Noninvasive seizure prediction using autonomic measurements in patients with refractory epilepsy

Seizure-related differences in biosignal 24-h modulation patterns

A seizure likelihood biomarker could improve seizure monitoring and facilitate adjustment of treatments based on seizure risk. Here, we tested differences in patient-specific 24-h-modulation patterns of electrodermal activity (EDA), peripheral body temperature (TEMP), and heart rate (HR) between patients with and without seizures. We enrolled patients who underwent continuous video-EEG monitoring at Boston Children's Hospital to wear a biosensor. We divided patients into two groups: those with no seizures and those with at least one seizure during the recording period. We assessed the 24-h modulation level and amplitude of EDA, TEMP, and HR. We performed machine learning including physiological and clinical variables. Subsequently, we determined classifier performance by cross-validated machine learning. Patients with seizures (n = 49) had lower EDA levels (p = 0.031), EDA amplitudes (p = 0.045), and trended toward lower HR levels (p = 0.060) compared to patients without seizures (n = 68). Averaged cross-validated classification accuracy was 69% (AUC-ROC: 0.75). Our results show the potential to monitor and forecast risk for epileptic seizures based on changes in 24-h patterns in wearable recordings in combination with clinical variables. Such biomarkers might be applicable to inform care, such as treatment or seizure injury risk during specific periods, scheduling diagnostic tests, such as admission to the epilepsy monitoring unit, and potentially other neurological and chronic conditions.

Advanced Bioelectrical Signal Processing Methods: Past, Present and Future Approach-Part II: Brain Signals

As it was mentioned in the previous part of this work (Part I)-the advanced signal processing methods are one of the quickest and the most dynamically developing scientific areas of biomedical engineering with their increasing usage in current clinical practice. In this paper, which is a Part II work-various innovative methods for the analysis of brain bioelectrical signals were presented and compared. It also describes both classical and advanced approaches for noise contamination removal such as among the others digital adaptive and non-adaptive filtering, signal decomposition methods based on blind source separation, and wavelet transform.

Performance Evaluation of Epileptic Seizure Prediction Using Time, Frequency, and Time–Frequency Domain Measures

The prediction of epileptic seizures is crucial to aid patients in gaining early warning and taking effective intervention. Several features have been explored to predict the onset via electroencephalography signals, which are typically non-stationary, dynamic, and varying from person-to-person. In the former literature, features applied in the classification have shared similar contributions to all patients. Therefore, in this paper, we analyze the impact of the specific combination of feature and channel from time, frequency, and time–frequency domains on prediction performance of disparate patients. Based on the minimal-redundancy-maximal-relevance criterion, the proposed framework uses a sequential forward selection approach to individually find the optimal features and channels. Trained models could discriminate the pre-ictal and inter-ictal electroencephalography with a sensitivity of 90.2% and a false prediction rate of 0.096/h. We also present the comparison between the classification accuracy obtained by the optimal features, several features summarized from optimal features, and the complete set of features from three domains. The results indicate that various patient interpretations have a certain specificity in the selection of feature-channel. Furthermore, the detailed list of optimal features and summarized features are proffered for reference to those who research the corresponding database.

[Mobile seizure monitoring in epilepsy patients]

Wearables are receiving much attention from both epilepsy patients and treating physicians, for monitoring of seizure frequency and warning of seizures. They are also of interest for the detection of seizure-associated risks of patients, for differential diagnosis of rare seizure types and prediction of seizure-prone periods. Accelerometry, electromyography (EMG), heart rate and further autonomic parameters are recorded to capture clinical seizure manifestations. Currently, a clinical use to document nocturnal motor seizures is feasible. In this review the available devices, data on the performance in the documentation of seizures, current options for clinical use and developments in data analysis are presented and critically discussed.