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Identification of ictal tachycardia in focal motor‐ and non‐motor seizures by means of a wearable ppg sensor

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Martin Glasstetter, Sebastian Böttcher, Nicolas Zabler, Nino Epitashvili, Matthias Dümpelmann, Mark P. Richardson, Andreas Schulze‐bonhage

Original languageEnglish
Article number6017
JournalSENSORS
Volume21
Issue number18
DOIs
PublishedSep 2021

Bibliographical note

Funding Information: Conflicts of Interest: A.S.‐B. receives research funding from the German Ministry of Science, European Union, National Institute of Health, and from the companies BIAL, Precisis, and UNEEG, is an advisory board member of SEER Medical, and has received honoraria for lectures or advice from Arvelle, BIAL, EISAI, GW and UCB. M.P.R. holds or co‐holds research funding from the UK Medical Research Council, UK National Institute for Health Research, Wellcome Trust, UK Engineering and Physical Sciences Research Council, Epilepsy Research UK, Epilepsy Foundation of America, European Commission, Canadian Institutes of Health Research, GW Pharma; has research collaborations with UNEEG Medical, Seer Medical, UCB Pharma, ANT Neuro, and IMEC; is a Trustee of Epilepsy Research UK and an advisory board member of SUDEP Action; M.P.R. does not receive personal remuneration from any of these sources. M.P.R. holds a patent WO2013182848A1. Funding Information: Funding: This research was partially funded by the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 115902. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation program and EFPIA. Further, this work was supported by the Epilepsy Foundation’s Epilepsy Innovation Institute My Seizure Gauge Project. The article processing charge was funded by the Baden‐Wuerttemberg Ministry of Science, Research and Art and the University of Freiburg in the funding programme Open Access Publishing. Funding Information: This research was partially funded by the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 115902. This Joint Undertaking receives support from the European Union?s Horizon 2020 research and innovation program and EFPIA. Further, this work was supported by the Epilepsy Foundation?s Epilepsy Innovation Institute My Seizure Gauge Project. The article processing charge was funded by the Baden?Wuerttemberg Ministry of Science, Research and Art and the University of Freiburg in the funding programme Open Access Publishing. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

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Abstract

Photoplethysmography (PPG) as an additional biosignal for a seizure detector has been underutilized so far, which is possibly due to its susceptibility to motion artifacts. We investigated 62 focal seizures from 28 patients with electrocardiography‐based evidence of ictal tachycardia (IT). Seizures were divided into subgroups: those without epileptic movements and those with epileptic movements not affecting and affecting the extremities. PPG‐based heart rate (HR) derived from a wrist‐worn device was calculated for sections with high signal quality, which were identified using spectral entropy. Overall, IT based on PPG was identified in 37 of 62 (60%) seizures (9/19, 7/8, and 21/35 in the three groups, respectively) and could be found prior to the onset of epileptic movements affecting the extremities in 14/21 seizures. In 30/37 seizures, PPG‐based IT was in good temporal agreement (<10 s) with ECG‐based IT, with an average delay of 5.0 s relative to EEG onset. In summary, we observed that the identification of IT by means of a wearable PPG sensor is possible not only for non‐motor seizures but also in motor seizures, which is due to the early manifestation of IT in a relevant subset of focal seizures. However, both spontaneous and epileptic movements can impair PPG‐based seizure detection.

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