Wednesday, December 9, 2015

EEG patch

Researchers have developed a wearable electroencephalogram (EEG) device that can detect and record seizure activity in epilepsy patients in the outpatient setting, they reported on Monday at the annual meeting of the American Epilepsy Society in Philadelphia.
The so-called EEG Patch, a small, waterproof, scalp-mounted device, was designed to help patients more accurately track their seizures, Mark Lehmkuhle, PhD, a research assistant professor in neurosurgery at the University of Utah School of Medicine in Salt Lake City, who presented the findings at the meeting, told the Neurology Today Conference Reporter ahead of the session.
The EEG Patch is designed to be fixed to a part of the patient’s scalp where seizures are known to originate based on EEG recorded in-hospital during a traditional epilepsy diagnosis. The device is waterproof and can be worn for up to seven days without needing to be removed or recharged, Dr. Lehmkuhle said.
“There have been quite a few studies to show that seizure diaries can be inaccurate, or in some cases even misleading,” Dr. Lehmkuhle said. “A lot of seizures are non-convulsive or subclinical, and a person may not even know they’re having a seizure. With this device, we’re trying to help people keep track of their seizures better so that they can report them to their epileptologist. The epileptologist would then have a more accurate report of how many seizures a person is having and be able to fine-tune a person’s treatment based on that report.”
The device was manufactured by Epitel Inc., which was founded in 2007 to develop wireless EEG recording technology for research on animal models of epilepsy in the lab of F. Edward Dudek, PhD, a professor of neurosurgery at the University of Utah and a coauthor on the study. It is currently being tested in a small pilot feasibility trial led by Mark C. Spitz, MD, a professor of neurology at the University of Colorado in Denver.
The pilot trial will compare EEG recordings of seizures from the EEG Patch to seizure activity recorded for between three and seven days using wired EEG at the University of Colorado’s epilepsy monitoring unit, Dr. Lehmkuhle said.
Presenting preliminary data in a poster session, Dr. Lehmkuhle said three of four patients had seizures in the EEG monitoring unit, and the waveform recordings from the wired EEG and the EEG Patch looked very similar. “We think we can see the simultaneously recorded seizures in both the wireless and the wired EEG channels,” he said.
Commenting on the study, Robert S. Fisher, MD, PhD, FAAN, the Maslah Saul professor of neurology and director of the Stanford Epilepsy Center at Stanford University Medical Center, said: “There is a major need for new EEG technology that can be used long-term in the outpatient environment. Having a low-profile way of recording EEG long-term would help us with diagnosis of seizures and counting numbers of seizures, and eventually it might, as technology improves, even help us with seizure prediction.”
The device “appears to be potentially very good at counting seizures where you know the location of the seizure a priori,” he added. However, “it might not be quite as applicable to making a diagnosis of epileptic versus non-epileptic events, because in that setting you wouldn’t really know where to put the one electrode.”
Dr. Fisher disclosed that he holds stock options in two companies that develop EEG equipment, Advanced Neurometrics Inc. and Zeto Inc. Neither company was involved in the development of the EEG Patch.
(Abst. 2.158), 2015Development of a discrete, wearable, EEG device for counting seizuresAuthors: Mark Lehmkuhle, Michael Elwood, Jean Wheeler, John Fisher, F. Edward Dudek
Rationale: Over 1.2 million people in the US with epilepsy have intractable seizures, which are an immense financial and personal burden to the person with epilepsy and their family. To optimize treatment after initial diagnosis, epileptologists would ideally obtain high-quality, long-term EEG in the hospital with 26-channel wired EEG in the ‘10-20’ montage. This is rarely done because the process is prohibitively expensive, time consuming, and extremely inconvenient for patients. Optimal treatment depends on identifying the full extent of a patient’s convulsive and non-convulsive seizure activity. The current state-of-the-art for recording that seizure activity outside of the hospital is the seizure diary, a home-based, self-reported, incomplete record. Unfortunately, seizure diaries are difficult to maintain accurately, under-report non-convulsive seizures, and importantly, miss any records of seizures that occur during sleep. Thus, the diary can be inaccurate, confounding clinical decisions on appropriate pharmacological treatment. Better clinical decisions could be made if there were an easy-to-use EEG recording technology that enables continuous seizure tracking in the everyday home environment.
Methods: Towards this goal, we have developed an inexpensive, waterproof, 1-channel (2-electrode), discrete EEG monitoring device called the EEG PatchTM. The waterproof design provides users with freedom of mobility in daily activities such as bathing, sports, and sleep during continuous EEG monitoring. The EEG Patch is discrete, unobtrusive, and disposable with electrode spacing based on the classic wired EEG in the ’10-20’ montage. The EEG Patch simultaneously logs and transmits EEG in real time. The EEG can be downloaded off of the device at any time for review in the standard European Data Format. A small handheld device can be used to wirelessly observe the EEG signal in real time as a means to spot-check signal quality.
Results: The EEG Patch is 30x30x6 mm; it transmits and logs continuous EEG data for 7 days on a single charge (3 V, 1.14 mA; 3.42 mW). EEG is amplified and recorded on the device with bandwidth of 0.2 – 120 Hz, 8 dB per octave. The compact technology reduces electrical and movement artifacts, common in wired,“ambulatory” EEG. The device is placed on the scalp by an epileptologist at a selected location where seizures are known to manifest in the wired EEG record during a traditional diagnosis of epilepsy.
Conclusions: We have developed a self-contained, EEG-based device that is capable of continuously tracking seizures for 7 days and is robust enough for at-home use. The device will be validated against the gold-standard wired EEG in the EEG long-term monitoring unit. Armed with 7 day, location-specific EEG data, an epileptologist will have a robust record of quantitative seizure counts to better treat patients, revolutionizing therapy. See more at:

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