Unsupervised Clustering of HRV Features Reveals Preictal Changes in Human Epilepsy

Over a third of patients suffering from epilepsy continue to live with recurrent disabling seizures and would greatly benefit from personalized seizure forecasting. While electroencephalography (EEG) remains most popular for studying subject-specific epileptic precursors, dysfunctions of the autonom...

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Bibliographic Details
Published in:Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference Vol. 2020; pp. 698 - 701
Main Authors: Gagliano, L., Assi, E. Bou, Toffa, D. H., Nguyen, D. K., Sawan, M.
Format: Conference Proceeding Journal Article
Language:English
Published: IEEE 01.07.2020
ISSN:2694-0604, 1558-4615, 2694-0604
Online Access:Get full text
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Summary:Over a third of patients suffering from epilepsy continue to live with recurrent disabling seizures and would greatly benefit from personalized seizure forecasting. While electroencephalography (EEG) remains most popular for studying subject-specific epileptic precursors, dysfunctions of the autonomous nervous system, notably cardiac activity measured in heart rate variability (HRV), have also been associated with epileptic seizures. This work proposes an unsupervised clustering technique which aims to automatically identify preictal HRV changes in 9 patients who underwent simultaneous electrocardiography (ECG) and intracranial EEG presurgical monitoring at the University of Montreal Hospital Center. A 2-class k-means clustering combined with a quantitative preictal HRV change detection technique were adopted in a subject- and seizure-specific manner. Results indicate inter and intra-patient variability in preictal HRV changes (between 3.5 and 6.5 min before seizure onset) and a statistically significant negative correlation between the time of change in HRV state and the duration of seizures (p<0.05). The presented findings show promise for new avenues of research regarding multimodal seizure prediction and unsupervised preictal time assessment.Clinical Relevance- This study proposed an unsupervised technique for quantitatively identifying preictal HRV changes which can be eventually used to implement an ECG-based seizure forecasting algorithm.
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ISSN:2694-0604
1558-4615
2694-0604
DOI:10.1109/EMBC44109.2020.9175739