A Student’s Approach to Real-Time Seizure Detection

Tell us about your research project. What was the central biomedical issue your work addressed?

The goal of my thesis project was to develop and validate tools for tracking the signs and symptoms of epilepsy. Roughly 1% of the global population has an epilepsy diagnosis, and 1 out of 3 patients with epilepsy has seizures that can't be controlled with medication. Those patients may qualify for surgical resection or a surgically implanted brain stimulation device. Brain stimulation can be an effective treatment, but few patients experience prolonged periods free of seizures. The main problem is that the information that guides stimulation — patients' self-reported seizures — can be notoriously inaccurate.

In my thesis work, I proposed an algorithm compact enough to program directly onto an implanted device in a patient to detect when seizures are occurring. After preliminary studies, I piloted a prospective, real-time seizure detection algorithm for patients who were receiving high-frequency brain stimulation at home. This detector succeeded in having both a high sensitivity and a low false alarm rate. In addition, my patient cohort conducted a simple verbal memory task many times over their two years in the study, which allowed me to directly compare the interactions of stimulation frequency, seizure count and memory performance.

My thesis resulted in two tools that could be used in a clinical setting to help better address both seizure burden and verbal memory deficits related to epilepsy.

What types of innovative technologies or approaches did you use in your research, and how did they further your project?

Dr. Worrell's lab has a collaboration with Medtronic Inc. using the investigational version of its commercial deep brain stimulation device. Because of the features of the device, including constant data streaming, we could completely annotate a patient's brain activity report with information on seizure activity instead of relying on patient self-reporting. Dr. Worrell's lab is among the few in the world with such access to patient brain data.

What aspects of Mayo's culture and approach to training helped you grow as a scientist and as a thinker?

Everything we do at Mayo falls under the philosophy of "the needs of the patient come first." While my thesis project was heavy on engineering research, I also was embedded in a clinic with patients. I saw firsthand how different aspects of interesting, well-engineered projects may not be intuitive to a clinician or may actually be burdensome to a patient.
My training provided me with the unique ability to speak the language and see the perspectives of multiple stakeholders in device design — engineers, patients, and clinicians. This knowledge will allow me to promote new technologies that are not just useful to research, but also usable in patient care.