An international research team from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London, in collaboration with the Mayo Clinic and medtech company UNEEG Medical, has achieved a breakthrough in the monitoring of epilepsy. The researchers developed and tested an innovative subcutaneous electroencephalography (sqEEG), a small implantable sensor that continuously measures brain activity in the home environment.
The implantable electrode is about the size of a quarter and has a 10-centimetre wire. The device is placed under the scalp under local anaesthetic, just behind the ear, and connected wirelessly to an adhesive module behind the ear via an external recorder. This setup makes it possible to monitor brain waves over long periods of time and with high precision, without burdening the patient with hospital admissions or cumbersome equipment.
The research
For the study, ten adults with therapy-resistant epilepsy were monitored for a period of 15 months. They kept a symptom diary, wore a fitness tracker and collected brain activity data via the sqEEG system. In total, nearly 72,000 hours of brain data were recorded, detecting 754 seizures.
The results show that the traditional use of symptom diaries is far from reliable. Only 48 percent of the seizures recorded by the sqEEG system also appeared in the patient's diary. Conversely, more than a quarter of the seizures reported by patients themselves had no measurable correlation with epileptic activity. In addition, the system was also able to classify the type of seizure more accurately than the patient themselves. The findings have been published in the scientific journal Epilepsia.
Important for treatment-resistant epilepsy
Professor Mark Richardson, Professor of Epilepsy at King's IoPPN and lead author of the study, emphasises the importance of objective data in the treatment of treatment-resistant epilepsy. ‘This technology offers a reliable alternative to self-reporting, which is often incomplete or inaccurate. Thanks to this system, we can better understand epilepsy and develop personalised treatment strategies.’
‘The ability to continuously collect data on the type and timing of seizures provides clinicians with valuable insights that are otherwise difficult to obtain. This can greatly improve the quality of care and treatment outcomes,’ adds Dr. Pedro Viana, neurologist and co-investigator.
Technological milestone
The study is also considered a milestone from a technological perspective. Jonas Duun-Henriksen, Senior Director AI & Science at UNEEG Medical, states: ‘Although we had already heard positive experiences from users, this is the first long-term study to quantitatively demonstrate how effective and useful our technology is in practice.’
The researchers point out that further research with larger groups is needed to further substantiate the clinical added value of sqEEG. Nevertheless, the system already appears to be a promising step towards better diagnosis and treatment of epilepsy in everyday practice.
Innovations in epilepsy treatment
In the PROSE study, the Kempenhaeghe expertise centre, together with SEIN and New Life Wearables, is investigating whether a smart breath test (eNose technology via the ‘BreathPass’) can predict epileptic seizures based on volatile organic compounds (VOCs) in exhaled air. The measurements are carried out in the controlled environment of the Epilepsy Monitoring Unit (EMU), with the aim of accurately linking seizure patterns to changes in the breathing profile. The use of AI enables early signals to be recognised, offering prospects for improved safety and quality of life for people with epilepsy. Although the research is still in its infancy, preliminary results show promising potential for future home monitoring.
Last year, the Maastro radiotherapy centre in Maastricht launched a study into an innovative application of precision radiation in the treatment of therapy-resistant epilepsy. The study involved patients for whom medication is ineffective or for whom brain surgery is not an option. The technique focuses a high dose of radiation very precisely on the specific area of the brain where epileptic seizures begin, with promising international results: in most patients, the number of seizures decreases significantly within two years, and some become completely seizure-free. In the PRECISION study, participants are divided into two groups: immediate treatment versus standard care with later radiation, in order to compare effectiveness.
