Artificial Intelligence Enhanced Epileptic Seizure Detection from Wearables.

Abstract

Wrist or ankle-worn devices are less intrusive than the widely used electroencephalogram systems for monitoring epileptic seizures. Using custom-developed deep-learning seizure detection models, we demonstrate the detection of a broad range of seizure types by wearable signals. Patients admitted to the epilepsy monitoring unit were enrolled and asked to wear wearable sensors on either wrists or ankles. We collected patients' electrodermal activity, accelerometry (ACC), and photoplethysmography from which blood volume pulse (BVP) is derived. Board-certified epileptologists determined seizure onset, offset, and seizure types using video and EEG recordings per ILAE 2017 classification. We applied three neural network models: a CNN and a CNN-LSTM-based generalized detection model and an autoencoder-based personalized detection model, to the raw time-series sensor data to detect seizures and utilized performance measures, including sensitivity, false positive rate (the number of false alarms divided by the total number of non-seizure segments), number of false alarms per day, and detection delay. We applied a 10-fold patient-wise cross-validation scheme to the multi-signal biosensor data and evaluated model performance on 28 seizure types. We analyzed 166 patients (47.6% female, median age: 10.0 years) and 900 seizures (13254 hours of sensor data) for 28 seizure types. With a CNN-LSTM-based seizure detection model, ACC, BVP, and their fusions' performances performed better than chance; ACC and BVP data fusion reached the best detection performance of 83.9% sensitivity and 35.3% false positive rate (FPR). Nineteen out of 28 seizure types could be detected by at least one data modality with AUC-ROC > 0.8 performance. Results from this in-hospital study contribute to a paradigm shift in epilepsy care that entails non-invasive seizure detection, provides time-sensitive and accurate data on additional clinical seizure types, and proposes a novel combination of an out-of-the-box monitoring algorithm with an individualized person-oriented seizure detection approach.