Cyberphysical Systems for Epilepsy and Related Brain Disorders

Cyberphysical Systems for Epilepsy and Related Brain Disorders

Nikolaos S. Voros Christos P. Antonopoulos Editors Cyberphysical Systems for Epilepsy and Related Brain Disorders Multi-parametric Monitoring and Analysis for Diagnosis and Optimal Disease Management

Editors Nikolaos S. Voros Computer & Informatics Engineering Department Technological Educational Institute of Western Greece Antirio, Greece Christos P. Antonopoulos Computer & Informatics Engineering Department Technological Educational Institute of Western Greece Antirio, Greece ISBN 978-3-319-20048-4 DOI 10.1007/978-3-319-20049-1 ISBN 978-3-319-20049-1 (ebook) Library of Congress Control Number: 2015942893 Springer Cham Heidelberg New York Dordrecht London Springer International Publishing Switzerland 2015 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper Springer International Publishing AG Switzerland is part of Springer Science+Business Media (www.springer.com)

Foreword Writing books on epilepsy for the past three millennia is well justified since epilepsy is the most common serious chronic neurological disease affecting almost 65 million worldwide. It affects people of all ages, with maximal rates of occurrence in children and in old age. Unlike many other serious diseases, epilepsy is readily treatable with inexpensive medications in the majority of cases. At least 70 % of people with epilepsy can have their seizures controlled and can enjoy a normal life if they are diagnosed and treated appropriately. However, in certain cases, definitive diagnosis of a paroxysmal event cannot be made even in hospital setting despite thorough neurological and EEG assessment. These cases often demand multimodal, personalized, and long-term monitoring, ideally at home and especially during sleep, for proper seizure diagnosis, differential diagnosis, and classification. At the International Bureau for Epilepsy, we look forward to efforts aiming to exploit modern technology for the benefit of patients with epilepsy avoiding misdiagnosis, delayed or inappropriate diagnosis. This book stems from an effort to contribute in facing this problem by exploiting the latest advancements in Information and Communication Technology (ICT). In the relevant chapters of this book, we read how the above challenge can be approached and in some cases how novel approaches can provide new solutions that nevertheless require clinical validation. The approaches include: (a) developing a holistic, personalized, medically efficient, convenient to the patient, and economical home-monitoring system; (b) managing and analysis of a large number of data from brain and body activities of patients with epilepsy; and (c) allowing to detect, monitor, predict, and make diagnosis remotely. Arguments are given that such a system will facilitate and increase the yield of diagnosis, treatment, and practice, reduce epilepsy-related management costs, and increase understanding of epileptic seizures and their relationship to other non-epileptic paroxysmal events. In parallel, the advances made in ICT are described, i.e., developing novel multi-parametric data processing, management, and analysis tools, both for real-time and off-line monitoring, adopting and adapting of communication platforms providing robust and flexible end-to-end communication, and assuring security and privacy on sensitive medical data. v

vi Foreword I consider it a virtue of this book that it reflects a rarely successful but increasingly demanded common understanding and effective close collaboration by blending theory and practice, between academic research laboratories and epilepsy clinics as well as accomplished industrial partners from five European countries. I believe that this book can be easily read by scientists of both epileptology and ICT background and by people generally interested in epilepsy and/or long-term monitoring. The effort will advance their capacity for mutual understanding and effective collaboration. The book conveys an optimism that advanced home monitoring systems like ARMOR can provide reliable detection of life-threatening seizures and improve the level of care and the quality of life of the patient, while avoiding hospital stays and thus drastically reducing costs. With one more push, this effort can lead to a muchneeded tool. Dr. Athanasios Covanis President of International Bureau for Epilepsy

Acknowledgments The research work that provided the material for this book was carried out during 2011 2015 mainly in the ARMOR STREP Project ( Advanced multi-parametric M onitoring and analysis for diagnosis and O ptimal management of epilepsy and R elated brain disorders) partially supported by the European Commission under the Grant Agreement number 287720. The guidance and the comments of EU Project Officer Dr. Amalia Irina Vlad and EU Reviewers Mr. Jean Delbeke, Mr. Henry Kanoui, and Mr. Paulo Mendes on research direction are highly appreciated. In addition to the authors, the management teams of the partners participating in the ARMOR consortium are gratefully acknowledged for their valuable support. Last but not least, the editors express their special thanks to Mr. Athanasios Covanis, M.D., Epileptologist and President of International Bureau of Epilepsy for his valuable remarks and his willingness to contribute to the final review of the material presented in the book. vii

Contents 1 Introduction to ARMOR Project... 1 Nikolaos S. Voros, Christos P. Antonopoulos, Michalis Koutroumanidis, George K. Kostopoulos, and Andreas A. Ioannides 2 Introduction to Epilepsy and Related Brain Disorders... 11 Evangelia Giourou, Alkistis Stavropoulou-Deli, Aspasia Giannakopoulou, George K. Kostopoulos, and Michalis Koutroumanidis 3 Sleep Features and Underlying Mechanisms Related to Epilepsy and Its Long Term Monitoring... 39 Evangelia Giourou, Alkistis Stavropoulou-Deli, Konstantinos Theofilatos, George K. Kostopoulos, Andreas A. Ioannides, and Michalis Koutroumanidis 4 Source-Estimation from Non-invasive Recordings of Brain Electrical Activity in Sleep and Epilepsy... 61 Andreas A. Ioannides, Lichan Liu, Vahe Poghosyan, Khalid Hamandi, and George K. Kostopoulos 5 Current Practices in Epilepsy Monitoring; Future Prospects and the ARMOR Challenge... 87 Andreas A. Ioannides, Vahe Poghosyan, and George K. Kostopoulos 6 Data Management Processes... 111 Christos P. Antonopoulos and Nikolaos S. Voros 7 System Architecture... 127 Stefan Hey, Panagiota Anastasopoulou, André Bideaux, Christos P. Antonopoulos, Nikolaos S. Voros, Alberto Fernandez, Vasilis Megalooikonomou, and Arthur Krukowski ix

x Contents 8 Mobile Sensors for Multiparametric Monitoring in Epileptic Patients... 137 Stefan Hey, Panagiota Anastasopoulou, André Bideaux, Christos P. Antonopoulos, Nikolaos S. Voros, and Mark Richardson 9 Secure and Efficient WSN Communication Infrastructure... 163 Christos P. Antonopoulos, Nikolaos S. Voros, Stefan Hey, Panagiota Anastasolpoulou, and André Bideaux 10 System Middleware... 189 André Bideaux, Stefan Hey, Panagiota Anastasolpoulou, Alberto Fernandez, Christos P. Antonopoulos, and Nikolaos S. Voros 11 Personal Health Record... 205 Artur Krukowski, Carlos Cavero Barca, Juan Mario Rodríguez, and Emmanouela Vogiatzaki 12 Offl ine Analysis Server and Offline Algorithms... 239 Vasileios Megalooikonomou, Dimitrios Triantafyllopoulos, Evangelia I. Zacharaki, and Iosif Mporas 13 Personalized Management of Epilepsy Through Smart Use of EEG and Detailed MEG Analysis... 255 Vahe Poghosyan and Andreas A. Ioannides 14 DSMS and Online Algorithms... 271 Vasileios Megalooikonomou, Dimitrios Triantafyllopoulos, Evangelia I. Zacharaki, and Iosif Mporas