Evaluating multimodal autonomic correlations in pediatric epilepsy using wearable biosignals
Fatemeh Mohammad Alizadeh Chafjiri1, Tanuj Hasija2, Emily Peter1,3
1Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Epilepsia
|January 28, 2026
Summary
Antiseizure medication dosage impacts autonomic nervous system correlations in children with epilepsy. Higher doses may influence seizure risk, suggesting wearable monitoring for personalized treatment.
Area of Science:
- Neurology
- Biomedical Engineering
- Autonomic Neuroscience
Background:
- Antiseizure medications (ASMs) may influence autonomic nervous system (ANS) activity.
- Understanding this relationship is crucial for managing epilepsy in pediatric patients.
Purpose of the Study:
- To investigate the correlation between antiseizure medication (ASM) dosage and multimodal ANS signal patterns in pediatric patients with epilepsy (PWE).
- To explore how ASM dosage affects autonomic regulation and seizure vulnerability.
Main Methods:
- Utilized wearable Empatica E4 devices to record multimodal ANS data (heart rate, electrodermal activity, temperature, respiratory rate) from pediatric PWE.
- Conducted within-patient comparisons of high-dose versus no-dose and high-dose versus low-dose ASM days.
- Employed principal component and canonical correlation analyses to assess multimodal interactions.
Main Results:
- An interaction between ASM dose and time was observed, with autonomic correlations increasing on high-dose days and decreasing on no-dose days.
- Electrodermal activity increased and heart rate decreased with higher ASM doses.
- Higher ASM doses were associated with a reduced hazard of seizures.
Conclusions:
- ASM dosage is linked to multimodal autonomic correlations, indicating effects on central autonomic regulation and seizure vulnerability.
- Wearable-based monitoring of ANS correlations shows potential for seizure risk assessment and personalized epilepsy treatment.
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