{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T14:11:43Z","timestamp":1788617503457,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T00:00:00Z","timestamp":1788566400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["GRF DGE\u20101845298"],"award-info":[{"award-number":["GRF DGE\u20101845298"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["GRF DGE\u20102236662"],"award-info":[{"award-number":["GRF DGE\u20102236662"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000861","name":"Burroughs Wellcome Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000861","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["DP1\u2010NS\u2010122038"],"award-info":[{"award-number":["DP1\u2010NS\u2010122038"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["NS121401\u201001A1"],"award-info":[{"award-number":["NS121401\u201001A1"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R01\u2010NS\u2010125137"],"award-info":[{"award-number":["R01\u2010NS\u2010125137"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R01NS148413"],"award-info":[{"award-number":["R01NS148413"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["T32NS091006"],"award-info":[{"award-number":["T32NS091006"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      Subscalp electroencephalographic (\n                      <jats:styled-content style=\"fixed-case\">EEG)<\/jats:styled-content>\n                      systems with few channels have emerged as promising solutions for ultra\u2010long\u2010term seizure monitoring, but the impact of montage configuration on automated seizure detection is unclear. We compared automated detection performance between full\u2010scalp and simulated reduced montages approximating published subscalp devices, and assessed variation by epilepsy type, lateralization, and localization.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cross\u2010sectional study of consecutive epilepsy monitoring unit (EMU) admissions from January 2017 to December 2024 at the Hospital of the University of Pennsylvania. Admissions with at least one clinician\u2010annotated seizure and at least one interictal segment of \u226520\u2009min from any seizure were included. We simulated reduced bipolar montages from standard 10\u201320 scalp EEG. Three validated detectors, a one\u2010class support vector machine (SVM), a convolutional neural network (SPaRCNet), and a long short\u2010term memory autoregressive model with neural dynamic divergence method (NDD), were applied to montages and evaluated using event\u2010level F1 scores. We additionally evaluated the contributions of patient, detector, and montage to performance variance and associations between performance and epilepsy characteristics using linear mixed\u2010effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 466 admissions from 436 patients (mean [SD] age\u2009=\u200939.0 [14.4] years; 54.4% female) met inclusion criteria, comprising 1683 seizures and 1527 interictal clips. SPaRCNet achieved the highest performance (mean [SD] F1 = .61 [.30]), followed by NDD (.56 [.28]) and SVM (.39 [.25]). Absolute decreases in F1 score with reduced montages were modest (\u2264.09). Patient admission accounted for the most of performance variance (29.2%), followed by detector (10.3%), whereas montage contributed minimally (.4%). Performance between full and reduced montages was correlated (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u2009.29\u2013.73).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Automated seizure detection performance was primarily driven by patient and algorithm factors rather than montage. Findings support the feasibility of seizure monitoring with reduced montages approximating chronic subscalp device geometries, despite the need for improved detection algorithms, and suggest that EMU\u2010based full\u2010montage performance could help identify candidates for these devices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70482","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T13:19:52Z","timestamp":1788614392000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How much does the reduced electroencephalographic montage matter for seizure detection? A large\u2010cohort simulation study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0879-2489","authenticated-orcid":false,"given":"Joe","family":"Kojima","sequence":"first","affiliation":[{"name":"Department of Bioengineering, School of Engineering and Applied Science University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5273-8371","authenticated-orcid":false,"given":"Haoer","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, School of Engineering and Applied Science University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Center for Neuroengineering and Therapeutics University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7168-9875","authenticated-orcid":false,"given":"Svanik","family":"Jaikumar","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, School of Engineering and Applied Science University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5166-536X","authenticated-orcid":false,"given":"William K. S.","family":"Ojemann","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, School of Engineering and Applied Science University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Center for Neuroengineering and Therapeutics University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9460-3549","authenticated-orcid":false,"given":"Carlos","family":"Aguila","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, School of Engineering and Applied Science University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Center for Neuroengineering and Therapeutics University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2017-3851","authenticated-orcid":false,"given":"Juri","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, School of Engineering and Applied Science University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Center for Neuroengineering and Therapeutics University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2390-868X","authenticated-orcid":false,"given":"Taneeta Mindy","family":"Ganguly","sequence":"additional","affiliation":[{"name":"Department of Neurology, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2732-6927","authenticated-orcid":false,"given":"Brian","family":"Litt","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, School of Engineering and Applied Science University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Center for Neuroengineering and Therapeutics University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Department of Neurology, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8910-1817","authenticated-orcid":false,"given":"Erin C.","family":"Conrad","sequence":"additional","affiliation":[{"name":"Center for Neuroengineering and Therapeutics University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Department of Neurology, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania 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