Multimodal wearable EEG, EMG and accelerometry measurements improve the accuracy of tonic-clonic seizure detection.

Objective. This paper aims to investigate the possibility of detecting tonic-clonic seizures (TCSs) with behind-the-ear, two-channel wearable electroencephalography (EEG), and to evaluate its added value to non-EEG modalities in TCS detection.Methods. We included 27 participants with a total of 44 TCSs from the European multicenter study SeizeIT2. The wearable Sensor Dot (Byteflies) was used to measure behind-the-ear EEG, electromyography (EMG), electrocardiography, accelerometry (ACC) and gyroscope. We evaluated automatic unimodal detection of TCSs, using sensitivity, precision, false positive rate (FPR) and F1-score. Subsequently, we fused the different modalities and again assessed performance. Algorithm-labeled segments were then provided to two experts, who annotated true positive TCSs, and discarded false positives.Results. Wearable EEG outperformed the other single modalities with a sensitivity of 100% and a FPR of 10.3/24 h. The combination of wearable EEG and EMG proved most clinically useful, delivering a sensitivity of 97.7%, an FPR of 0.4/24 h, a precision of 43%, and an F1-score of 59.7%. The highest overall performance was achieved through the fusion of wearable EEG, EMG, and ACC, yielding a sensitivity of 90.9%, an FPR of 0.1/24 h, a precision of 75.5%, and an F1-score of 82.5%.Conclusions. In TCS detection with a wearable device, combining EEG with EMG, ACC or both resulted in a remarkable reduction of FPR, while retaining a high sensitivity.Significance. Adding wearable EEG could further improve TCS detection, relative to extracerebral-based systems.

Computationally-Efficient Algorithm for Real-Time Absence Seizure Detection in Wearable Electroencephalography.

Advances in electroencephalography (EEG) equipment now allow monitoring of people with epilepsy in their daily-life environment. The large volumes of data that can be collected from long-term out-of-clinic monitoring require novel algorithms to process the recordings on board of the device to identify and log or transmit only relevant data epochs. Existing seizure-detection algorithms are generally designed for post-processing purposes, so that memory and computing power are rarely considered as constraints. We propose a novel multi-channel EEG signal processing method for automated absence seizure detection which is specifically designed to run on a microcontroller with minimal memory and processing power. It is based on a linear multi-channel filter that is precomputed offline in a data-driven fashion based on the spatial-temporal signature of the seizure and peak interference statistics. At run-time, the algorithm requires only standard linear filtering operations, which are cheap and efficient to compute, in particular on microcontrollers with a multiply-accumulate unit (MAC). For validation, a dataset of eight patients with juvenile absence epilepsy was collected. Patients were equipped with a 20-channel mobile EEG unit and discharged for a day-long recording. The algorithm achieves a median of 0.5 false detections per day at 95% sensitivity. We compare our algorithm with state-of-the-art absence seizure detection algorithms and conclude it performs on par with these at a much lower computational cost.

Automated Epileptic Seizure Detection Based on Wearable ECG and PPG in a Hospital Environment.

Electrocardiography has added value to automatically detect seizures in temporal lobe epilepsy (TLE) patients. The wired hospital system is not suited for a long-term seizure detection system at home. To address this need, the performance of two wearable devices, based on electrocardiography (ECG) and photoplethysmography (PPG), are compared with hospital ECG using an existing seizure detection algorithm. This algorithm classifies the seizures on the basis of heart rate features, extracted from the heart rate increase. The algorithm was applied to recordings of 11 patients in a hospital setting with 701 h capturing 47 (fronto-)temporal lobe seizures. The sensitivities of the hospital system, the wearable ECG device and the wearable PPG device were respectively 57%, 70% and 32%, with corresponding false alarms per hour of 1.92, 2.11 and 1.80. Whereas seizure detection performance using the wrist-worn PPG device was considerably lower, the performance using the wearable ECG is proven to be similar to that of the hospital ECG.