Wearable Devices - the Futuristic Slant in Epilepsy!

Creator: Karishma Abhishek
Keywords: Epilepsy, Seizure, wearable device, wearable devices examples, wearable devices in healthcare, device for epilepsy, epilepsy smartwatch, wearable devices use, wearable devices market, wearable devices app, smartwatch for seizures, seizure detection device, best seizure monitoring device

Author - Karishma Abhishek, Physician Assistant (Neurology), M.Sc. Neuroscience

Medically Reviewed by Dr. Sunil Shroff, MBBS, MS, FRCS (UK), D. Urol (Lond) on Oct 11, 2022

Introduction

Wearable devices - with their routine usage are crafting a revolutionary change in the diagnosis and treatment of epilepsy. The FDA has recently cleared a device for routine use and more similar devices at reasonable costs are likely to appear in the market in the near future.

Understanding these recent developments is important for both the patients and the caregivers.

What are Wearable Devices?

Machine learning (ML) and Artificial Intelligence (AI) techniques through cloud technologies are gaining potential insights into designing non-invasive, real-time health trackers that aid in the continuous monitoring of health and disease(1^✔). These applications work by capturing the body signals that are concomitant with specific diseases, thereby improving the diagnosis and treatment of the diseases.

The multi-model and custom-developed approach in algorithms has allowed for the evolution of wireless, miniaturized gadgets that help in better tracking of real-time seizure onsets and patterns - crucial for epilepsy management(2^✔).

Amongst these, wearable devices (wearable technology, designed for use while being worn) have emerged as a non-invasive, inexpensive yet effective measure of detecting, and recording seizures, and forewarning caregivers(3^✔).

What is Epilepsy?

Epilepsy is a progressive neurological disorder characterized by sudden, unprovoked, recurrent attacks of seizures or convulsions with or without loss of consciousness, due to hypersynchronous, abnormal bursts of electrical activity in the brain(4^✔).

Rising Burden of Epilepsy

There are various forms of epileptic seizures affecting over 65 million people globally with one in every third of epileptic patients having resistance to anti-seizure treatment(4^✔).

Certain forms of seizures may present with prior-warning signs or symptoms (aura) but others may occur with almost little or no warning, thereby adding to their burden and morbidity(1^✔). It is thereby congruently critical to address the increased mortality risk from repeated seizure attacks as it may lead to SUDEP (Sudden Unexpected Death in Epilepsy)(5^✔, 6^✔).

SUDEP

Sudden Unexpected Death in Epilepsy - is a fatal complication of epilepsy defined as "death in a patient with epilepsy that is not due to trauma, drowning, status epilepticus, or other known causes but for which there is often evidence of an associated seizure"(6^✔). This occurs due to complications such as aspiration during a seizure. It is estimated that 1 out of 1,000 people with epilepsy die annually as per The Centers for Disease Control and Prevention (CDC)(5^✔).

Newer Technology for Diagnosis and Treatment of Epilepsy

Conventional management of epilepsy relies upon clinical monitoring of seizures, non-invasive scalp electroencephalography (EEG), a witness from family or friends, or a record of seizure diaries(2^✔). However, these approaches may often slip in detecting seizures, mandating better and more appropriate long-term ambulatory monitoring systems(7^✔).

Various types of epilepsies trigger the sympathetic nervous system, thereby leading to autonomic changes like abrupt fluctuations in heartbeat rate, autonomic respiratory reflexes, increased blood pressure, and involuntary changes in pupillary, cutaneous, gastrointestinal, urinary, and genital functions(2^✔, 7^✔, 8^✔).

These diverse autonomic and functional manifestations of epilepsy open a newer window for tracking seizures through technological advancements thereby evolving its treatment and management strategies.

How Wearable Devices Can Help Detect Epilepsy?

Typically these wearable devices/sensors allow tracking of seizure episodes by collecting the various signals (autonomic and similar changes) from the human body that may help detect the occurrence of epilepsy disease and aid in precise treatment(2^✔).

This includes measurements via electrodermal activity (EDA � measures neurally mediated effects on sweat gland), accelerometry (records human motions, as evident during a seizure), electromyography (EMG � records the electrical activity of skeletal muscles), photoplethysmography (PPG � monitors heart rate)(2^✔, 3^✔), microelectromechanical systems (MEMS � predicts the muscular convolutions)(9^✔) and similar other coded body signals during a seizure that might be missed in a traditional clinical environment.

Ultimately, these wearable devices transmit these coded body signal that helps create control signals for switching an alarm device using wireless communication (GSM modem and GPS), and thereby trace the exact location of the patient for alerting their relatives, friends, and consulting doctors(9^✔).

How Far are we?

Some of the wearable devices that have been developed and those under the pipeline include the following:

Empatica (co-founded by MIT professor and wearables pioneer Rosalind Picard) has developed a wristband, called Embrace, which monitors the occurrences of a seizure attack by tracking the coded body signals among the wearers(10^✔).
Wearable/portable caps are available that collect real-time EEG records of patients with epilepsy by utilizing deep machine learning and analytical tools(9^✔).
CMOS-integrated devices have also been used for detecting epilepsy where a low-power detector is utilized to extract the time-to-time information on seizure onset from various body signals(11^✔).
Studies on multichannel EEG signals have also reported the use of artificial neural networks like the Elman network (EN) in the automatic detection of epileptic seizures(12^✔).
Algorithms using the convolutional neural network are found to be highly attuned to detecting EEG-based brain activities with a more comprehensive and objective portrayal(9^✔).
Scientists at the Massachusetts Institute of Technology are now working on a watch that would help detect abnormal electrical signals during a seizure (especially in complex partial seizures) via measurement of changes in skin moisture(13^✔).
BioStamp � a flexible adhesive sensor like a Band-Aid has been developed by MC10 (a startup in Cambridge, MA) that collects brain and muscle activity in epilepsy via wireless smartphone(13^✔).
The use of long-lasting scalp electrodes, headbands, skullcaps, flexible bed sensors, and wristwatchesis also being developed as a potential tool for measuring early abnormal electrical changes in seizures(13^✔).

Similar other devices have also been developed to detect various signs of seizure onsets and patterns.

Benefits of Wearable Devices in Epilepsy

Wearable devices can be used as a life-saving regime, especially in scenarios where epileptic patients present with seizures while driving, sleeping, or when in a remote area(9^✔). Some of the other benefits of wearable devices in epilepsy are the following:

Better sensitivity rates in predicting seizures(9^✔).
Aid in optimized (objective data) yet cost-effective management of millions with epilepsy(9^✔).
Help track the remote location of the epileptic patients, which is beneficial in cases of a seizure attack(2^✔).
Allow for better mobility and QoL (quality of life) among patients with epilepsy through real-time prediction/tracking of the seizures(9^✔, 13^✔).
Rising user acceptance due to comfort/ease of use and accuracy(1^✔).

Wearable Technology � a New Treatment Transition in Epilepsy?

Wearable technologies are emerging as promising and probabilistic forecasts for evaluating long-term seizures. Their potential may help clinicians in understanding the seizure risk factors at an individual level and thereby customizing their management accordingly.

Although wearable devices provide multiple benefits in the precision treatment and management of patients with epilepsy, faulty signal processing at times may lead to false/lag in the identification of epileptic seizures resulting in faulty/delayed treatment or death(9^✔).

It would be imperative to thereby outweigh the risks and benefits of newer technologies over conventional management and tailor the needs of patients with epilepsy.

"We are on the edge of obtaining, for the first time, a reliable and truly accurate record of seizure activity day or night using this (wearable technology) new technology," says Dr. Robert Fisher, MD, PhD, FAAN, the Maslah Saul MD professor of neurology and director of the Stanford University Epilepsy Center and a consultant for wearable technology companies(13^✔).

References:

Preferences and User Experiences of Wearable Devices in Epilepsy - (https://n.neurology.org/content/early/2022/06/15/WNL.0000000000200794)
Seizure detection using wearable sensors and machine learning: Setting a benchmark - (https://onlinelibrary.wiley.com/doi/full/10.1111/epi.16967)
Seizure Diaries and Forecasting With Wearables: Epilepsy Monitoring Outside the Clinic - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8315760/)
A Wearable device for Continuous Detection and Screening of Epilepsy during Daily Life - (https://www.ijsdr.org/papers/IJSDR2003033.pdf)
Wristband detects and alerts for seizures, monitors stress - (https://news.mit.edu/2016/empatica-wristband-detects-alerts-seizures-monitors-stress-0309)
Sudden Unexpected Death in Epilepsy - (https://www.ncbi.nlm.nih.gov/books/NBK559104/)
Effects of Seizures on Autonomic and Cardiovascular Function - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC531654/#:~:text=Autonomic%20changes%20are%20the%20most,may%20predominate%20during%20partial%20seizures)
Autonomic symptoms during epileptic seizures - (https://pubmed.ncbi.nlm.nih.gov/11679301/)
A Wearable device for Continuous Detection and Screening of Epilepsy during Daily Life - (https://www.ijsdr.org/papers/IJSDR2003033.pdf)
Wristband detects and alerts for seizures, monitors stress - (https://news.mit.edu/2016/empatica-wristband-detects-alerts-seizures-monitors-stress-0309)
A new method for predicting epilepsy seizure - (https://www.researchgate.net/publication/282792727_A_new_method_for_predicting_epilepsy_seizure)
Artificial Neural Network Based Epileptic Detection Using Time-Domain and Frequency-Domain Features - (https://www.researchgate.net/publication/7530326_Artificial_Neural_Network_Based_Epileptic_Detection_Using_Time-Domain_and_Frequency-Domain_Features)
New Wearable Medical Tech Tracks More than Just Steps - (https://www.brainandlife.org/articles/wristbands-smartwatches-and-other-wearable-devices-allow-for-more-real)

Cite this Article ⇣⇡

Please use one of the following formats to cite this article in your essay, paper or report:

APA
Karishma Abhishek. (2022, October 11). Wearable Devices - the Futuristic Slant in Epilepsy!. Medindia. Retrieved on Nov 15, 2024 from https://www.medindia.net/health/lifestyle/wearable-devices-the-futuristic-slant-in-epilepsy.htm.
MLA
Karishma Abhishek. "Wearable Devices - the Futuristic Slant in Epilepsy!". Medindia. Nov 15, 2024. <https://www.medindia.net/health/lifestyle/wearable-devices-the-futuristic-slant-in-epilepsy.htm>.
Chicago
Karishma Abhishek. "Wearable Devices - the Futuristic Slant in Epilepsy!". Medindia. https://www.medindia.net/health/lifestyle/wearable-devices-the-futuristic-slant-in-epilepsy.htm. (accessed Nov 15, 2024).
Harvard
Karishma Abhishek. 2022. Wearable Devices - the Futuristic Slant in Epilepsy!. Medindia, viewed Nov 15, 2024, https://www.medindia.net/health/lifestyle/wearable-devices-the-futuristic-slant-in-epilepsy.htm.