King’s College London researchers develop a minimally invasive under-the-skin electrode that allows continuous, real-world tracking of epilepsy seizures, improving diagnosis and treatment options
Researchers at King’s College London have developed an innovative under-the-skin electrode that allows for constant monitoring of epilepsy seizures in real-life settings. This breakthrough technology promises more accurate tracking and better management of epilepsy outside traditional clinical environments.
The findings are detailed in Epilepsia.
Epilepsy seizure monitoring using AI
Epilepsy seizure monitoring is challenging and relies on the patient keeping a diary. However, it is an unreliable format as seizures can occur without realising, due to impairment of consciousness and memory loss.
This is particularly important for those with treatment-resistant epilepsy, who have ongoing seizures despite treatment with anti-seizure medication, which is known to occur in around a third of people with epilepsy.
To combat this challenge, researchers from KCL have tested the feasibility, acceptability and overall clinical utility of Novel subcutaneous electroencephalography (sqEEG) systems consisting of a small electrode placed beneath the skin, for epilepsy seizure monitoring.
sqEEG is an AI-powered miniature implantable EEG for real-life monitoring of people with epilepsy. It is about the size of a UK pound coin and has a small 10cm wire attached. Under local anaesthetic, it is placed behind the ear beneath the scalp, and the wire is directed to where the seizures are expected to occur. The device wirelessly communicates with an external recorder attached with an adhesive pad behind the ear and fixed with a magnet or clip, from which clinicians and researchers can access the data.
Patients correctly recorded half of their seizure episodes when keeping a diary
The researchers studied ten adults with treatment-resistant epilepsy who recorded as much data as possible over 15 months regarding their epilepsy seizures. They were tasked to keep a seizure diary and track their health and fitness with a wearable fitness tracker.
During the study, almost 72,000 hours of real-world brainwave data were collected, capturing 754 epilepsy seizures. Participants largely reported that the implant was acceptable and unobtrusive, with half recording for more than 20 hours a day.
The researchers made several observations, comparing the electronic data to the participants’ diaries; the participants had only correctly recorded 48% of their episodes. More than a quarter (27%) of episodes that they’d recorded in their diaries were not associated with seizure activity.
Professor Mark Richardson, Paul Getty III Professor of Epilepsy at King’s IoPPN and the study’s senior author, said, “It is vital that people with treatment-resistant epilepsy can access the best possible care. This is made significantly more challenging because clinicians must rely on patient reporting to establish when episodes have taken place. Our study has provided a vital and viable alternative to relying on self-reported episodes. A small tracker placed under the skin was able to detect seizures far more accurately than the participants themselves.”
Researchers again found that the sqEEG system was able to more accurately track the type of seizure experienced versus the participants’ diaries.
Dr. Pedro Viana, Senior Clinical Research Fellow and Neurologist at King’s IoPPN and the study’s lead author said, “The ability to monitor seizures in the real world, accurately collecting data on the type and timing that they occur will be an invaluable tool for clinicians moving forwards, and should hopefully have a big impact on how we approach the treatment of this life-threatening condition. While this is an important step forward, it’s now vital that we conduct larger trials to further validate this technology, with a view to hopefully making this available to everyone in need.”
Dr. Benjamin Brinkmann, Ph.D., Professor of Neurology at Mayo Clinic, said, “Overall, these results demonstrate that Subscalp EEG devices can provide objective information about seizures and brain activity over long timeframes.
This technology could provide physicians and patients with new insights about long-term patterns and help optimise their epilepsy treatment.”
Jonas Duun-Henriksen, Senior Director AI & Science at UNEEG medical, said, “This study is a significant milestone for UNEEG medical.”
“While we’ve long heard from both people living with epilepsy and their treating physicians that they are very satisfied with our system and that it has helped improve outcomes, this is the first time a study based on more than a full year of continuous EEG recordings confirms those experiences.“
“We’ve gained valuable quantitative insights throughout the study, and we’re especially grateful for the valuable feedback from the clinicians at King’s College London – which we’ve already started incorporating into our solution to enhance its clinical value further.”
