Optimizing Pharmacotherapy with Noninvasive Wearable Sensors and Subscalp EEG

项目摘要 癫痫发作的明显随机性是影响患者生活质量的最重要因素之一 患有癫痫准确的癫痫发作预测对癫痫患者来说可能是变革性的， 调整活动以避免风险，服用速效药物以在癫痫发作之前阻止癫痫发作，并提供 一种战胜疾病的力量感成功的癫痫发作预测现在已经建立使用 移动式颅内脑电图设备。不幸的是，目前没有这样的设备可用于患者，因为没有 迄今为止，商业供应商已经成功地获得了这种设备的临床使用的批准。 此外，考虑到植入物的植入，侵入性颅内植入物可能不适合于许多患者或对许多患者来说是不可接受的。 感染和出血的相关风险。头皮下脑电图记录最近已成为一种可行的手段 长期监测癫痫患者。器械在欧盟市售，但不 在美国还没有食品药品管理局的许可最近发表的研究表明，该设备是可靠和强大的， 据报道，记录时间超过6个月。此外，癫痫发作风险的周期已被确定， 可穿戴设备的生理信号，并且这些长期周期可能能够有助于 缉获预测的准确性。这一项目将发展从2000年至2005年对缉获量进行前瞻性预测的能力， 同时头皮下EEG和腕戴可穿戴信号，并将评估安全性和可行性， 管理一个快速作用的补充药物与癫痫发作的预测，以防止癫痫发作。

Project Summary The apparently random nature of seizures is one of the most significant factors affecting quality of life for patients with epilepsy. Accurate seizure forecasting could be transformative for patients with epilepsy, allowing patients to modify activities to avoid risk, take fast-acting medications to stop seizures before they develop, and provide a sense of empowerment over their disease. Successful seizure prediction has now been established using ambulatory intracranial EEG devices. Unfortunately, no such device is currently available to patients, as no commercial vendor has been successful to date at obtaining approval for clinical use of such a device. Furthermore, invasive intracranial implants may not be appropriate for or acceptable to many patients given the associated risk of infection and hemorrhage. Subscalp EEG recording has recently emerged as a viable means for long-term monitoring of patients with epilepsy. A device is commercially available in the EU, but does not yet have FDA clearance in the US. Recently published studies show the device to be reliable and robust, and recordings longer than 6 months have been reported. In addition cycles of seizure risk have been identified in wearable device physiological signals, and these long-term cycles may be capable of contributing to the accuracy of seizure forecasts. This project will develop the ability to prospectively forecast seizures from simultaneous subscalp EEG and wrist-worn wearable signals, and will assess the safety and feasibility of administering a fast-acting supplemental medication with seizure forecasts to prevent seizures.