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Multimodal nocturnal seizure detection in a residential care setting: A long-term prospective trial

OBJECTIVE: To develop and prospectively evaluate a method of epileptic seizure detection combining heart rate and movement. METHODS: In this multicenter, in-home, prospective, video-controlled cohort study, nocturnal seizures were detected by heart rate (photoplethysmography) or movement (3-D accele...

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Autores principales: Arends, Johan, Thijs, Roland D., Gutter, Thea, Ungureanu, Constantin, Cluitmans, Pierre, Van Dijk, Johannes, van Andel, Judith, Tan, Francis, de Weerd, Al, Vledder, Ben, Hofstra, Wytske, Lazeron, Richard, van Thiel, Ghislaine, Roes, Kit C.B., Leijten, Frans
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6260200/
https://www.ncbi.nlm.nih.gov/pubmed/30355702
http://dx.doi.org/10.1212/WNL.0000000000006545
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author Arends, Johan
Thijs, Roland D.
Gutter, Thea
Ungureanu, Constantin
Cluitmans, Pierre
Van Dijk, Johannes
van Andel, Judith
Tan, Francis
de Weerd, Al
Vledder, Ben
Hofstra, Wytske
Lazeron, Richard
van Thiel, Ghislaine
Roes, Kit C.B.
Leijten, Frans
author_facet Arends, Johan
Thijs, Roland D.
Gutter, Thea
Ungureanu, Constantin
Cluitmans, Pierre
Van Dijk, Johannes
van Andel, Judith
Tan, Francis
de Weerd, Al
Vledder, Ben
Hofstra, Wytske
Lazeron, Richard
van Thiel, Ghislaine
Roes, Kit C.B.
Leijten, Frans
author_sort Arends, Johan
collection PubMed
description OBJECTIVE: To develop and prospectively evaluate a method of epileptic seizure detection combining heart rate and movement. METHODS: In this multicenter, in-home, prospective, video-controlled cohort study, nocturnal seizures were detected by heart rate (photoplethysmography) or movement (3-D accelerometry) in persons with epilepsy and intellectual disability. Participants with >1 monthly major seizure wore a bracelet (Nightwatch) on the upper arm at night for 2 to 3 months. Major seizures were tonic-clonic, generalized tonic >30 seconds, hyperkinetic, or others, including clusters (>30 minutes) of short myoclonic/tonic seizures. The video of all events (alarms, nurse diaries) and 10% completely screened nights were reviewed to classify major (needing an alarm), minor (needing no alarm), or no seizure. Reliability was tested by interobserver agreement. We determined device performance, compared it to a bed sensor (Emfit), and evaluated the caregivers’ user experience. RESULTS: Twenty-eight of 34 admitted participants (1,826 nights, 809 major seizures) completed the study. Interobserver agreement (major/no major seizures) was 0.77 (95% confidence interval [CI] 0.65–0.89). Median sensitivity per participant amounted to 86% (95% CI 77%–93%); the false-negative alarm rate was 0.03 per night (95% CI 0.01–0.05); and the positive predictive value was 49% (95% CI 33%–64%). The multimodal sensor showed a better sensitivity than the bed sensor (n = 14, median difference 58%, 95% CI 39%–80%, p < 0.001). The caregivers' questionnaire (n = 33) indicated good sensor acceptance and usability according to 28 and 27 participants, respectively. CONCLUSION: Combining heart rate and movement resulted in reliable detection of a broad range of nocturnal seizures.
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spelling pubmed-62602002018-12-11 Multimodal nocturnal seizure detection in a residential care setting: A long-term prospective trial Arends, Johan Thijs, Roland D. Gutter, Thea Ungureanu, Constantin Cluitmans, Pierre Van Dijk, Johannes van Andel, Judith Tan, Francis de Weerd, Al Vledder, Ben Hofstra, Wytske Lazeron, Richard van Thiel, Ghislaine Roes, Kit C.B. Leijten, Frans Neurology Article OBJECTIVE: To develop and prospectively evaluate a method of epileptic seizure detection combining heart rate and movement. METHODS: In this multicenter, in-home, prospective, video-controlled cohort study, nocturnal seizures were detected by heart rate (photoplethysmography) or movement (3-D accelerometry) in persons with epilepsy and intellectual disability. Participants with >1 monthly major seizure wore a bracelet (Nightwatch) on the upper arm at night for 2 to 3 months. Major seizures were tonic-clonic, generalized tonic >30 seconds, hyperkinetic, or others, including clusters (>30 minutes) of short myoclonic/tonic seizures. The video of all events (alarms, nurse diaries) and 10% completely screened nights were reviewed to classify major (needing an alarm), minor (needing no alarm), or no seizure. Reliability was tested by interobserver agreement. We determined device performance, compared it to a bed sensor (Emfit), and evaluated the caregivers’ user experience. RESULTS: Twenty-eight of 34 admitted participants (1,826 nights, 809 major seizures) completed the study. Interobserver agreement (major/no major seizures) was 0.77 (95% confidence interval [CI] 0.65–0.89). Median sensitivity per participant amounted to 86% (95% CI 77%–93%); the false-negative alarm rate was 0.03 per night (95% CI 0.01–0.05); and the positive predictive value was 49% (95% CI 33%–64%). The multimodal sensor showed a better sensitivity than the bed sensor (n = 14, median difference 58%, 95% CI 39%–80%, p < 0.001). The caregivers' questionnaire (n = 33) indicated good sensor acceptance and usability according to 28 and 27 participants, respectively. CONCLUSION: Combining heart rate and movement resulted in reliable detection of a broad range of nocturnal seizures. Lippincott Williams & Wilkins 2018-11-20 /pmc/articles/PMC6260200/ /pubmed/30355702 http://dx.doi.org/10.1212/WNL.0000000000006545 Text en Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Article
Arends, Johan
Thijs, Roland D.
Gutter, Thea
Ungureanu, Constantin
Cluitmans, Pierre
Van Dijk, Johannes
van Andel, Judith
Tan, Francis
de Weerd, Al
Vledder, Ben
Hofstra, Wytske
Lazeron, Richard
van Thiel, Ghislaine
Roes, Kit C.B.
Leijten, Frans
Multimodal nocturnal seizure detection in a residential care setting: A long-term prospective trial
title Multimodal nocturnal seizure detection in a residential care setting: A long-term prospective trial
title_full Multimodal nocturnal seizure detection in a residential care setting: A long-term prospective trial
title_fullStr Multimodal nocturnal seizure detection in a residential care setting: A long-term prospective trial
title_full_unstemmed Multimodal nocturnal seizure detection in a residential care setting: A long-term prospective trial
title_short Multimodal nocturnal seizure detection in a residential care setting: A long-term prospective trial
title_sort multimodal nocturnal seizure detection in a residential care setting: a long-term prospective trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6260200/
https://www.ncbi.nlm.nih.gov/pubmed/30355702
http://dx.doi.org/10.1212/WNL.0000000000006545
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