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Multimodal, automated detection of nocturnal motor seizures at home: Is a reliable seizure detector feasible?

OBJECTIVE: Automated seizure detection and alarming could improve quality of life and potentially prevent sudden, unexpected death in patients with severe epilepsy. As currently available systems focus on tonic–clonic seizures, we want to detect a broader range of seizure types, including tonic, hyp...

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Autores principales: van Andel, Judith, Ungureanu, Constantin, Arends, Johan, Tan, Francis, Van Dijk, Johannes, Petkov, George, Kalitzin, Stiliyan, Gutter, Thea, de Weerd, Al, Vledder, Ben, Thijs, Roland, van Thiel, Ghislaine, Roes, Kit, Leijten, Frans
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862103/
https://www.ncbi.nlm.nih.gov/pubmed/29588973
http://dx.doi.org/10.1002/epi4.12076
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author van Andel, Judith
Ungureanu, Constantin
Arends, Johan
Tan, Francis
Van Dijk, Johannes
Petkov, George
Kalitzin, Stiliyan
Gutter, Thea
de Weerd, Al
Vledder, Ben
Thijs, Roland
van Thiel, Ghislaine
Roes, Kit
Leijten, Frans
author_facet van Andel, Judith
Ungureanu, Constantin
Arends, Johan
Tan, Francis
Van Dijk, Johannes
Petkov, George
Kalitzin, Stiliyan
Gutter, Thea
de Weerd, Al
Vledder, Ben
Thijs, Roland
van Thiel, Ghislaine
Roes, Kit
Leijten, Frans
author_sort van Andel, Judith
collection PubMed
description OBJECTIVE: Automated seizure detection and alarming could improve quality of life and potentially prevent sudden, unexpected death in patients with severe epilepsy. As currently available systems focus on tonic–clonic seizures, we want to detect a broader range of seizure types, including tonic, hypermotor, and clusters of seizures. METHODS: In this multicenter, prospective cohort study, the nonelectroencephalographic (non‐EEG) signals heart rate and accelerometry were measured during the night in patients undergoing a diagnostic video‐EEG examination. Based on clinical video‐EEG data, seizures were classified and categorized as clinically urgent or not. Seizures included for analysis were tonic, tonic–clonic, hypermotor, and clusters of short myoclonic/tonic seizures. Features reflecting physiological changes in heart rate and movement were extracted. Detection algorithms were developed based on stepwise fulfillment of conditions during increases in either feature. A training set was used for development of algorithms, and an independent test set was used for assessing performance. RESULTS: Ninety‐five patients were included, but due to sensor failures, data from only 43 (of whom 23 patients had 86 seizures, representing 402 h of data) could be used for analysis. The algorithms yield acceptable sensitivities, especially for clinically urgent seizures (sensitivity = 71–87%), but produce high false alarm rates (2.3–5.7 per night, positive predictive value = 25–43%). There was a large variation in the number of false alarms per patient. SIGNIFICANCE: It seems feasible to develop a detector with high sensitivity, but false alarm rates are too high for use in clinical practice. For further optimization, personalization of algorithms may be necessary.
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spelling pubmed-58621032018-03-27 Multimodal, automated detection of nocturnal motor seizures at home: Is a reliable seizure detector feasible? van Andel, Judith Ungureanu, Constantin Arends, Johan Tan, Francis Van Dijk, Johannes Petkov, George Kalitzin, Stiliyan Gutter, Thea de Weerd, Al Vledder, Ben Thijs, Roland van Thiel, Ghislaine Roes, Kit Leijten, Frans Epilepsia Open Full‐length Original Research OBJECTIVE: Automated seizure detection and alarming could improve quality of life and potentially prevent sudden, unexpected death in patients with severe epilepsy. As currently available systems focus on tonic–clonic seizures, we want to detect a broader range of seizure types, including tonic, hypermotor, and clusters of seizures. METHODS: In this multicenter, prospective cohort study, the nonelectroencephalographic (non‐EEG) signals heart rate and accelerometry were measured during the night in patients undergoing a diagnostic video‐EEG examination. Based on clinical video‐EEG data, seizures were classified and categorized as clinically urgent or not. Seizures included for analysis were tonic, tonic–clonic, hypermotor, and clusters of short myoclonic/tonic seizures. Features reflecting physiological changes in heart rate and movement were extracted. Detection algorithms were developed based on stepwise fulfillment of conditions during increases in either feature. A training set was used for development of algorithms, and an independent test set was used for assessing performance. RESULTS: Ninety‐five patients were included, but due to sensor failures, data from only 43 (of whom 23 patients had 86 seizures, representing 402 h of data) could be used for analysis. The algorithms yield acceptable sensitivities, especially for clinically urgent seizures (sensitivity = 71–87%), but produce high false alarm rates (2.3–5.7 per night, positive predictive value = 25–43%). There was a large variation in the number of false alarms per patient. SIGNIFICANCE: It seems feasible to develop a detector with high sensitivity, but false alarm rates are too high for use in clinical practice. For further optimization, personalization of algorithms may be necessary. John Wiley and Sons Inc. 2017-09-06 /pmc/articles/PMC5862103/ /pubmed/29588973 http://dx.doi.org/10.1002/epi4.12076 Text en © 2017 The Authors. Epilepsia Open published by Wiley Periodicals Inc. on behalf of International League Against Epilepsy. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Full‐length Original Research
van Andel, Judith
Ungureanu, Constantin
Arends, Johan
Tan, Francis
Van Dijk, Johannes
Petkov, George
Kalitzin, Stiliyan
Gutter, Thea
de Weerd, Al
Vledder, Ben
Thijs, Roland
van Thiel, Ghislaine
Roes, Kit
Leijten, Frans
Multimodal, automated detection of nocturnal motor seizures at home: Is a reliable seizure detector feasible?
title Multimodal, automated detection of nocturnal motor seizures at home: Is a reliable seizure detector feasible?
title_full Multimodal, automated detection of nocturnal motor seizures at home: Is a reliable seizure detector feasible?
title_fullStr Multimodal, automated detection of nocturnal motor seizures at home: Is a reliable seizure detector feasible?
title_full_unstemmed Multimodal, automated detection of nocturnal motor seizures at home: Is a reliable seizure detector feasible?
title_short Multimodal, automated detection of nocturnal motor seizures at home: Is a reliable seizure detector feasible?
title_sort multimodal, automated detection of nocturnal motor seizures at home: is a reliable seizure detector feasible?
topic Full‐length Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862103/
https://www.ncbi.nlm.nih.gov/pubmed/29588973
http://dx.doi.org/10.1002/epi4.12076
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