Circadian Profile and Seizure Forecasting: Still Cloudy but With Chance for Sunshine.
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ABSTRACT:
SUBMITTER: Lee JW
PROVIDER: S-EPMC5967594 | biostudies-literature | 2018 Jan-Feb
REPOSITORIES: biostudies-literature
Publications
Circadian Profile and Seizure Forecasting: Still Cloudy but With Chance for Sunshine.
Epilepsy currents 20180101 1
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Project description:Cloud-hosted environments offer known benefits when computational needs outstrip affordable local workstations, enabling high-performance computation without a physical cluster. What has been less apparent, especially to novice users, is the transformative potential for cloud-hosted environments to bridge the digital divide that exists between poorly funded and well-resourced laboratories, and to empower modern research groups with remote personnel and trainees. Using cloud-based proteomic bioinformatic pipelines is not predicated on analyzing thousands of files, but instead can be used to improve accessibility during remote work, extreme weather, or working with under-resourced remote trainees. The general benefits of cloud-hosted environments also allow for scalability and encourage reproducibility. Since one possible hurdle to adoption is awareness, this paper is written with the nonexpert in mind. The benefits and possibilities of using a cloud-hosted environment are emphasized by describing how to setup an example workflow to analyze a previously published label-free data-dependent acquisition mass spectrometry data set of mammalian urine. Cost and time of analysis are compared using different computational tiers, and important practical considerations are described. Overall, cloud-hosted environments offer the potential to solve large computational problems, but more importantly can enable and accelerate research in smaller research groups with inadequate infrastructure and suboptimal local computational resources.
| S-EPMC8637422 | biostudies-literature
Project description:Objectives.People with refractory epilepsy are overwhelmed by the uncertainty of their next seizures. Accurate prediction of future seizures could greatly improve the quality of life for these patients. New evidence suggests that seizure occurrences can have cyclical patterns for some patients. Even though these cyclicalities are not intuitive, they can be identified by machine learning (ML), to identify patients with predictable vs unpredictable seizure patterns.Approach.Self-reported seizure logs of 153 patients from the Human Epilepsy Project with more than three reported seizures (totaling 8337 seizures) were used to obtain inter-seizure interval time-series for training and evaluation of the forecasting models. Two classes of prediction methods were studied: (1) statistical approaches using Bayesian fusion of population-wise and individual-wise seizure patterns; and (2) ML-based algorithms including least squares, least absolute shrinkage and selection operator, support vector machine (SVM) regression, and long short-term memory regression. Leave-one-person-out cross-validation was used for training and evaluation, by training on seizure diaries of all except one subject and testing on the left-out subject.Main results.The leading forecasting models were the SVM regression and a statistical model that combined the median of population-wise seizure time-intervals with a test subject's prior seizure intervals. SVM was able to forecast 50%, 70%, 81%, 84%, and 87% of seizures of unseen subjects within 0, 1, 2, 3 to 4 d of mean absolute forecasting error, respectively. The subject-wise performances show that patients with more frequent seizures were generally better predicted.Significance.ML models can leverage non-random patterns within self-reported seizure diaries to forecast future seizures. While diary-based seizure forecasting alone is only one of many aspects of clinical care of patients with epilepsy, studying the level of predictability across seizures and patients paves the path towards a better understanding of predictable vs unpredictable seizures on individualized and population-wise bases.
| S-EPMC9940727 | biostudies-literature
Project description:The unpredictability of epileptic seizures exposes people with epilepsy to potential physical harm, restricts day-to-day activities, and impacts mental well-being. Accurate seizure forecasters would reduce the uncertainty associated with seizures but need to be feasible and accessible in the long-term. Wearable devices are perfect candidates to develop non-invasive, accessible forecasts but are yet to be investigated in long-term studies. We hypothesized that machine learning models could utilize heart rate as a biomarker for well-established cycles of seizures and epileptic activity, in addition to other wearable signals, to forecast high and low risk seizure periods. This feasibility study tracked participants' (n = 11) heart rates, sleep, and step counts using wearable smartwatches and seizure occurrence using smartphone seizure diaries for at least 6 months (mean = 14.6 months, SD = 3.8 months). Eligible participants had a diagnosis of refractory epilepsy and reported at least 20 seizures (mean = 135, SD = 123) during the recording period. An ensembled machine learning and neural network model estimated seizure risk either daily or hourly, with retraining occurring on a weekly basis as additional data was collected. Performance was evaluated retrospectively against a rate-matched random forecast using the area under the receiver operating curve. A pseudo-prospective evaluation was also conducted on a held-out dataset. Of the 11 participants, seizures were predicted above chance in all (100%) participants using an hourly forecast and in ten (91%) participants using a daily forecast. The average time spent in high risk (prediction time) before a seizure occurred was 37 min in the hourly forecast and 3 days in the daily forecast. Cyclic features added the most predictive value to the forecasts, particularly circadian and multiday heart rate cycles. Wearable devices can be used to produce patient-specific seizure forecasts, particularly when biomarkers of seizure and epileptic activity cycles are utilized.
| S-EPMC8320020 | biostudies-literature
Project description:Accurate seizure forecasting is emerging as a near-term possibility due to recent advancements in machine learning and EEG technology improvements. Large-scale data curation and new data element collection through consumer wearables and digital health tools such as longitudinal seizure diary data has uncovered new possibilities for personalized algorithm development that may be used to predict the likelihood of future seizures. The Epilepsy Foundation recognized the unmet need for development in seizure forecasting following a 2016 survey where an overwhelming majority of respondents across all seizure types and frequencies reported that unpredictability of seizures had the strongest impact on their life while living with or caring for someone living with epilepsy. In early 2021, the Epilepsy Foundation conducted an updated survey among those living with epilepsies and/or their caregivers to better understand the use-cases that best suit the needs of our community as seizure forecast research advances. These results will provide researchers with insight into user-acceptance of using a forecasting tool and incorporation into their daily life. Ultimately, this input from people living with epilepsy and caregivers will provide timely feedback on what the community needs are and ensure researchers and companies first and foremost consider these needs in seizure forecasting tools/product development.
| S-EPMC8488220 | biostudies-literature
Project description:This study aimed to identify factors that can influence show-jumping performance during top level competitions in the Western European League (2017/2018, CSI5*). The performance data of 144 riders and 222 horses were obtained from video records (FEI TV/ website). Riders with horses achieved a total of 9114 jumping-efforts over 320 obstacles including oxers (n = 142), oxers with water (n = 15), triple bars (n = 6), verticals (n = 136), verticals with water (n = 14) and walls (n = 7). Obstacles in the first round (FR) or in jump off (JO) were standing either as single (n = 6290) or as a combination of two or three fences in a row (n = 2824). The overall fault rate (dropping the pole or refusal/run-out to jump) was 7.85%. The probability of a fault increased with the rank of the fence in the course of FR (F (1, 7649) = 5.29, P < 0.0001, GzLMM; PROC GLIMMIX, SAS). The highest probability of a fault (F (5, 7649) = 2.51, P < 0.03) in FR was found on the vertical obstacle with water (0.125 ± 0.021, LSMEAN ± standard error) while the lowest was on the triple bar (0.037 ± 0.015) and wall (0.048 ± 0.020). Riders who completed more starts in previous competitions achieved a lower fault rate (F (1, 7649) = 6.17, P < 0.02) in FR as well as in JO (F (1, 931) = 7.05, P < 0.01). The probability of faults in JO decreased with a higher speed (F (1, 931) = 6.66, P < 0.01) but there was no significant correlation between the speed in JO and FR in individual horses (r = 0.26, P < 0.01). More faults were found on the fences within combinations in both rounds (FR, JO). The highest probability of faults was found on the first fence (FR 0.095 ± 0.016; JO 0.043 ± 0.008) or second fence (JO 0.055 ± 0.020) of the double combination compared to the least probability of faults on single obstacles (FR 0.057 ± 0.007, F (5, 7649) = 5.29, P < 0.0001; JO 0.100 ± 0.027, F (1, 931) = 3.39, P < 0.04). Other tested factors did not affect show-jumping performance. Some faults are still more likely and not random in a show-jumping course, therefore, the appropriate training focus can improve performance and safety in competitions.
| S-EPMC8926200 | biostudies-literature
Project description:Advances in ambulatory intracranial EEG devices have enabled objective analyses of circadian and multiday seizure periodicities, and seizure clusters in humans. This study characterizes circadian and multiday seizure periodicities, and seizure clusters in dogs with naturally occurring focal epilepsy, and considers the implications of an animal model for the study of seizure risk patterns, seizure forecasting and personalized treatment protocols. In this retrospective cohort study, 16 dogs were continuously monitored with ambulatory intracranial EEG devices designed for humans. Detailed medication records were kept for all dogs. Seizure periodicity was evaluated with circular statistics methods. Circular non-uniformity was assessed for circadian, 7-day and approximately monthly periods. The Rayleigh test was used to assess statistical significance, with correction for multiple comparisons. Seizure clusters were evaluated with Fano factor (index of dispersion) measurements, and compared to a Poisson distribution. Relationships between interseizure interval (ISI) and seizure duration were evaluated. Six dogs met the inclusion criteria of having at least 30 seizures and were monitored for an average of 65 weeks. Three dogs had seizures with circadian seizure periodicity, one dog had a 7-day periodicity, and two dogs had approximately monthly periodicity. Four dogs had seizure clusters and significantly elevated Fano factor values. There were subject-specific differences in the dynamics of ISI and seizure durations, both within and between lead and clustered seizure categories. Our findings show that seizure timing in dogs with naturally occurring epilepsy is not random, and that circadian and multiday seizure periodicities, and seizure clusters are common. Circadian, 7-day, and monthly seizure periodicities occur independent of antiseizure medication dosing, and these patterns likely reflect endogenous rhythms of seizure risk.
| S-EPMC7052793 | biostudies-literature
Project description:ObjectiveNon-invasive biomarkers have recently shown promise for seizure forecasting in people with epilepsy. In this work, we developed a seizure-day forecasting algorithm based on nocturnal sleep features acquired using a smart shirt.MethodsSeventy-eight individuals with epilepsy admitted to the Centre hospitalier de l'Université de Montréal epilepsy monitoring unit wore the Hexoskin biometric smart shirt during their stay. The shirt continuously measures electrocardiography, respiratory, and accelerometry activity. Ten sleep features, including sleep efficiency, sleep latency, sleep duration, time spent in non-rapid eye movement sleep (NREM) and rapid eye movement sleep (REM), wakefulness after sleep onset, average heart and breathing rates, high-frequency heart rate variability, and the number of position changes, were automatically computed using the Hexoskin sleep algorithm. Each night's features were then normalized using a reference night for each patient. A support vector machine classifier was trained for pseudo-prospective seizure-day forecasting, with forecasting horizons of 16- and 24-h to include both diurnal and nocturnal seizures (24-h) or diurnal seizures only (16-h). The algorithm's performance was assessed using a nested leave-one-patient-out cross-validation approach.ResultsImprovement over chance (IoC) performances were achieved for 48.7% and 40% of patients with the 16- and 24-h forecasting horizons, respectively. For patients with IoC performances, the proposed algorithm reached mean IoC, sensitivity and time in warning of 34.3%, 86.0%, and 51.7%, respectively for the 16-h horizon, and 34.2%, 64.4% and 30.2%, respectively, for the 24-h horizon.SignificanceSmart shirt-based nocturnal sleep analysis holds promise as a non-invasive approach for seizure-day forecasting in a subset of people with epilepsy. Further investigations, particularly in a residential setting with long-term recordings, could pave the way for the development of innovative and practical seizure forecasting devices.Plain language summarySeizure forecasting with wearable devices may improve the quality of life of people living with epilepsy who experience unpredictable, recurrent seizures. In this study, we have developed a seizure forecasting algorithm using sleep characteristics obtained from a smart shirt worn at night by a large number of hospitalized patients with epilepsy (78). A daily seizure forecast was generated following each night using machine learning methods. Our results show that around half of people with epilepsy may benefit from such an approach.
| S-EPMC11450616 | biostudies-literature
Project description:ObjectiveRecently, a deep learning AI model forecasted seizure risk using retrospective seizure diaries with higher accuracy than random forecasts. The present study sought to prospectively evaluate the same algorithm.MethodsWe recruited a prospective cohort of 46 people with epilepsy; 25 completed sufficient data entry for analysis (median 5 months). We used the same AI method as in our prior study. Group-level and individual-level Brier Skill Scores (BSS) compared random forecasts and simple moving average forecasts to the AI.ResultsThe AI had an AUC of 0.82. At the group level, the AI outperformed random forecasting (BSS=0.53). At the individual level, AI outperformed random in 28% of cases. At the group and individual level, the moving average outperformed the AI. If pre-enrollment (non-verified) diaries (with presumed under-reporting) were included, the AI significantly outperformed both comparators. Surveys showed most did not mind poor quality LOW-RISK or HIGH-RISK forecasts, yet 91% wanted access to these forecasts.SignificanceThe previously developed AI forecasting tool did not outperform a very simple moving average forecasting this prospective cohort, suggesting that the AI model should be replaced.
| S-EPMC10802655 | biostudies-literature
Project description:SEE MORMANN AND ANDRZEJAK DOI101093/BRAIN/AWW091 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE : Accurate forecasting of epileptic seizures has the potential to transform clinical epilepsy care. However, progress toward reliable seizure forecasting has been hampered by lack of open access to long duration recordings with an adequate number of seizures for investigators to rigorously compare algorithms and results. A seizure forecasting competition was conducted on kaggle.com using open access chronic ambulatory intracranial electroencephalography from five canines with naturally occurring epilepsy and two humans undergoing prolonged wide bandwidth intracranial electroencephalographic monitoring. Data were provided to participants as 10-min interictal and preictal clips, with approximately half of the 60 GB data bundle labelled (interictal/preictal) for algorithm training and half unlabelled for evaluation. The contestants developed custom algorithms and uploaded their classifications (interictal/preictal) for the unknown testing data, and a randomly selected 40% of data segments were scored and results broadcasted on a public leader board. The contest ran from August to November 2014, and 654 participants submitted 17 856 classifications of the unlabelled test data. The top performing entry scored 0.84 area under the classification curve. Following the contest, additional held-out unlabelled data clips were provided to the top 10 participants and they submitted classifications for the new unseen data. The resulting area under the classification curves were well above chance forecasting, but did show a mean 6.54 ± 2.45% (min, max: 0.30, 20.2) decline in performance. The kaggle.com model using open access data and algorithms generated reproducible research that advanced seizure forecasting. The overall performance from multiple contestants on unseen data was better than a random predictor, and demonstrates the feasibility of seizure forecasting in canine and human epilepsy.media-1vid110.1093/brain/aww045_video_abstractaww045_video_abstract.
| S-EPMC5022671 | biostudies-literature
Project description:ObjectiveSeizure forecasting algorithms have become increasingly accurate and may reduce the morbidity and mortality caused by seizure unpredictability. Translating these benefits into meaningful health outcomes for people with epilepsy requires effective data visualization of algorithm outputs. To date, no studies have investigated patient and physician perspectives on effective translation of algorithm outputs into data visualizations through health information technology.Materials and methodsWe developed front-end data visualizations as part of a Seizure Forecast Visualization Toolkit. We surveyed 627 people living with epilepsy and caregivers, and 28 epilepsy healthcare providers. Respondents scored each visualization in terms of international standardized software quality criteria for functionality, appropriateness, and usability.ResultsPeople with epilepsy and caregivers ranked hourly radar charts highest for protecting against errors in interpreting forecasts, reducing anxiety from seizure unpredictability, and understanding seizure patterns. Accuracy in interpreting visuals, such as a risk gauge, was dependent on seizure frequency. Visuals showing hourly/daily forecasts were more useful for patients who experienced seizure cycling than those who did not. Hourly line graphs and monthly heat maps were rated highest among clinicians for ease of understanding, anticipated integration into clinical practice, and the likelihood of clinical usage. Epilepsy providers indicated that daily heat maps, daily line graphs, and hourly line graphs were most useful for interpreting seizure diary patterns, assessing therapy impact, and counseling on seizure safety.DiscussionThe choice of data visualization impacts the effective translation of seizure forecast algorithms into meaningful health outcomes.ConclusionThis effort underlines the importance of incorporating standardized, quantitative methods for assessing the effectiveness of data visualization to translate seizure forecast algorithms into clinical practice.
| S-EPMC7935496 | biostudies-literature