Wearable devices feasible for tracking effects of antiseizure meds
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Key takeaways:
- Electrodermal activity was highest at peak post-intake time in those who took more than one antiseizure medication.
- Further research is needed to fully examine the effects of ASMs on certain physical processes.
LOS ANGELES — For young people with epilepsy, wearable devices may be a feasible method for tracking the effects of antiseizure medications on the autonomic nervous system, according to a presenter.
“For patients with epilepsy, we know there are some changes with their autonomic nervous system activity,” Fatemeh Mohammad Alizadeh Chafjiri, MD, of Boston Children’s Hospital, told attendees at the American Epilepsy Society annual meeting. “Wearable devices are able to detect and record these changes.”
As prior research has suggested that antiseizure medications (ASMs) may affect autonomic nervous system (ANS) activity in patients with epilepsy, Chafjiri and colleagues sought to examine their effect on ANS signals through devices before and after intake.
Their study included 92 individuals aged 1 month to 21 years who were admitted to Boston Children’s Hospital between February 2015 and February 2021 for long-term video-EEG monitoring. All participants donned at least one wearable (Empatica E4) tracker on the wrist and/or ankle.
The patient cohort was split into three sections: those who were not prescribed ASMs (n = 7; 57.1% girls and women; median age, 6.12 years); those prescribed one ASM (n = 18; 55.5% girls and women, median age, 10.67 years) and those prescribed more than one ASM (n = 67; 53.7% girls and women; median age, 9.05 years). The recordings were taken after evening ASM intake, lasting between 5 p.m. and 3 a.m.
Chafjiri and colleagues analyzed electrodermal activity (EDA), heart rate (HR) and root mean square of successive differences of heart rate variability (RMSSD) at baseline (1 hour before ASM intake) and at peak ASM effectiveness (30 minutes before and after ASM peak concentration). In the group taking more than one ASM, the peak was calculated as the average of all ASM peak concentrations per patient.
For the control group without ASMs, the researchers utilized the same mean ASM intake time and mean ASM peak times of both ASM groups. The analysis was comprised of one device recording per enrollee, which examined mean EDA, HR and RMSSD for all groups.
According to the results, the mean EDA was higher at mean ASM peak compared with baseline, with a trend to a group by time point interaction.
During a post-hoc analysis, Chafjiri and colleagues found a higher EDA at peak time compared with baseline for the control group and for those who took more than one ASM, but not for those taking exactly one ASM.
Data additionally showed HR was lower at peak time compared with baseline for all groups, while an overall group effect was demonstrated for RMSSD.
“Incorporating this data and the effect of medication on [autonomic nervous system] activity into seizure monitoring models may improve seizure detection and prediction,” Chafjiri said.