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抗癫痫药物临床试验中使用的癫痫发作检测设备:系统评价。

Seizure detection devices for use in antiseizure medication clinical trials: A systematic review.

机构信息

Department of Biomedical Engineering, Columbia University School of Engineering and Applied Science, New York, NY, USA.

Department of Biochemistry, Columbia University, New York, NY, USA.

出版信息

Seizure. 2019 Mar;66:61-69. doi: 10.1016/j.seizure.2019.02.007. Epub 2019 Feb 13.

Abstract

OBJECTIVE

This study characterizes the current capabilities of seizure detection device (SDD) technology and evaluates the fitness of these devices for use in anti-seizure medication (ASM) clinical trials.

METHODS

Through a systematic literature review, 36 wireless SDDs featured in published device validation studies were identified. Each device's seizure detection capabilities that addressed ASM clinical trial primary endpoint measurement needs were cataloged.

RESULTS

The two most common types of seizures targeted by ASMs in clinical trials are generalized tonic-clonic (GTC) seizures and focal with impaired awareness (FIA) seizures. The Brain Sentinel SPEAC achieved the highest performance for the detection of GTC seizures (F-score = 0.95). A non-commercial wireless EEG device achieved the highest performance for the detection of FIA seizures (F-score = 0.88).

DISCUSSION

A preliminary assessment of device capabilities for measuring selected ASM clinical trial secondary endpoints was performed. The need to address key limitations in validation studies is highlighted in order to support future assessments of SDD fitness for ASM clinical trial use. In tandem, a stepwise framework to streamline device testing is put forth. These suggestions provide a starting point for establishing SDD reporting requirements before device integration into ASM clinical trials.

摘要

目的

本研究描述了当前癫痫发作检测设备(SDD)技术的能力,并评估了这些设备在抗癫痫药物(ASM)临床试验中的适用性。

方法

通过系统文献回顾,确定了已发表的设备验证研究中 36 种无线 SDD。对每种设备的癫痫发作检测能力进行了分类,这些能力涉及到 ASM 临床试验的主要终点测量需求。

结果

临床试验中最常见的两种抗癫痫药物靶向的癫痫发作类型是全面强直-阵挛性发作(GTC)和伴有意识障碍的局灶性发作(FIA)。Brain Sentinel SPEAC 在检测 GTC 发作方面表现最佳(F 分数=0.95)。一种非商业性无线 EEG 设备在检测 FIA 发作方面表现最佳(F 分数=0.88)。

讨论

对设备测量选定 ASM 临床试验次要终点的能力进行了初步评估。为了支持未来对 SDD 适用于 ASM 临床试验使用的评估,需要解决验证研究中的关键限制。同时,提出了一个简化设备测试的分步框架。这些建议为在将 SDD 整合到抗癫痫药物临床试验之前建立 SDD 报告要求提供了一个起点。

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