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Evaluating the accuracy of monitoring seizure cycles with seizure diaries.

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Title: Evaluating the accuracy of monitoring seizure cycles with seizure diaries.
Authors: Reynolds, Ashley (AUTHOR), Stirling, Rachel E. (AUTHOR), Håkansson, Samuel (AUTHOR), Karoly, Philippa (AUTHOR), Lai, Alan (AUTHOR), Grayden, David B. (AUTHOR), Cook, Mark J. (AUTHOR), Nurse, Ewan S. (AUTHOR), Peterson, Andre (AUTHOR)
Source: Epilepsia (Series 4). May2025, Vol. 66 Issue 5, p1585-1598. 14p.
Subjects: Seizures (Medicine), Epilepsy, Evaluation methodology, Statistical accuracy, Data analysis, Neurophysiologic monitoring
Abstract: Objective: Epileptic seizures occurring in cyclical patterns is increasingly recognized as a significant opportunity to advance epilepsy management. Current methods for detecting seizure cycles rely on intrusive techniques or specialized biomarkers, thereby limiting their accessibility. This study evaluates a non‐invasive seizure cycle detection method using seizure diaries and compares its accuracy with cycles identified from intracranial electroencephalography (iEEG) seizures and interictal epileptiform discharges (IEDs). Methods: Using data from a previously published first in‐human iEEG device trial (n = 10), we analyzed seizure cycles identified through diary reports, iEEG seizures, and IEDs. Cycle similarities across diary reports, iEEG seizures, and IEDs were evaluated at periods of 1 to 45 days using spectral coherence, accuracy, precision, recall, and the false‐positive rate. Results: A spectral coherence analysis of the raw signals showed moderately similar periodic components between diary seizures/day and iEEG seizures/day (median =.43, IQR =.68). In contrast, there was low coherence between diary seizures/day and IEDs/day (median =.11, IQR =.18) and iEEG seizures/day and IEDs/day (median =.12, IQR =.19). Accuracy, precision, recall scores, and false‐positive rates of iEEG seizure cycles from diary seizure cycles were significantly higher than chance across all participants (accuracy (mean ± standard deviation):.95 ±.02; precision:.56 ±.19; recall:.56 ±.19; false‐positive rate:.02 ±.01). However, accuracy, precision, and recall scores of IED cycles from both diary and iEEG cycles did not perform above chance, on average. Recall scores were compared across good diary reporters, under‐reporters, and over‐reporters, with recall scores generally performing better in good reporters and under‐reporters compared to over‐reporters. Significance: These findings suggest that iEEG seizure cycles can be identified with diary reports, even in individuals who under‐ and over‐report seizures. This approach offers an accessible alternative for monitoring seizure cycles compared to more invasive methods. [ABSTRACT FROM AUTHOR]
Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Evaluating the accuracy of monitoring seizure cycles with seizure diaries.
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  Data: <searchLink fieldCode="JN" term="%22Epilepsia+%28Series+4%29%22">Epilepsia (Series 4)</searchLink>. May2025, Vol. 66 Issue 5, p1585-1598. 14p.
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  Data: <searchLink fieldCode="DE" term="%22Seizures+%28Medicine%29%22">Seizures (Medicine)</searchLink><br /><searchLink fieldCode="DE" term="%22Epilepsy%22">Epilepsy</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation+methodology%22">Evaluation methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+accuracy%22">Statistical accuracy</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis%22">Data analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Neurophysiologic+monitoring%22">Neurophysiologic monitoring</searchLink>
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  Data: Objective: Epileptic seizures occurring in cyclical patterns is increasingly recognized as a significant opportunity to advance epilepsy management. Current methods for detecting seizure cycles rely on intrusive techniques or specialized biomarkers, thereby limiting their accessibility. This study evaluates a non‐invasive seizure cycle detection method using seizure diaries and compares its accuracy with cycles identified from intracranial electroencephalography (iEEG) seizures and interictal epileptiform discharges (IEDs). Methods: Using data from a previously published first in‐human iEEG device trial (n = 10), we analyzed seizure cycles identified through diary reports, iEEG seizures, and IEDs. Cycle similarities across diary reports, iEEG seizures, and IEDs were evaluated at periods of 1 to 45 days using spectral coherence, accuracy, precision, recall, and the false‐positive rate. Results: A spectral coherence analysis of the raw signals showed moderately similar periodic components between diary seizures/day and iEEG seizures/day (median =.43, IQR =.68). In contrast, there was low coherence between diary seizures/day and IEDs/day (median =.11, IQR =.18) and iEEG seizures/day and IEDs/day (median =.12, IQR =.19). Accuracy, precision, recall scores, and false‐positive rates of iEEG seizure cycles from diary seizure cycles were significantly higher than chance across all participants (accuracy (mean ± standard deviation):.95 ±.02; precision:.56 ±.19; recall:.56 ±.19; false‐positive rate:.02 ±.01). However, accuracy, precision, and recall scores of IED cycles from both diary and iEEG cycles did not perform above chance, on average. Recall scores were compared across good diary reporters, under‐reporters, and over‐reporters, with recall scores generally performing better in good reporters and under‐reporters compared to over‐reporters. Significance: These findings suggest that iEEG seizure cycles can be identified with diary reports, even in individuals who under‐ and over‐report seizures. This approach offers an accessible alternative for monitoring seizure cycles compared to more invasive methods. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/epi.18309
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        Text: English
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      – SubjectFull: Epilepsy
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      – SubjectFull: Evaluation methodology
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      – SubjectFull: Statistical accuracy
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      – SubjectFull: Data analysis
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      – SubjectFull: Neurophysiologic monitoring
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              M: 05
              Text: May2025
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              Y: 2025
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