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Spike detection in the wild: Screening of suspected temporal lobe epilepsy cases using a tailored 2-channel wearable EEG

dc.contributor.authorBorges, Daniel Filipe
dc.contributor.authorSoares, Joana Isabel
dc.contributor.authorDias, Daniela
dc.contributor.authorCordeiro, Helena
dc.contributor.authorLeal, Alberto
dc.contributor.authorBorges, Daniel Filipe
dc.date.accessioned2025-02-28T12:31:00Z
dc.date.available2025-02-28T12:31:00Z
dc.date.issued2025-02-18
dc.description.abstractTo clinically validate the contribution of a custom-built-wearable device (waEEG) compared to a full 10–20 electrode array ambulatory EEG (aEEG) for screening epilepsy cases in patients with suspected temporal lobe epilepsy (TLE) but negative routine EEGs. Patients (aged 16–91 years) with clinically suspected TLE who were referred for a 24 h aEEG were fitted with an additional 2-channel bipolar waEEG device and prospectively enrolled in the study until 20 TLE diagnoses were confirmed by aEEG. 41 patients were included and their waEEG was blindly reviewed by two experienced clinical neurophysiologists and a semi-automated spike detection software to categorize patients into TLE (spikes present) and non-TLE (no spikes) groups. The experts achieved good sensitivity (95%–100%) and accuracy (98%–93%) with excellent interrater agreement (kappa>0.80) in patient labelling. The semi-automated software performed poorly (40% sensitivity, 68% accuracy) and failed to classify TLE in more than half the cases. Classification was not affected by restricting spike detection to the evening and night time, which reduced the average length of the analyzed EEG from 23.4 to 10.4 h. Three false-positive spike detections were thoroughly analyzed and reclassified as artifacts due to eye and body movements and electrocardiographic contamination. To better control cardiac artifacts, the addition of an ECG channel to the waEEG is recommended. Detection of spikes with waEEG allows accurate detection of epilepsy in suspected TLE cases, with less technical and professional effort and improved acceptance. This screening tool could improve the yield of follow-up with a conventional aEEG and provide an accessible method for monitoring interictal epileptiform activity in TLE. Epilepsy is a chronic short circuit in the brain. In adults, it most often affects the temporal lobes, resulting in temporal lobe epilepsy (TLE). Seizures are infrequent but difficult to treat. Electroencephalography (EEG) is the best method to detect the electrical disturbances and is crucial to distinguish epilepsy from other non-epileptic disorders. Developing simple, inexpensive and easily accessible portable EEG methods that complement in-hospital assessment could significantly impact patient care. Our study aims to clinically validate a wearable epilepsy screening device to aid in TLE management, reduce delays in diagnosis and enable straightforward assessment of epileptic activity.por
dc.identifier.citationBorges, D. F., Soares, J. I., Dias, D., Cordeiro, H., & Leal, A. (2025). Spike detection in the wild: Screening of suspected temporal lobe epilepsy cases using a tailored 2-channel wearable EEG. Epilepsia Open, n/a(n/a). https://doi.org/10.1002/epi4.70004
dc.identifier.doi10.1002/epi4.70004
dc.identifier.eissn2470-9239
dc.identifier.urihttp://hdl.handle.net/10400.22/29767
dc.language.isopor
dc.peerreviewedyes
dc.publisherWilley
dc.relation.hasversionhttps://onlinelibrary.wiley.com/doi/full/10.1002/epi4.70004
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectElectroencephalography
dc.subjectEpilepsy
dc.subjectNeurotechnology
dc.subjectTemporal lobe epilepsy
dc.subjectWearable devices
dc.titleSpike detection in the wild: Screening of suspected temporal lobe epilepsy cases using a tailored 2-channel wearable EEGpor
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleEpilepsia Open
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameBorges
person.givenNameDaniel Filipe
person.identifier3235598
person.identifier.ciencia-id0217-87F9-58DF
person.identifier.orcid0000-0003-0189-7908
person.identifier.ridJVO-1831-2024
person.identifier.scopus-author-id57912703700
relation.isAuthorOfPublicationf67e814a-8ad9-4440-820a-deaccea87bb8
relation.isAuthorOfPublication.latestForDiscoveryf67e814a-8ad9-4440-820a-deaccea87bb8

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