Detection of focal to bilateral tonic-clonic seizures using a connected shirt.
Epilepsia
; 65(8): 2280-2294, 2024 Aug.
Article
em En
| MEDLINE
| ID: mdl-38780375
ABSTRACT
OBJECTIVE:
This study was undertaken to develop and evaluate a machine learning-based algorithm for the detection of focal to bilateral tonic-clonic seizures (FBTCS) using a novel multimodal connected shirt.METHODS:
We prospectively recruited patients with epilepsy admitted to our epilepsy monitoring unit and asked them to wear the connected shirt while under simultaneous video-electroencephalographic monitoring. Electrocardiographic (ECG) and accelerometric (ACC) signals recorded with the connected shirt were used for the development of the seizure detection algorithm. First, we used a sliding window to extract linear and nonlinear features from both ECG and ACC signals. Then, we trained an extreme gradient boosting algorithm (XGBoost) to detect FBTCS according to seizure onset and offset annotated by three board-certified epileptologists. Finally, we applied a postprocessing step to regularize the classification output. A patientwise nested cross-validation was implemented to evaluate the performances in terms of sensitivity, false alarm rate (FAR), time in false warning (TiW), detection latency, and receiver operating characteristic area under the curve (ROC-AUC).RESULTS:
We recorded 66 FBTCS from 42 patients who wore the connected shirt for a total of 8067 continuous hours. The XGBoost algorithm reached a sensitivity of 84.8% (56/66 seizures), with a median FAR of .55/24 h and a median TiW of 10 s/alarm. ROC-AUC was .90 (95% confidence interval = .88-.91). Median detection latency from the time of progression to the bilateral tonic-clonic phase was 25.5 s.SIGNIFICANCE:
The novel connected shirt allowed accurate detection of FBTCS with a low false alarm rate in a hospital setting. Prospective studies in a residential setting with a real-time and online seizure detection algorithm are required to validate the performance and usability of this device.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Convulsões
/
Algoritmos
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Eletroencefalografia
/
Dispositivos Eletrônicos Vestíveis
Limite:
Adolescent
/
Adult
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Epilepsia
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Canadá