Abstract Details

Title Integrated Digital System for Long-term Behavioral Tracking and Adaptive Electrical Brain Stimulation: Canines and Humans with Epilepsy

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) Epilepsy/Clinical Neurophysiology (EEG) Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 065

Objective We focused on development of the system with implantable electrical stimulation of brain (ESB) devices to enable precise long-term tracking of seizures, behavior, cognition, and mood comorbidities. This will improve a management of patients with drug resistant epilepsy (DRE) by streaming continuous data from implanted devices, wearable devices, patient reported events, measures of sleep, cognition, and mood. The system will provide accurate seizure diaries, dense behavioral tracking, and automated patient specific adaptive stimulation in the near real-time.

Background For diseases of the brain and mind, ESB is an emerging therapy in people with DRE which are candidates for FDA approved ESB. Current devices are largely palliative and do not target comorbidities, such as mood, anxiety and cognition.

Design/Methods We did initial pre-clinical work and research in pet canines with epilepsy implanted with the investigational Medtronic Summit RC+S system (bilateral hippocampus & anterior nucleus of the thalamus). The system has wireless connectivity with mobile device to acquire continuous intracranial EEG, data from wearable devices, and patient annotations. The Digital health system in cloud powered by AI provides a large-scale data management and analytics for physicians to review data, create gold standard labels, and automatically retrain algorithms.

Results We demonstrated real-time seizure detection, forecasting, and tracking limbic system evoked potentials to classify brain-states in thirteen canines that underwent monitoring using the system (>800 days). The web-based Epilepsy Dashboard provided a seamless interactive interface between patient and physicians for tracking precise behavioral data, brain state, and to optimize ESB therapy. The system is currently deployed in 2 pet dogs with naturally DRE living with their owners in California and one human subject.

Conclusions The Digital Health System provides personalized approach to track epilepsy and adaptively optimize treatments in a population of patients with DRE. The system should prove useful for a wide range of neurological and psychiatric diseases.

Authors/Disclosures
Vaclav Kremen (Mayo Clinic) PRESENTER	Vaclav Kremen has nothing to disclose.
Benjamin H. Brinkmann, PhD (Mayo Clinic)	Dr. Brinkmann has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eisai. Dr. Brinkmann has stock in Cadence Neuroscience. The institution of Dr. Brinkmann has received research support from Epilepsy Foundation of America. The institution of Dr. Brinkmann has received research support from National Institutes of Health. The institution of Dr. Brinkmann has received research support from National Institutes of Health. The institution of Dr. Brinkmann has received research support from UNEEG A/S. The institution of Dr. Brinkmann has received research support from Seer Medical Pty. The institution of Dr. Brinkmann has received research support from Neurelis Inc. Dr. Brinkmann has received intellectual property interests from a discovery or technology relating to health care.
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Jamie J. Van Gompel, MD	Jamie J. Van Gompel, MD has stock in Neuroone.
Gregory A. Worrell, MD (Mayo Clinic College of Medicine)	Dr. Worrell has received stock or an ownership interest from NeuroOne Inc.. Dr. Worrell has received stock or an ownership interest from Cadence Neuroscience Inc. The institution of Dr. Worrell has received research support from NIH. The institution of Dr. Worrell has received research support from Medtronic Inc.. The institution of Dr. Worrell has received research support from Neuropace Inc,. The institution of Dr. Worrell has received research support from Epilepsy Foundation of America. Dr. Worrell has received intellectual property interests from a discovery or technology relating to health care. Dr. Worrell has received intellectual property interests from a discovery or technology relating to health care.

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Abstract Details