG, and multimodal sensors, highlighting their advantages in improving the accuracy of seizure recording. It also discussed the latest advances in the prediction and treatment of seizure using wearable devices.

Citation： MEI Aoxue, FU Cong, LV Kun, LUAN Guoming. Application and progress of wearable devices in epilepsy monitoring, prediction, and treatment. Journal of Epilepsy, 2024, 10(5): 417-425. doi: 10.7507/2096-0247.202408003 Copy

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1. Megiddo I, Colson A, Chisholm D, et al. Health and economic benefits of public financing of epilepsy treatment in India: an agent-based simulation model. Epilepsia, 2016, 57(3): 464-74.
2. Hoppe C, Feldmann M, Blachut B, et al. Novel techniques for automated seizure registration: patients' wants and needs. Epilepsy & Behavior, 2015, 52(Pt A): 1-7.
3. Jory C, Shankar R, Coker D, et al. Safe and sound? A systematic literature review of seizure detection methods for personal use. Seizure, 2016, 36: 4-15.
4. Patel AD, Moss R, Rust S W, et al. Patient-centered design criteria for wearable seizure detection devices. Epilepsy & Behavior, 2016, 64(Pt A): 116-121.
5. Schulze-Bonhage A, Sales F, Wagner K, et al. Views of patients with epilepsy on seizure prediction devices. Epilepsy & Behavior, 2010, 18(4): 388-396.
6. Tovar Quiroga DF, Britton JW, Wirrell EC. Patient and caregiver view on seizure detection devices: a survey study. Seizure, 2016, 41: 179-181.
7. Van de Vel A, Cuppens K, Bonroy B, et al. Non-EEG seizure detection systems and potential SUDEP prevention: State of the art: review and update. Seizure, 2016, 41: 141-153.
8. Van de Vel A, Smets K, Wouters K, et al. Automated non-EEG based seizure detection: Do users have a say? Epilepsy & Behavior, 2016, 62: 121-128.
9. Holst AG, Winkel BG, Risgaard B, et al. Epilepsy and risk of death and sudden unexpected death in the young: a nationwide study. Epilepsia, 2013, 54(9): 1613-1620.
10. Cendes F, Sakamoto AC, Spreafico R, et al. Epilepsies associated with hippocampal sclerosis. Acta Neuropathologica, 2014, 128(1): 21-37.
11. Stirling RE, Grayden DB, D'Souza W, et al. Forecasting seizure likelihood with wearable technology. Frontiers in Neurology, 2021, 12: 704060.
12. Elger CE, Hoppe C. Diagnostic challenges in epilepsy: seizure under-reporting and seizure detection. The Lancet Neurology, 2018, 17(3): 279-288.
13. Choi SA, Lim K, Baek H, et al. Impact of mobile health application on data collection and self-management of epilepsy. Epilepsy & Behavior, 2021, 119: 107982.
14. Hixson JD, Braverman L. Digital tools for epilepsy: opportunities and barriers. Epilepsy Research, 2020, 162: 106233.
15. Weisdorf S, Duun-Henriksen J, Kjeldsen MJ, et al. Ultra-long-term subcutaneous home monitoring of epilepsy-490 days of EEG from nine patients. Epilepsia, 2019, 60(11): 2204-2214.
16. Karakis I. Getting under the skin of seizure monitoring: a subcutaneous EEG tool to keep a tally over the long haul. Epilepsy Currents, 2023, 23(6): 351-353.
17. Duun-Henriksen J, Kjaer TW, Looney D, et al. EEG signal quality of a subcutaneous recording system compared to standard surface electrodes. Journal of Sensors, 2015, 2015(1): 341208.
18. Zibrandtsen IC, Kidmose P, Christensen CB, et al. Ear-EEG detects ictal and interictal abnormalities in focal and generalized epilepsy - a comparison with scalp EEG monitoring. Clinical Neurophysiology, 2017, 128(12): 2454-2461.
19. Gu Y, Cleeren E, Dan J, et al. Comparison between scalp EEG and behind-the-ear EEG for Development of a wearable seizure detection system for patients with focal epilepsy. Sensors (Basel, Switzerland), 2017, 18(1): 29.
20. Bleichner MG, Lundbeck M, Selisky M, et al. Exploring miniaturized EEG electrodes for brain-computer interfaces. An EEG you do not see? Physiological Reports, 2015, 3(4): e12362.
21. Debener S, Emkes R, De Vos M, et al. Unobtrusive ambulatory EEG using a smartphone and flexible printed electrodes around the ear. Scientific Reports, 2015, 5: 16743.
22. Japaridze G, Loeckx D, Buckinx T, et al. Automated detection of absence seizures using a wearable electroencephalographic device: a phase 3 validation study and feasibility of automated behavioral testing. Epilepsia, 2023, 64(Suppl 4): S40-S46.
23. El Atrache R, Tamilia E, Mohammadpour Touserkani F, et al. Photoplethysmography: a measure for the function of the autonomic nervous system in focal impaired awareness seizures. Epilepsia, 2020, 61(8): 1617-1626.
24. Wang R, Blackburn G, Desai M, et al. Accuracy of wrist-worn heart rate monitors. JAMA Cardiology, 2017, 2(1): 104-106.
25. Yamakawa T, Miyajima M, Fujiwara K, et al. Wearable epileptic seizure prediction system with machine-learning-based anomaly detection of heart rate variability. Sensors (Basel, Switzerland), 2020, 20(14): 3987.
26. Billeci L, Marino D, Insana L, et al. Patient-specific seizure prediction based on heart rate variability and recurrence quantification analysis. PloS One, 2018, 13(9): e0204339.
27. Zelano J, Beniczky S, Ryvlin P, et al. Report of the ILAE SUDEP Task Force on national recommendations and practices around the world regarding the use of wearable seizure detection devices: a global survey. Epilepsia Open, 2023, 8(4): 1271-1278.
28. Opeskin K, Berkovic SF. Risk factors for sudden unexpected death in epilepsy: a controlled prospective study based on coroners cases. Seizure, 2003, 12(7): 456-464.
29. Nei M, Ho RT, Abou-Khalil BW, et al. EEG and ECG in sudden unexplained death in epilepsy. Epilepsia, 2004, 45(4): 338-345.
30. Kanner A M. Peri-ictal cardiac and respiratory disturbances in epilepsy: incidental finding or culprit of SUDEP. Epilepsy currents, 2011, 11(1): 16-18.
31. Arends J, Thijs RD, Gutter T, et al. Multimodal nocturnal seizure detection in a residential care setting: a long-term prospective trial. Neurology, 2018, 91(21): e2010-e2019.
32. Lazeron RHC, Thijs RD, Arends J, et al. Multimodal nocturnal seizure detection: Do we need to adapt algorithms for children? Epilepsia Open, 2022, 7(3): 406-413.
33. Meritam P, Ryvlin P, Beniczky S. User-based evaluation of applicability and usability of a wearable accelerometer device for detecting bilateral tonic-clonic seizures: a field study. Epilepsia, 2018, 59(Suppl 1): 48-52.
34. Whitmire L, Voyles S, Cardenas D, et al. Diagnostic utility of continuous sEMG monitoring in a home setting - real-world use of the SPEAC® System (P4.5-012). Neurology, 92(Suppl 1): 15.
35. Regalia G, Onorati F, Lai M, et al. Multimodal wrist-worn devices for seizure detection and advancing research: focus on the empatica wristbands. Epilepsy Research, 2019, 153: 79-82.
36. Hofstra WA, de Weerd AW. The circadian rhythm and its interaction with human epilepsy: a review of literature. Sleep Medicine Reviews, 2009, 13(6): 413-420.
37. van Campen JS, Hompe EL, Jansen FE, et al. Cortisol fluctuations relate to interictal epileptiform discharges in stress sensitive epilepsy. Brain, 2016, 139(Pt 6): 1673-1679.
38. Wang ET, Chiang S, Cleboski S, et al. Seizure count forecasting to aid diagnostic testing in epilepsy. Epilepsia, 2022, 63(12): 3156-3167.
39. Jarosiewicz B, Morrell M. The RNS System: brain-responsive neurostimulation for the treatment of epilepsy. Expert Review of Medical Devices, 2021, 18(2): 129-138.
40. Ngadimon IW, Aledo-Serrano A, Arulsamy A, et al. An interplay between post-traumatic epilepsy and associated cognitive decline: a systematic review. Frontiers in Neurology, 2022, 13: 827571.
41. Jacobs J, Wu JY, Perucca P, et al. Removing high-frequency oscillations: a prospective multicenter study on seizure outcome. Neurology, 2018, 91(11): e1040-e1052.
42. Roehri N, Pizzo F, Lagarde S, et al. High-frequency oscillations are not better biomarkers of epileptogenic tissues than spikes. Annals of Neurology, 2018, 83(1): 84-97.
43. Behbahani S, Dabanloo NJ, Nasrabadi AM, et al. Pre-ictal heart rate variability assessment of epileptic seizures by means of linear and non-linear analyses. Anadolu Kardiyoloji Dergisi, 2013, 13(8): 797-803.
44. Jeppesen J, Fuglsang-Frederiksen A, Johansen P, et al. Seizure detection based on heart rate variability using a wearable electrocardiography device. Epilepsia, 2019, 60(10): 2105-2113.
45. Cogan D, Birjandtalab J, Nourani M, et al. Multi-biosignal analysis for epileptic seizure monitoring. International Journal of Neural Systems, 2017, 27(1): 1650031.
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