Abstract
Objective
Home monitoring of 3 Hz spike-wave discharges (SWD) in patients with refractory absence epilepsy could improve clinical care by replacing the inaccurate seizure diary with objective counts. We investigated the use and performance of the Sensor Dot (Byteflies) wearable in persons with absence epilepsy in their home environment.
Methods
Thirteen participants (median age = 22 y; 11 female) were enrolled at the university hospitals Leuven and Freiburg. At home, participants had to attach the Sensor Dot and behind-the-ear electrodes to record two-channel EEG, accelerometry and gyroscope data. Ground truth annotations were created during a visual review of the full Sensor Dot recording. Generalized SWDs were annotated if they were 3 Hz and at least 3 seconds on EEG. Potential 3 Hz SWDs were flagged by an automated seizure detection algorithm, using: (i) only EEG, and (ii) with an additional postprocessing step using accelerometer and gyroscope to discard motion artifacts. Afterwards, two readers (W.V.P. and L.S.) reviewed algorithm-labelled segments and annotated true positive detections. Sensitivity, precision, and F1-score were calculated. Patients had to keep a seizure diary and complete questionnaires about their experiences.
Results
Total recording time was 394h 42min. Overall, 234 SWDs were captured in 11 of 13 participants. Review of the unimodal algorithm-labelled recordings resulted in a mean sensitivity of 0.84, precision of 0.93, and F1-score of 0.89. Visual review of the multimodal algorithm-labelled segments resulted in a similar F1-score and shorter review time due to fewer FP labels. Participants reported that the device was comfortable and would be willing to wear it on demand of their neurologist, for a maximum of 1 week or with intermediate breaks.
Significance
The Sensor Dot improved seizure documentation at home, relative to patient self-reporting. Additional benefits were the short review time and the patients’ device acceptance due to user-friendliness and comfortability.
DIC