Proof of concept project aims to reliably detect, predict full spectrum of seizures to improve patient quality of life

What if people with epilepsy could reliably detect all types of seizures with a wearable device, like a smartwatch? What if it could predict them?

That kind of tool would not only transform how providers and patients manage epilepsy, but also vastly improve patient safety and quality of life, allowing individuals with epilepsy to live independently.

Photo above, EEG technologists Christian Shoulders and Pedro Tamayo demonstrate the monitoring and watch. (OHSU/Rachel Shafer)

Epilepsy is one of the most common conditions affecting the human brain, according to the CDC. In the U.S., about 5.1 million children and adults have a history of epilepsy, and 3.4 million people live with active epilepsy.

This spring, Oregon Health & Science University neurologists formed a joint research agreement with semiconductor company Analog Devices, Inc. to conduct a year-long study to determine whether ADI’s vital signs monitoring, or VSM, watch can measure key indicators that can be used to detect and predict seizures.

Testing against the gold standard

Paul Motika, M.D., associate professor of neurology, OHSU School of Medicine, Ilker Yaylali, M.D., Ph.D., professor of neurology, OHSU School of Medicine, and team will gather and analyze data from consenting patients who will wear the watch while undergoing EEG diagnostic monitoring or presurgical evaluation in OHSU’s Epilepsy Monitoring Unit.

EEG, or the electroencephalogram, is a test that measures electrical activity in the brain using electrodes attached to the scalp; it’s the clinical gold standard for detecting and measuring seizures.

Study participants will wear the watch on their wrist, where multimodal sensors such as an accelerometer, thermometer, a sensor to measure electrical changes in the skin, and additional biometric sensors, will record physiological data in real time. The researchers will test whether the watch data can be correlated to the EEG measurements to definitively determine the presence of focal to bilateral tonic clonic seizures.

The long-term goal of the project is to build machine learning algorithms to better identify a patient’s seizures over time and eventually develop predictive software for the watch that will give advance warning to individuals (and caregivers and families) about a forthcoming seizure.

Power of wearables

“This collaboration is a perfect example of the potential of these technologies to improve the lives of our patients and their families, while also allowing for more personalized care from their health care providers” — Dan Marks, M.D., Ph.D., senior associate dean for research, OHSU School of Medicine.  

The VSM watch is a modular development, demonstration and data collection platform for high performance vital signs monitoring applications based on ADI analog front-end technology,sensors, and algorithm suite.

The wearable, battery-powered device enables the continuous monitoring and on-demand spot check measurement of photoplethysmography (the change in blood volume), electrodermal activity (electrical changes in the skin), skin temperature, electrocardiography (the measurement of electrical activity in the heart), and motion or activity based on a 3‑axis accelerometer.

The VSM watch allows synchronized, multiparameter data storage on its internal memory for later data retrieval and offline analysis and/or live monitoring on a PC (Windows® OS) or Android- or iOS-based device.

ADI says it’s excited to apply the VSM watch capabilities to detecting seizures in people with epilepsy.

“This is aligned to our vision to engineer good for humanity through our innovative products and technologies” said Shekhar Bakshi, technology development manager, ADI.

Building a practical tool

Neurologists found that the currently available wearable medical device, approved by the FDA to detect seizures, is functionally limited because it doesn’t detect a spectrum of seizures, produces false positives and isn’t predictive.

“The hope is that our project could potentially accomplish a goal that has eluded the field for many years,” said Motika, who specializes in EEG/clinical neurophysiology and epilepsy. “More importantly, it would offer a critically needed service to our patients with epilepsy and their families.”

Yaylali, is trained in clinical neurophysiology and biomedical engineering, and is interested in biological signal processing and data analysis. “Once an artificial intelligence proof-of-concept has been developed, we will work with the industry to validate the technology,” he said. “We anticipate that the first algorithm will require refinement for accuracy and for the inclusion of additional seizure types. Our goal would be to license the software to allow patients to access it.”

“Modern medicine and biomedical research benefit greatly from advances in wearable devices and biometric analysis of normal human activity,” said Dan Marks, M.D., Ph.D., senior associate dean for research, OHSU School of Medicine. “This collaboration is a perfect example of the potential of these technologies to improve the lives of our patients and their families, while also allowing for more personalized care from their health care providers.”

Multiple collaborations

“Catalyzing innovative opportunities at OHSU, like this one, is what I love about my role” —  Laura Erker, Ph.D., OHSU School of Medicine’s director of strategic partnerships

The study got its start when OHSU School of Medicine’s Laura Erker, Ph.D., director of strategic partnerships, presented at an OHSU neurology department meeting last year about services provided by the university’s Technology Transfer Office and potential collaborations with industry such as ADI.

Technology Transfer’s Arvin Paranjpe, J.D., M.S., senior technology development manager, connected Erker, Yaylali and Motika with ADI.

“This is an excellent example of how OHSU Innovates helps cultivate and support unique opportunities for our scientists looking to enhance their research programs via our collaborative network of offices on campus that support innovation at OHSU,” said Travis Cook, M.S., M.B.A., senior director of the Office of Technology Transfer.

The study is the second collaboration between OHSU and ADI using ADI’s VSM watch, and both parties hope this will continue to enhance said collaborations between OHSU scientists and ADI.

“Catalyzing innovative opportunities at OHSU, like this one, is what I love about my role,” said Erker.  “It’s hard to believe that a decade ago, no one predicted we’d be using our watches to track our health, but here we are. Ilker and Paul are applying this in a really innovative way to increase the quality of life of people with epilepsy.”

Funding for this project was provided by the OHSU Office of Technology Transfer via OHSU Innovates funding.

For more information about this and other research collaborations in the OHSU School of Medicine, contact Laura Erker.