{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:19:05Z","timestamp":1792513145914,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100011878","name":"Vlaamse regering","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011878","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014419","name":"EIT Health","doi-asserted-by":"publisher","award":["21263"],"award-info":[{"award-number":["21263"]}],"id":[{"id":"10.13039\/100014419","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["1SB5922N"],"award-info":[{"award-number":["1SB5922N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["G0D8321N"],"award-info":[{"award-number":["G0D8321N"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Currently available wearable devices for detecting focal seizures primarily target major motor seizures or involve semi\u2010invasive subscalp implants. There is a pressing need for accurate, non\u2010invasive methods to detect diverse focal seizures for long\u2010term, out\u2010of\u2010hospital monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicenter study (SeizeIT2), people with refractory focal epilepsy undergoing long\u2010term video\u2010electroencephalography (EEG) monitoring were simultaneously recorded with the Sensor Dot, a multimodal wearable device using EEG and electrocardiography (ECG). Wearable recordings were first processed with an offline detection algorithm, after which the algorithm\u2010labeled segments underwent blinded review by a human expert, and results were compared with ground truth video\u2010EEG. Post\u2010hoc analyses were performed to evaluate how specific seizure characteristics, defined by the gold\u2010standard recordings, influenced detection sensitivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We recruited 192 adult participants, documenting a total of 616 focal seizures. The mean duration of Sensor Dot monitoring was 5\u2009days. The seizure detection algorithm achieved an overall sensitivity of 0.73, precision of 0.004 and F1 score of 0.01. Following human review, a precision of 0.83 was achieved, albeit with a sensitivity of 0.31, resulting in an F1 score of 0.45. Seizure detection was influenced by the seizure type (focal impaired awareness seizure (FIAS) or focal\u2010to\u2010bilateral tonic\u2013clonic seizures (FBTCS)) and the presence of a distinct ictal pattern on behind\u2010the\u2010ear EEG, constituting mostly temporal lobe seizures. In a post\u2010hoc subgroup analysis of seizures with a clear ictal EEG pattern and ictal tachycardia (as determined by the ground truth), a sensitivity of 0.74 was observed, whereas a sensitivity of 0.60 was achieved when there was visible electrographic seizure activity without tachycardia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>The overall performance of the Sensor Dot in focal seizure detection was limited in an unselected group of focal seizure types. Our findings suggest that the proposed approach, combining algorithm\u2010based detection with human review, provides detection performance comparable with diary self\u2010reporting, in terms of sensitivity, but with higher precision (0.83 vs. 0.60). Our findings suggest that this multimodal approach may be particularly beneficial for the subset of patients whose seizures are characterized by distinct ictal EEG patterns and tachycardia\u2014features frequently seen in temporal lobe epilepsy. However, the prospective utility of these markers for patient selection requires further validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>Wearable devices may help improve seizure detection in people with epilepsy, but few non\u2010invasive options exist for detecting focal seizures. We studied a behind\u2010the\u2010ear wearable device (Sensor Dot) using automated analysis combined with expert review. Overall, this approach resulted in detection of seizures with low sensitivity but high precision. Post\u2010hoc subgroup analysis suggested that for seizures characterized by a distinct ictal EEG pattern and tachycardia\u2014features often seen in temporal lobe epilepsy\u2014this multimodal approach achieved a sensitivity of 0.74. Further prospective validation is required to confirm if this performance can be replicated through pre\u2010monitoring patient selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70260","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T10:42:25Z","timestamp":1775644945000},"page":"883-894","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A multicenter, video\u2010\n                    <scp>EEG<\/scp>\n                    \u2010based validation of a multimodal wearable device for focal seizure detection in adults: The\n                    <scp>SeizeIT2<\/scp>\n                    study"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0531-9101","authenticated-orcid":false,"given":"Lauren","family":"Swinnen","sequence":"first","affiliation":[{"name":"Laboratory for Epilepsy Research, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2436-1738","authenticated-orcid":false,"given":"Miguel","family":"Bhagubai","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering (ESAT) STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Chatzichristos","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering (ESAT) STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0806-5592","authenticated-orcid":false,"given":"Yvonne","family":"Weber","sequence":"additional","affiliation":[{"name":"Section of Epileptology, Department of Neurology RWTH University of Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1460-6623","authenticated-orcid":false,"given":"Stefan","family":"Wolking","sequence":"additional","affiliation":[{"name":"Section of Epileptology, Department of Neurology RWTH University of Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ummehan","family":"Ermis","sequence":"additional","affiliation":[{"name":"Section of Epileptology, Department of Neurology RWTH University of Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Schriewer","sequence":"additional","affiliation":[{"name":"Section of Epileptology, Department of Neurology RWTH University of Aachen  Aachen 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nino","family":"Epitashvilli","sequence":"additional","affiliation":[{"name":"Epilepsy Center, University Medical Center, Freiburg University  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benno","family":"Mahler","sequence":"additional","affiliation":[{"name":"Department of Neurology Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8948-4763","authenticated-orcid":false,"given":"Arjune","family":"Sen","sequence":"additional","affiliation":[{"name":"Oxford Epilepsy Research Group, Nuffield Department of Clinical Neurosciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mkael","family":"Symmonds","sequence":"additional","affiliation":[{"name":"Oxford Epilepsy Research Group, Nuffield Department of Clinical Neurosciences University of 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