ArticleEpilepsia2023
Seizure occurrence is linked to multiday cycles in diverse physiological signals.
Article in Epilepsia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Movement Disorders and Smart Wrist Devices: A Comprehensive Study.Sensors (Basel, Switzerland) · 2025Pooled it
- Gamma suppression correlates with thalamic stimulation therapeutic response in intractable epilepsy.Epilepsia · 2026Article
- Article
- Circular mixture model-based characterization of time-of-day seizure patterns during presurgical monitoring.Scientific reports · 2026Article
- Article
- Timing is everything: Expert opinion on researching epilepsy rhythms by the ILAE Task Force on Chronobiology.Epilepsia · 2026Review
- Pathway to Adaptive Neuromodulation: Modeling Epileptogenic Brain States Using SEEG.Epilepsy currents · 2026Article
- CNN-Autoformer: Automated EEG-Based Seizure Detection and Localization Using Hybrid Deep Learning.Biomedical signal processing and control · 2026Article
- Synchrony is a robust iEEG biomarker for antiseizure medication load in epileptic patients.bioRxiv : the preprint server for biology · 2026Article
- Investigation of stress hormones across multiday seizure cycles.Brain communications · 2026Article
- Rhythms in Longitudinal Thalamic Recordings are Linked to Seizure Risk.medRxiv : the preprint server for health sciences · 2025Article
- Epilepsy in women of childbearing age: a focused review.Neurological research and practice · 2025Review
- Autonomic biosignals, seizure detection, and forecasting.Epilepsia · 2025Review
- Forecasting epileptic seizures with wearable devices: A hybrid short- and long-horizon pseudo-prospective approach.Epilepsia · 2025Article
- Rest-activity rhythm phenotypes in adults with epilepsy and intellectual disability.Epilepsia open · 2025Article
- Epileptiform Activity and Seizure Risk Follow Long-Term Non-Linear Attractor Dynamics.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Seizure prediction and forecasting: a scoping review.Current opinion in neurology · 2025Article
- Diminished circadian and ultradian rhythms of human brain activity in pathological tissue in vivo.Nature communications · 2024Article
- Hippocampal network activity forecasts epileptic seizures.Nature medicine · 2024Article
- Article
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Authors and funding
16 authors.
Funding
Abstract
objectiveThe factors that influence seizure timing are poorly understood, and seizure unpredictability remains a major cause of disability. Work in chronobiology has shown that cyclical physiological phenomena are ubiquitous, with daily and multiday cycles evident in immune, endocrine, metabolic, neurological, and cardiovascular function. Additionally, work with chronic brain recordings has identified that seizure risk is linked to daily and multiday cycles in brain activity. Here, we provide the first characterization of the relationships between the cyclical modulation of a diverse set of physiological signals, brain activity, and seizure timing.
methodsIn this cohort study, 14 subjects underwent chronic ambulatory monitoring with a multimodal wrist-worn sensor (recording heart rate, accelerometry, electrodermal activity, and temperature) and an implanted responsive neurostimulation system (recording interictal epileptiform abnormalities and electrographic seizures). Wavelet and filter-Hilbert spectral analyses characterized circadian and multiday cycles in brain and wearable recordings. Circular statistics assessed electrographic seizure timing and cycles in physiology.
resultsTen subjects met inclusion criteria. The mean recording duration was 232 days. Seven subjects had reliable electroencephalographic seizure detections (mean = 76 seizures). Multiday cycles were present in all wearable device signals across all subjects. Seizure timing was phase locked to multiday cycles in five (temperature), four (heart rate, phasic electrodermal activity), and three (accelerometry, heart rate variability, tonic electrodermal activity) subjects. Notably, after regression of behavioral covariates from heart rate, six of seven subjects had seizure phase locking to the residual heart rate signal. SIGNIFICANCE: Seizure timing is associated with daily and multiday cycles in multiple physiological processes. Chronic multimodal wearable device recordings can situate rare paroxysmal events, like seizures, within a broader chronobiology context of the individual. Wearable devices may advance the understanding of factors that influence seizure risk and enable personalized time-varying approaches to epilepsy care.
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