Associate Professor of Neurology Mayo Clinic Rochester, Minnesota
Rationale: Noninvasive and minimally invasive devices may be able to improve patient care by detecting and forecasting seizures. The Epilepsy Foundation sponsored My Seizure Gague project is a three-year project aimed at advancing these capabilities. Methods: The Empatica E4, Empatica Embrace2, and Fitbit Charge 3 and Inspire were chosen for long-term ambulatory wearable device monitoring of patients with concurrent EEG Monitoring. Signal quality metrics were developed to aid automated evaluation of data quality during the ambulatory phase of the project. Epilepsy patients at King’s College London were recruited to undergo implantation with the UNEEG SubQ subscalp EEG system. Patients at Mayo Clinic enrolled in the ongoing RC+S trial were recruited, as were patients with implanted NeuroPace RNS systems. Patients at the University of Melbourne enrolled in the EpiMinder subscalp device trial were recruited. Wearable data from enrolled patients was recorded for up to eight months and uploaded to shared space on a cloud-based platform for analysis. Electronic seizure diaries and periodic mood and symptom surveys were kept by participants as well. Recorded data will be analyzed to assess the ability to detect seizures, to identify circadian and multi-day cycles, and to forecast seizures. Selected wearable data are freely available on EpilepsyEcosystem.org to foster exploration and academic collaboration. Results: To date sixteen patients and one volunteer have recorded a combined 1,890 days of data, including 195 seizures. Two patients were implanted with the UNEEG device and wore Fitbit Charge 3 devices, until a technical problem prevented further EEG recording in both patients. Both patients recorded a total of 273 days of subscalp EEG and 28 seizures whilst using a Fitbit Charge 3. One patient with the RC+S device recorded six days of data with the Empatica Embrace2 before leaving the study due to the burden of device management. Nine patients with implanted RNS devices have been enrolled in the study recording 1,090 days of data and 136 seizures with the Empatica E4. Four patients with EpiMinder subscalp devices are enrolled in the study and have recorded 198 days of data to date using the Fitbit charge. Seizure counts for these patients are pending. Conclusions: Wearable devices show promise for objective seizure counting and identification of cycles of seizure risk. Funding: Please list any funding that was received in support of this abstract.: This work was funded by the ‘My Seizure Gauge’ grant provided by the Epilepsy Innovation Institute, a research program of the Epilepsy Foundation of America.