{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:33:17Z","timestamp":1792103597606,"version":"4.4.0"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T00:00:00Z","timestamp":1726531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["K23NS124656"],"award-info":[{"award-number":["K23NS124656"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["T32 HL007901\u201025"],"award-info":[{"award-number":["T32 HL007901\u201025"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to assess whether population\u2010level patterns in seizure occurrence previously observed in self\u2010reported diaries, medical records, and electroencephalographic recordings were also present in tonic\u2013clonic seizure (TCS) diaries produced via the combined input of a US Food and Drug Administration\u2010cleared wristband with an artificial intelligence detection algorithm and patient self\u2010reports. We also investigated the characteristics of patient interactions with wearable seizure alerts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed wristband data from patients with TCSs who had at least three reported TCSs over a minimum of 90\u2009days. We quantified TCS frequency and cycles, and the relationship between the mean and variability of monthly TCS counts. We also assessed interaction metrics such as false alarm dismissal and seizure confirmation rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Applying strict criteria for usable data, we reviewed 137\u2009490 TCSs from 3012 patients, with a median length of TCS alert records of 445\u2009days (range\u2009=\u200990\u20131806). Analyses showed consistency between prior diary studies and the present data concerning (1) the distribution of monthly TCS frequency (median\u2009=\u20093.1, range = .08\u201326); (2) the linear relationship (slope\u2009=\u2009.79, <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u2009.83) between the logarithm of the mean and the logarithm of the SD of monthly TCS frequency (L\u2010relationship); and (iii) the prevalence of multiple coexisting seizure cycles, including circadian (84.0%), weekly (24.6%), and long\u2010term cycles (31.1%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Key population\u2010level patterns in seizure occurrence are recapitulated in wrist\u2010worn device recordings, supporting their validity for tracking TCS burden. Compared to other approaches, wearables can provide noninvasive, objective, long\u2010term data, revealing cycles in seizure risk. However, improved patient engagement with wristband alerts and further validation of detection accuracy in ambulatory settings are needed. Together, these findings suggest that data from smart wristbands may be used to derive features of TCS records and, ultimately, facilitate remote monitoring and the development of personalized forecasting tools for TCS management. Our findings may not generalize to other types of seizures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.18109","type":"journal-article","created":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T18:44:12Z","timestamp":1726598652000},"page":"3255-3264","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Statistical characteristics of large\u2010scale objective tonic\u2013clonic seizure records from medical smartwatches used in daily life"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8446-7614","authenticated-orcid":false,"given":"Boyu","family":"Zhang","sequence":"first","affiliation":[{"name":"Media Lab Massachusetts Institute of Technology  Cambridge Massachusetts USA"},{"name":"Division of Sleep and Circadian Disorders Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9550-2553","authenticated-orcid":false,"given":"Weixuan V.","family":"Chen","sequence":"additional","affiliation":[{"name":"Empatica  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6577-9057","authenticated-orcid":false,"given":"Giulia","family":"Regalia","sequence":"additional","affiliation":[{"name":"Empatica  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8370-2758","authenticated-orcid":false,"given":"Daniel M.","family":"Goldenholz","sequence":"additional","affiliation":[{"name":"Department of Neurology Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Neurology Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5661-0022","authenticated-orcid":false,"given":"Rosalind W.","family":"Picard","sequence":"additional","affiliation":[{"name":"Media Lab Massachusetts Institute of Technology  Cambridge Massachusetts USA"},{"name":"Empatica  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2301913"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25812"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.713794"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(13)70075\u20109"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.724904"},{"key":"e_1_2_11_7_1","unstructured":"510(k) Premarket Notification. Accessed November 18 2023. Available from:https:\/\/www.accessdata.fda.gov\/scripts\/cdrh\/cfdocs\/cfPMN\/pmn.cfm?ID=K181861"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582\u2010021\u201000464\u20101"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467\u2010017\u201002577\u2010y"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(18)30274\u20106"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.5370"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/epi4.12237"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.519"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000177"},{"key":"e_1_2_11_15_1","unstructured":"The Human Epilepsy Project.The Human Epilepsy Project. Accessed November 9 2023. Available from:http:\/\/www.humanepilepsyproject.org"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17471"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(18)30038\u20103"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2010.08.014"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00424\u2010011\u20101044\u20100"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010publhealth\u2010031914\u2010122838"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2008.10.003"}],"container-title":["Epilepsia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/epi.18109","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T16:14:24Z","timestamp":1731946464000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/epi.18109"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,17]]},"references-count":20,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1111\/epi.18109"],"URL":"https:\/\/doi.org\/10.1111\/epi.18109","archive":["Portico"],"relation":{},"ISSN":["0013-9580","1528-1167"],"issn-type":[{"value":"0013-9580","type":"print"},{"value":"1528-1167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,17]]},"assertion":[{"value":"2023-12-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}