A wearable electroencephalogram (EEG) device for continuous monitoring of patients suffering from epilepsy would provide valuable information for the management of the disease. Currently no EEG setup is small and unobtrusive enough to be used in daily life. Recording behind the ear could prove to be a solution to a wearable EEG setup. This article examines the feasibility of recording epileptic EEG from behind the ear. It is achieved by comparison with scalp EEG recordings. Traditional scalp EEG and behind-the-ear EEG were simultaneously acquired from 12 patients with temporal, parietal, or occipital lobe epilepsy. Behind-the-ear EEG consisted of cross-head channels and unilateral channels. The analysis on Electrooculography (EOG) artifacts resulting from eye blinking showed that EOG artifacts were absent on cross-head channels and had significantly small amplitudes on unilateral channels. Temporal waveform and frequency content during seizures from behind-the-ear EEG visually resembled that from scalp EEG. Further, coherence analysis confirmed that behind-the-ear EEG acquired meaningful epileptic discharges similarly to scalp EEG. Moreover, automatic seizure detection based on support vector machine (SVM) showed that comparable seizure detection performance can be achieved using these two recordings. With scalp EEG, detection had a median sensitivity of 100% and a false detection rate of 1.14 per hour, while, with behind-the-ear EEG, it had a median sensitivity of 94.5% and a false detection rate of 0.52 per hour. These findings demonstrate the feasibility of detecting seizures from EEG recordings behind the ear for patients with focal epilepsy.

The need for high‐quality automated seizure detection algorithms based on electroencephalography (EEG) becomes ever more pressing with the increasing use of ambulatory and long‐term EEG monitoring. Heterogeneity in validation methods of these algorithms influences the reported results and makes comprehensive evaluation and comparison challenging. This heterogeneity concerns in particular the choice of datasets, evaluation methodologies, and performance metrics. In this paper, we propose a unified framework designed to establish standardization in the validation of EEG‐based seizure detection algorithms. Based on existing guidelines and recommendations, the framework introduces a set of recommendations and standards related to datasets, file formats, EEG data input content, seizure annotation input and output, cross‐validation strategies, and performance metrics. We also propose the EEG 10–20 seizure detection benchmark, a machine‐learning benchmark based on public datasets converted to a standardized format. This benchmark defines the machine‐learning task as well as reporting metrics. We illustrate the use of the benchmark by evaluating a set of existing seizure detection algorithms. The SzCORE (Seizure Community Open‐Source Research Evaluation) framework and benchmark are made publicly available along with an open‐source software library to facilitate research use, while enabling rigorous evaluation of the clinical significance of the algorithms, fostering a collective effort to more optimally detect seizures to improve the lives of people with epilepsy.

Accurate extraction of heart rate from photoplethysmography (PPG) signals remains challenging due to motion artifacts and signal degradation. Although deep learning methods trained as a data-driven inference problem offer promising solutions, they often underutilize existing knowledge from the medical and signal processing community. In this paper, we address three shortcomings of deep learning models: motion artifact removal, degradation assessment, and physiologically plausible analysis of the PPG signal. We propose KID-PPG, a knowledge-informed deep learning model that integrates expert knowledge through adaptive linear filtering, deep probabilistic inference, and data augmentation. We evaluate KID-PPG on the PPGDalia dataset, achieving an average mean absolute error of 2.85 beats per minute, surpassing existing reproducible methods. Our results demonstrate a significant performance improvement in heart rate tracking through the incorporation of prior knowledge into deep learning models. This approach shows promise in enhancing various biomedical applications by incorporating existing expert knowledge in deep learning models.

Objective: To develop and validate a wrist‐worn accelerometer‐based, deep‐learning tunable algorithm for the automated detection of generalized or bilateral convulsive seizures (CSs) to be integrated with off‐the‐shelf smartwatches.Methods: We conducted a prospective multi‐center study across eight European epilepsy monitoring units, collecting data from 384 patients undergoing video electroencephalography (vEEG) monitoring with a wrist‐worn three dimensional (3D)–accelerometer sensor. We developed an ensemble‐based convolutional neural network architecture with tunable sensitivity through quantile‐based aggregation. The model, referred to as Episave, used accelerometer amplitude as input. It was trained on data from 37 patients who had 54 CSs and evaluated on an independent dataset comprising 347 patients, including 33 who had 49 CSs.Results: Cross‐validation on the training set showed that optimal performance was obtained with an aggregation quantile of 60, with a 98% sensitivity, and a false alarm rate (FAR) of 1/6 days. Using this quantile on the independent test set, the model achieved a 96% sensitivity (95% confidence interval [CI]: 90%–100%), a FAR of <1/8 days (95% CI: 1/9–1/7 days) with 1 FA/61 nights, and a median detection latency of 26 s. One of the two missed CSs could be explained by the patient's arm, which was wearing the sensor, being trapped in the bed rail. Other quantiles provided up to 100% sensitivity at the cost of a greater FAR (1/2 days) or very low FAR (1/100 days) at the cost of lower sensitivity (86%).Significance: This Phase 2 clinical validation study suggests that deep learning techniques applied to single‐sensor accelerometer data can achieve high CS detection performance while enabling tunable sensitivity.

Objective. We aimed to analyze whether complexity of brain electrical activity (EEG) measured by multiscale entropy (MSE) increases with brain maturation during the first two years of life. We also aimed to investigate whether this complexity shows regional differences across the brain, and whether changes in complexity are influenced by extrauterine life experience duration. Approach. We measured MSE of EEG signals recorded longitudinally using a high-density setup (64 or 128 electrodes) in 84 typically developing infants born preterm ( 0.8) with increasing age. Regional analysis showed significantly increased MSE between 3 and 24 months of corrected age in the posterior and middle regions with respect to the anterior region. We found a weak relationship (adjusted R ² = 0.135) between MSE and extrauterine life duration. Significance. These findings suggest that brain functional connectivity increases with maturation during the first two years of life. EEG complexity shows regional differences with earlier maturation of the visual cortex and brain regions involved in joint attention than of regions involved in cognitive analysis, abstract thought, and social behavior regulation. Finally, our MSE analysis suggested only a weak influence of early extrauterine life experiences (prior to term age) on EEG complexity.