title: Quickest detection of drug-resistant seizures: an optimal control approach.
abstract: Epilepsy affects 50 million people worldwide, and seizures in 30% of the cases remain drug resistant. This has increased interest in responsive neurostimulation, which is most effective when administered during seizure onset. We propose a novel framework for seizure onset detection that involves (i) constructing statistics from multichannel intracranial EEG (iEEG) to distinguish nonictal versus ictal states; (ii) modeling the dynamics of these statistics in each state and the state transitions; you can remove this word if there is no room. (iii) developing an optimal control-based "quickest detection" (QD) strategy to estimate the transition times from nonictal to ictal states from sequential iEEG measurements. The QD strategy minimizes a cost function of detection delay and false positive probability. The solution is a threshold that non-monotonically decreases over time and avoids responding to rare events that normally trigger false positives. We applied QD to four drug resistant epileptic patients (168 hour continuous recordings, 26-44 electrodes, 33 seizures) and achieved 100% sensitivity with low false positive rates (0.16 false positive/hour). This article is part of a Supplemental Special Issue entitled The Future of Automated Seizure Detection and Prediction.
authors.affiliation: Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218–2686, USA.
authors.forename: Sabato
authors.initials: S
authors.lastname: Santaniello
authors.forename: Samuel P
authors.initials: SP
authors.lastname: Burns
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Golby
authors.forename: Jedediah M
authors.initials: JM
authors.lastname: Singer
authors.forename: William S
authors.initials: WS
authors.lastname: Anderson
authors.forename: Sridevi V
authors.initials: SV
authors.lastname: Sarma
mesh_terms: D000465:Algorithms; D000927:Anticonvulsants / Q000009:adverse effects; D001931:Brain Mapping; D058256:Brain Waves / Q000502:physiology*; D004566:Electrodes; D004569:Electroencephalography / Q000379:methods; D001330:Electronic Data Processing; D005260:Female; D006801:Humans; D008297:Male; D008390:Markov Chains; D012640:Seizures / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology*; D012680:Sensitivity and Specificity
chemical_list: D000927:Anticonvulsants
references.citation: J Neurosci Methods. 2007 Oct 15;166(1):138-57
references.pmid: 17692927
references.citation: Clin Neurophysiol. 2005 Feb;116(2):427-42
references.pmid: 15661120
references.citation: Electroencephalogr Clin Neurophysiol. 1976 Nov;41(5):513-29
references.pmid: 61855
references.citation: Clin Neurophysiol. 2008 Dec;119(12):2687-96
references.pmid: 18993113
references.citation: J Clin Neurophysiol. 2008 Jun;25(3):119-31
references.pmid: 18469727
references.citation: Neural Comput. 2010 Aug;22(8):2002-30
references.pmid: 20438334
references.citation: Epilepsy Res. 2008 May;79(2-3):173-86
references.pmid: 18359200
references.citation: Clin Neurophysiol. 2005 Oct;116(10):2460-72
references.pmid: 16125459
references.citation: Epilepsia. 2010 Jul;51 Suppl 3:93-7
references.pmid: 20618410
references.citation: Clin Neurophysiol. 2005 Oct;116(10):2480-9
references.pmid: 16099210
references.citation: J Med Syst. 2010 Aug;34(4):755-65
references.pmid: 20703931
references.citation: Chaos. 2008 Sep;18(3):033119
references.pmid: 19045457
references.citation: Electroencephalogr Clin Neurophysiol. 1982 Nov;54(5):530-40
references.pmid: 6181976
references.citation: Med Eng Phys. 2007 Oct;29(8):895-909
references.pmid: 17097325
references.citation: Clin Neurophysiol. 2007 May;118(5):1134-43
references.pmid: 17382583
references.citation: J Comput Neurosci. 2003 Nov-Dec;15(3):335-45
references.pmid: 14618068
references.citation: Epilepsia. 2011 Jan;52(1):84-93
references.pmid: 21126244
references.citation: Int J Neural Syst. 2009 Jun;19(3):157-72
references.pmid: 19575506
references.citation: Epilepsia. 2002 Dec;43(12):1522-35
references.pmid: 12460255
references.citation: Curr Opin Neurol. 2006 Apr;19(2):164-8
references.pmid: 16538091
references.citation: J Clin Neurophysiol. 2010 Jun;27(3):163-78
references.pmid: 20461014
references.citation: IEEE Trans Biomed Eng. 2010 Jun;57(6):1297-305
references.pmid: 20172804
references.citation: Epilepsy Behav. 2004 Aug;5(4):483-98
references.pmid: 15256184
references.citation: Cereb Cortex. 2011 Sep;21(9):2147-57
references.pmid: 21330467
references.citation: J Neurosci. 2010 Feb 17;30(7):2559-70
references.pmid: 20164341
references.citation: Brain. 2007 Jan;130(Pt 1):65-77
references.pmid: 17082199
references.citation: J Neurosci Methods. 2010 Aug 15;191(1):94-100
references.pmid: 20566351
references.citation: J Clin Neurophysiol. 2007 Apr;24(2):137-46
references.pmid: 17414969
references.citation: Epilepsy Res. 2010 Mar;89(1):72-81
references.pmid: 20004556
references.citation: J Clin Neurophysiol. 2001 May;18(3):259-68
references.pmid: 11528297
references.citation: J Neurophysiol. 2008 Oct;100(4):2441-52
references.pmid: 18614757
references.citation: Epilepsia. 2010 Jul;51 Suppl 3:88-92
references.pmid: 20618409
references.citation: Clin Neurophysiol. 2005 Mar;116(3):517-26
references.pmid: 15721065
references.citation: Neurology. 1989 Oct;39(10):1288-93
references.pmid: 2797451
references.citation: J Clin Neurophysiol. 2009 Dec;26(6):381-91
references.pmid: 19952562
references.citation: Clin Neurophysiol. 2003 May;114(5):898-908
references.pmid: 12738437
references.citation: Epilepsia. 2008 Nov;49 Suppl 8:124-6
references.pmid: 19049609
references.citation: J Neurosci Methods. 2010 Aug 15;191(1):101-9
references.pmid: 20595035
references.citation: Phys Rev E Stat Nonlin Soft Matter Phys. 2011 Jun;83(6 Pt 2):066215
references.pmid: 21797469
references.citation: IEEE Trans Biomed Eng. 2007 Sep;54(9):1545-51
references.pmid: 17867346
references.citation: Epilepsia. 1998 Jun;39(6):615-27
references.pmid: 9637604
references.citation: J Comb Optim. 2008 Apr;15(3):276-286
references.pmid: 19079790
references.citation: J Neurosci Methods. 2010 Oct 30;193(1):156-63
references.pmid: 20817036
references.citation: Epilepsy Behav. 2009 Nov;16(3):391-6
references.pmid: 19783218
references.citation: Clin Neurophysiol. 2006 Jun;117(6):1204-16
references.pmid: 16600676
references.citation: IEEE Trans Inf Technol Biomed. 2007 May;11(3):288-95
references.pmid: 17521078
references.citation: Clin Neurophysiol. 2005 Aug;116(8):1785-95
references.pmid: 16005680
references.citation: IEEE Trans Biomed Eng. 2008 Feb;55(2 Pt 1):512-8
references.pmid: 18269986
references.citation: IEEE Trans Biomed Eng. 2004 Mar;51(3):493-506
references.pmid: 15000380
references.citation: Clin Neurophysiol. 2009 Sep;120(9):1648-57
references.pmid: 19632891
references.citation: Clin Neurophysiol. 2011 Mar;122(3):464-473
references.pmid: 20713314
references.citation: J Neurosci Methods. 2005 Oct 30;148(2):167-76
references.pmid: 16023730
references.citation: Phys Rev E Stat Nonlin Soft Matter Phys. 2005 Apr;71(4 Pt 2):046116
references.pmid: 15903735