{
  "abstract": "Background Patients with anti-leucine-rich glioma-inactivated 1 (anti-LGI1) autoimmune encephalitis (AIE) frequently present with faciobrachial dystonic seizures (FBDS), which are often under-detected due to their subtle motor features and lack of consistent EEG correlates. Conventional in-hospital monitoring and patient-reported seizure diaries are limited, particularly during nocturnal periods. In this pilot feasibility study, we evaluated the use of a wearable device (Empatica E4) to objectively monitor FBDS-related motor and autonomic activity in seven patients with anti-LGI1 AIE and four control subjects.Methods Wearable recordings included accelerometry (ACC), electrodermal activity (EDA), photoplethysmography (PPG) and skin temperature. A support vector machine-based algorithm was developed to identify disorder-related events using ACC and EDA features. Analyses were restricted to sleep periods to minimise confounding from voluntary movements.Results Pretreatment recordings from two patients (P1 and P2) showed significantly elevated motor event frequency, ACC magnitude and EDA activity compared to controls. Post-treatment recordings demonstrated marked reductions in these metrics, consistent with patient-reported clinical improvement. Other patients showed variable results depending on treatment timing and signal quality.Conclusion Our pilot study demonstrates the feasibility of using wearable technology for objective, real-world monitoring and assessment of patient status in anti-LGI1 AIE. Nocturnal monitoring offers a low-noise baseline for detecting seizure-related activity and may support earlier diagnosis, more accurate evaluation of treatment response and reduced reliance on resource-intensive inpatient evaluations. Future studies should expand monitoring to daytime periods and validate findings against conventional modalities such as video-EEG and electromyography polygraphy.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA",
        "Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Jie Cui"
    },
    {
      "affiliations": [
        "Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Andrea Duque-Lopez"
    },
    {
      "affiliations": [
        "Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Gabriella Brinkmann"
    },
    {
      "affiliations": [
        "Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA",
        "Epilepsy Unit, Foundation IRCCS Neurological Institute \"C. Besta” Milan, Milan, Italy",
        "Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Andrea Stabile"
    },
    {
      "affiliations": [
        "Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Joseph Boney"
    },
    {
      "affiliations": [
        "Kern Center, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Louis Faust"
    },
    {
      "affiliations": [
        "Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Julianna Ethridge"
    },
    {
      "affiliations": [
        "Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA",
        "Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Gregory Worrell"
    },
    {
      "affiliations": [
        "Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA",
        "Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Divyanshu Dubey"
    },
    {
      "affiliations": [
        "Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA",
        "Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Benjamin Brinkmann"
    }
  ],
  "title": "Seizure burden and treatment efficacy evaluation in anti-LGI1 autoimmune encephalitis patients using wearable device: a pilot feasibility study",
  "uid": "0d620e0d-7974-57f9-a121-c75e05b9ae62"
}